Risk Assessment of Oral Leukoplakia by Individual Dysplasia Features.

IF 2.7 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral Pathology & Medicine Pub Date : 2025-05-27 DOI:10.1111/jop.13633

Andresa Borges Soares, Saman Warnakulasuriya, Letícia da Silveira Terra Junqueira, André Luis Santana de Freitas, Amanda Schneider, Alan Roger Santos Silva, Marcelo Sperandio

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引用次数: 0

Abstract

Objectives: Malignant transformation (MT) risk assessment in oral leukoplakia (OL) relies on tissue sample and oral epithelial dysplasia (OED) grading. The aim of this study was to evaluate the role of each OED feature in predicting MT in OL.

Subjects and methods: Ninety-nine OL patients were selected (81 non-transforming and 18 with MT). All OED features were individually scored for each case. Follow-up data were obtained from both local and regional cancer registries. Spearman correlation, logistic regression, and Kaplan-Meier were tested with MT as outcome. Thresholds for number of features indicating risk and predictive values (PV) were calculated. A random forest (RF) model was built to assess the relevance of each feature.

Results: Loss of epithelial cohesion, increased nucleoli, and inflammation were the associated with MT (p ≤ 0.016). Combining these three features yielded high specificity (95%) and PV (50% positive and 85% negative). Using a six-feature threshold to establish risk reached 54%, 26% and 90%, and 72%, respectively. Specifying and counting OED features proved crucial to establishing risk.

Conclusion: Loss of epithelial cohesion, increased size and number of nucleoli, and inflammation are key risk features and sum of OED features is the most useful predictor of MT.

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个体发育不良特征对口腔白斑的风险评估。

目的：口腔白斑（OL）恶性转化（MT）风险评估依赖于组织样本和口腔上皮发育不良（OED）分级。本研究的目的是评估每个OED特征在预测OL中MT的作用。对象和方法：选择OL患者99例（非转化81例，MT 18例）。每个案例的所有OED特征都被单独评分。随访数据来自当地和区域癌症登记处。以MT为结果进行Spearman相关、logistic回归和Kaplan-Meier检验。计算了指示风险和预测值（PV）的特征数量的阈值。建立随机森林（RF）模型来评估每个特征的相关性。结果：上皮内聚丧失、核仁增加、炎症与MT相关（p≤0.016）。结合这三个特征获得了高特异性（95%）和PV（50%阳性和85%阴性）。使用六特征阈值来确定风险分别达到54%、26%、90%和72%。事实证明，指定和计算OED功能对于确定风险至关重要。结论：上皮内聚丧失、核仁大小和数量增加以及炎症是关键的危险特征，OED特征的总和是MT最有用的预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Oral Pathology & Medicine 医学-病理学

CiteScore

5.90

自引率

6.10%

发文量

121

审稿时长

4-8 weeks

期刊介绍： The aim of the Journal of Oral Pathology & Medicine is to publish manuscripts of high scientific quality representing original clinical, diagnostic or experimental work in oral pathology and oral medicine. Papers advancing the science or practice of these disciplines will be welcomed, especially those which bring new knowledge and observations from the application of techniques within the spheres of light and electron microscopy, tissue and organ culture, immunology, histochemistry and immunocytochemistry, microbiology, genetics and biochemistry.