分化型异型增生在预测口腔白斑恶变中的作用。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2023-09-25 DOI:10.1111/jop.13483
Leon J. Wils, Jos B. Poell, Laura A. N. Peferoen, Ilkay Evren, Elisabeth R. Brouns, Jan G. A. M. de Visscher, Erik H. van der Meij, Ruud H. Brakenhoff, Elisabeth Bloemena
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引用次数: 0

摘要

目的:口腔白斑是口腔最常见的潜在恶性疾病。口腔白斑的恶性转化每年发生率为1%-7%。世界卫生组织定义的经典上皮发育不良是口腔黏膜病变恶变的重要预测因子,但我们之前在一项概念验证研究中表明,通过结合发育不良的结构模式(也称为分化型发育不良),预测会得到改善。我们的目的是在更大的患者队列中分析这一发现。方法:对176例口腔白斑患者进行回顾性研究。评估所有患者的活检是否存在发育不良,并分析细胞角蛋白13和17的表达。此外,确定了分化型发育不良诊断的观察者间一致性。结果:176例患者中,有33例在随访期间发展为口腔鳞状细胞癌。典型上皮发育不良使癌症风险增加两倍(HR = 2.18,p = 0.026)。没有典型上皮发育不良的病变可以根据分化型发育不良的存在进行进一步的风险分层(HR = 7.36,p 讨论:本研究强调了识别分化性发育不良的结构模式作为预测口腔白斑恶变风险的独立实体的重要性。任何发育不良模式的存在都能准确预测口腔白斑的恶性转化风险。
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The role of differentiated dysplasia in the prediction of malignant transformation of oral leukoplakia

Objective

Oral leukoplakia is the most common oral potentially malignant disorder. Malignant transformation of oral leukoplakia occurs at an annual rate of 1%–7%. WHO-defined classic epithelial dysplasia is an important predictor of malignant transformation of oral leukoplakia, but we have previously shown in a proof of concept study that prediction improves by incorporation of an architectural pattern of dysplasia, also coined as differentiated dysplasia. We aimed to analyze this finding in a larger cohort of patients.

Method

For this retrospective study 176 oral leukoplakia patients were included. Biopsies for all patients were assessed for the presence of dysplasia and analyzed for cytokeratin 13 and 17 expression. Moreover, the inter-observer agreement for the diagnosis of differentiated dysplasia was determined.

Results

In total, 33 of 176 patients developed oral squamous cell carcinoma during follow-up. Presence of classic epithelial dysplasia increased cancer risk two-fold (HR = 2.18, p = 0.026). Lesions without classic epithelial dysplasia could be further risk-stratified by the presence of differentiated dysplasia (HR = 7.36, p < 0.001). Combined classic epithelial and differentiated dysplasia imparted a seven-fold increased risk of malignant transformation (7.34, p = 0.001). Inter-observer agreement for the diagnosis of dysplasia, including differentiated dysplasia, was moderate (κ = 0.56, p < 0.001).

Discussion

This study emphasizes the importance of the recognition of the architectural pattern of differentiated dysplasia as a separate entity for risk prediction of malignant transformation of oral leukoplakia. Presence of any pattern of dysplasia results in accurate prediction of malignant transformation risk of oral leukoplakia.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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