Development and validation of a multivariable model for prediction of malignant transformation and recurrence of oral epithelial dysplasia.

Autor: Mahmood H; Academic Unit of Oral & Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, UK. h.mahmood@sheffield.ac.uk., Shephard A; Tissue Image Analytics Centre, Department of Computer Science, University of Warwick, Warwick, UK., Hankinson P; Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK., Bradburn M; Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK., Araujo ALD; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil., Santos-Silva AR; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil., Lopes MA; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil., Vargas PA; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil., McCombe KD; Precision Medicine Centre, Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK., Craig SG; Precision Medicine Centre, Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK., James J; Precision Medicine Centre, Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK., Brooks J; Institute of Head and Neck Studies and Education, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Nankivell P; Institute of Head and Neck Studies and Education, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Mehanna H; Institute of Head and Neck Studies and Education, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Rajpoot N; Tissue Image Analytics Centre, Department of Computer Science, University of Warwick, Warwick, UK., Khurram SA; Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2023 Nov; Vol. 129 (10), pp. 1599-1607. Date of Electronic Publication: 2023 Sep 27.
DOI: 10.1038/s41416-023-02438-0
Abstrakt: Background: Oral epithelial dysplasia (OED) is the precursor to oral squamous cell carcinoma which is amongst the top ten cancers worldwide. Prognostic significance of conventional histological features in OED is not well established. Many additional histological abnormalities are seen in OED, but are insufficiently investigated, and have not been correlated to clinical outcomes.
Methods: A digital quantitative analysis of epithelial cellularity, nuclear geometry, cytoplasm staining intensity and epithelial architecture/thickness is conducted on 75 OED whole-slide images (252 regions of interest) with feature-specific comparisons between grades and against non-dysplastic/control cases. Multivariable models were developed to evaluate prediction of OED recurrence and malignant transformation. The best performing models were externally validated on unseen cases pooled from four different centres (n = 121), of which 32% progressed to cancer, with an average transformation time of 45 months.
Results: Grade-based differences were seen for cytoplasmic eosin, nuclear eccentricity, and circularity in basal epithelial cells of OED (p < 0.05). Nucleus circularity was associated with OED recurrence (p = 0.018) and epithelial perimeter associated with malignant transformation (p = 0.03). The developed model demonstrated superior predictive potential for malignant transformation (AUROC 0.77) and OED recurrence (AUROC 0.74) as compared with conventional WHO grading (AUROC 0.68 and 0.71, respectively). External validation supported the prognostic strength of this model.
Conclusions: This study supports a novel prognostic model which outperforms existing grading systems. Further studies are warranted to evaluate its significance for OED prognostication.
(© 2023. The Author(s).)
Databáze: MEDLINE
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