Oral Leukoplakia: An Overview of Histopathological Spectrum Focusing On WHO Grading System and Binary System of Oral Epithelial Dysplasia
Oral Leukoplakia: Histopathological Spectrum Focusing On Oral Epithelial Dysplasia
DOI:
https://doi.org/10.54393/pjhs.v6i1.2438Keywords:
Oral Leukoplakia, Histopathological Spectrum, Oral Epithelial Dysplasia, Binary SystemAbstract
Oral leukoplakia by definition is a white patch with uncertain risk, not including other lesions that could develop into cancer. Objectives: To assess the histopathological spectrum of oral leukoplakia and focus on their relation with WHO-classified histological grades and binary system of dysplasia. Methods: This study comprised patients diagnosed with oral leukoplakia. Hematoxylin and eosin-stained slides of 60 cases were assessed based on the World Health Organization 2005 classification system: epithelial precursor lesions and binary system of oral epithelial dysplasia. The chi-square test was used to compare different categorical variables related to oral leukoplakia. For analyzing data SPSS version 20.0 was used. Results: Of the 60 oral leukoplakia subjects 43 (71.7%) were found to be male while 17 (28.3%) were female. Whereas 26 cases showed dysplastic features (n=26, 43.3%) Among the cases of oral epithelial dysplasia, a higher number of cases of moderate dysplasia was observed (n=12, 46.1%) followed by severe dysplasia (n=10, 38.5%), and the least number of cases had mild dysplasia (n=4, 15.4%). There was a statistically significant relationship between the binary system of oral epithelial dysplasia and variants of oral epithelial dysplasia, mildly dysplastic, moderately dysplastic, and severely dysplastic epithelium (p<0.04). Conclusions: It was concluded that as oral leukoplakia is such a disorder having a high chance of conversion into cancer early detection is of utmost importance to prevent conversion into malignancy. In addition to the WHO Classification of the said lesions, a binary system of dysplasia can also be promoted.
References
Naushin T, Khan AS, Ishfaq M, Bashir N, Iqbal F, ul Hassan M. Histopathological Assessment of Oral Leukoplakia Among Snuff Users and Non-Users. Journal of Medical Sciences. 2023 Mar; 31(01): 72-5. doi: 10.52764/jms.23.31.1.14. DOI: https://doi.org/10.52764/jms.23.31.1.14
Mao T, Xiong H, Hu X, Hu Y, Wang C, Yang L et al. DEC1: A Potential Biomarker of Malignant Transformation in Oral Leukoplakia. Brazilian Oral Research. 2020 Jun; 34: e052. doi: 10.1590/1807-3107bor-2020.vol34.0052. DOI: https://doi.org/10.1590/1807-3107bor-2020.vol34.0052
Naushin T, Khan MM, Ahmed S, Iqbal F, Bashir N, Khan AS. Determination of Ki-67 Expression in Oral Leukoplakia in Snuff Users and Non-Users in Khyber Pakhtunkhwa Province of Pakistan. The Professional Medical Journal. 2020 Apr; 27(04): 682-7. doi: 10.29309/TPMJ/2020.27.04.3124. DOI: https://doi.org/10.29309/TPMJ/2020.27.04.3124
Naushin T, Khan AS, Alam S, Motahir N, Iqbal F, Younas HM et al. Clinicopathological Features of Oral Leukoplakia Among Snuff Users and Non-Users: An Analytical Study: Clinicopathological Features of Oral Leukoplakia. Pakistan Journal of Health Sciences. 2023 Jun; 24(6): 182-6. doi: 10.54393/pjhs.v4i06.845. DOI: https://doi.org/10.54393/pjhs.v4i06.845
Maloney B, Galvin S, Healy C. Oral Leukoplakia: An Update for Dental Practitioners. Journal of the Irish Dental Association. 2024 Feb. doi: 10.58541/001c.93880. DOI: https://doi.org/10.58541/001c.93880
Kazi JA, Rosli NH, Nazri NS, Abd Aziz NA. Genetic Mechanisms of Oral Leukoplakia: A Systematic Review. Compendium of Oral Science. 2024 Sep; 11(2): 71-95. doi: 10.24191/cos.v11i2.27505. DOI: https://doi.org/10.24191/cos.v11i2.27505
Warnakulasuriya S. Clinical Features and Presentation of Oral Potentially Malignant Disorders. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2018 Jun; 125(6): 582-90. doi: 10.1016/j.oooo.2018.03.011. DOI: https://doi.org/10.1016/j.oooo.2018.03.011
Ranganathan K and Kavitha L. Oral Epithelial Dysplasia: Classifications and Clinical Relevance in Risk Assessment of Oral Potentially Malignant Disorders. Journal of Oral and Maxillofacial Pathology. 2019 Jan; 23(1): 19-27. doi: 10.4103/jomfp.JOMFP_13_19. DOI: https://doi.org/10.4103/jomfp.JOMFP_13_19
Müller S. Oral Epithelial Dysplasia, Atypical Verrucous Lesions and Oral Potentially Malignant Disorders: Focus On Histopathology. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2018 Jun; 125(6): 591-602. doi: 10.1016/j.oooo.2018.02.012. DOI: https://doi.org/10.1016/j.oooo.2018.02.012
Shubhasini AR, Praveen BN, Hegde U, Uma K, Shubha G, Keerthi G et al. Inter-and Intra-Observer Variability in Diagnosis of Oral Dysplasia. Asian Pacific Journal of Cancer Prevention. 2017; 18(12): 3251. doi: 10.22034/APJCP.2017.18.12.3251.
Arrogante O. Sampling Techniques and Sample Size Calculation: How and How Many Participants Should I Select for My Research? Enfermeria Intensiva. 2021 Apr: S1130-2399. doi: 10.1016/j.enfi.2021.03.004 . DOI: https://doi.org/10.1016/j.enfi.2021.03.004
Khan AS, Khan ZA, Nisar M, Saeed S, Maryam H, Haq M et al. Description of Clinicopathological Characteristics of Oral Potentially Malignant Disorders with Special Focus On Two Histopathologic Grading Systems and Sub-Epithelial Inflammatory Infiltrate. Journal of Cancer Research and Therapeutics. 2023 Jan; 19(Suppl 2): S724-30. doi: 10.4103/jcrt.jcrt_969_22. DOI: https://doi.org/10.4103/jcrt.jcrt_969_22
Pires FR, Barreto ME, Nunes JG, Carneiro NS, de Azevedo AB, dos Santos TC. Oral Potentially Malignant Disorders: A Clinical-Pathological Study of 684 Cases Diagnosed in a Brazilian Population. Medicina Oral, Patología Oral y Cirugía Bucal. 2020 Jan; 25(1): e84. doi: 10.4317/medoral.23197. DOI: https://doi.org/10.4317/medoral.23197
Saldivia-Siracusa C, González-Arriagada WA. Difficulties in the Prognostic Study of Oral Leukoplakia: Standardisation Proposal of Follow-Up Parameters. Frontiers in Oral Health. 2021 Feb; 2: 614045. doi: 10.3389/froh.2021.614045. DOI: https://doi.org/10.3389/froh.2021.614045
Khan AS, Ahmad S, Iqbal F, Saboor A, Nisar M, Naushin T et al. A Immune-Histochemical Expression of P53 in Oral Squamous Cell Carcinoma, Oral Epithelial Precursor Lesions, and Normal Oral Mucosa. Journal of Medical Sciences. 2021; 29(04): 255-60. doi: 10.52764/jms.21.29.4.9. DOI: https://doi.org/10.52764/jms.21.29.4.9
Mello FW, Miguel AF, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra EN et al. Prevalence of Oral Potentially Malignant Disorders: A Systematic Review and Meta‐Analysis. Journal of Oral Pathology and Medicine. 2018 Aug; 47(7): 633-40. doi: 10.1111/jop.12726. DOI: https://doi.org/10.1111/jop.12726
Aittiwarapoj A, Juengsomjit R, Kitkumthorn N, Lapthanasupkul P. Oral Potentially Malignant Disorders and Squamous Cell Carcinoma at the Tongue: Clinicopathological Analysis in a Thai Population. European Journal of Dentistry. 2019 Jul; 13(03): 376-82. doi: 10.1055/s-0039-1698368. DOI: https://doi.org/10.1055/s-0039-1698368
Speight PM, Khurram SA, Kujan O. Oral Potentially Malignant Disorders: Risk of Progression to Malignancy. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2018 Jun; 125(6): 612-27. doi: 10.1016/j.oooo.2017.12.011. DOI: https://doi.org/10.1016/j.oooo.2017.12.011
Ganesh D, Sreenivasan P, Öhman J, Wallström M, Braz-Silva PH, Giglio D et al. Potentially Malignant Oral Disorders and Cancer Transformation. Anticancer Research. 2018 Jun; 38(6): 3223-9. doi: 10.21873/anticanres.12587. DOI: https://doi.org/10.21873/anticanres.12587
Câmara PR, Dutra SN, Takahama Júnior A, Fontes KB, Azevedo RS. A Comparative Study Using WHO and Binary Oral Epithelial Dysplasia Grading Systems in Actinic Cheilitis. Oral Diseases. 2016 Sep; 22(6): 523-9. doi: 10.1111/odi.12484. DOI: https://doi.org/10.1111/odi.12484
Kujan O, Oliver RJ, Khattab A, Roberts SA, Thakker N, Sloan P. Evaluation of a New Binary System of Grading Oral Epithelial Dysplasia for Prediction of Malignant Transformation. Oral Oncology. 2006 Nov; 42(10): 987-93. doi: 10.1016/j.oraloncology.2005.12.014. DOI: https://doi.org/10.1016/j.oraloncology.2005.12.014
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