New IPCL Classification Using NBI for Early Detection of OPMDs Malignant Transformation.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Oral diseases Pub Date : 2024-11-25 DOI:10.1111/odi.15200

Yiming Xu, Tianyu Zhang, Dan Liu, Xuemei Qiu, Feifei Hou, Jiongke Wang, Xiaobo Luo, Hongxia Dan, Yu Zhou, Xing Zeng, Lu Jiang, Qianming Chen

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引用次数: 0

Abstract

Objectives: Introduce a new intrapapillary capillary loop (IPCL) classification using narrow-band imaging (NBI) to diagnose early malignant transformation in oral potentially malignant disorders (OPMDs).

Methods: In the exploratory phase, NBI images from 241 patients with OPMDs and oral squamous cell carcinoma (OSCC) were assessed for three basic IPCL features-dilation, unevenness, and tortuosity-to identify patterns associated with OPMDs malignant transformation. Chi-square analysis and logistic regression differentiated these patterns between low-risk (no/mild dysplasia) and high-risk (moderate/severe dysplasia, invasive carcinoma) lesions, establishing a new classification system. In the validation phase, the system was applied to 90 patients with histopathological results confirming diagnostic accuracy.

Results: Four distinct IPCL types were identified: normal, dilated, irregular, and chaotic, with increasing odds ratios for high-risk lesions. The ROC curve had an AUC of 0.913, with irregular and chaotic types providing the best diagnostic performance, achieving sensitivities and specificities of 84.2% and 88.4%, respectively. In the validation phase, the new classification achieved an overall diagnostic accuracy of 84.4% and substantial inter-observer consistency (κ = 0.694).

Conclusion: The new IPCL classification effectively identifies high-risk oral lesions, enhancing the diagnostic utility of NBI for early detection of OPMDs malignant transformations.

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来源期刊

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.