Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Head Neck Pathol. 2021 Jun;15(2):443-460. doi: 10.1007/s12105-020-01216-1. Epub 2020 Sep 16.
The current WHO histopathologic criteria for oral epithelial dysplasia (ED) are based on architectural and cytologic alterations, and do not address other histopathologic features of ED. Here we propose new diagnostic criteria including architectural, organizational, and cytologic features for oral ED. Cases of unifocal leukoplakia (UL) and proliferative leukoplakia (PL) with clinical photographs and follow-up information were identified. Only cases that showed minimal cytologic atypia or mild ED were used to demonstrate critical architectural changes as defined in this study. Eight biopsies from eight UL patients and 34 biopsies from four PL patients were included. The biopsies showed (a) corrugated, verrucous or papillary architecture, (b) hyperkeratosis with epithelial atrophy, (c) bulky squamous epithelial proliferation, and (d) demarcated hyperkeratosis and "skip" segments. The architectural alterations defined here are as important as the currently used criteria for the diagnosis of ED. Clinicopathologic correlation when diagnosing oral ED is also of the utmost importance in accurate diagnosis.
目前世界卫生组织（WHO）用于口腔上皮异型增生（ED）的组织病理学标准基于结构和细胞学改变，并未涉及 ED 的其他组织病理学特征。在这里，我们提出了新的诊断标准，包括口腔 ED 的结构、组织和细胞学特征。选择具有临床照片和随访信息的局灶性白色角化病（UL）和增殖性白色角化病（PL）病例。仅使用显示最小细胞学异型性或轻度 ED 的病例来证明本研究中定义的关键结构改变。纳入了 8 例 UL 患者的 8 份活检和 4 例 PL 患者的 34 份活检。活检显示：（a）波纹状、疣状或乳头状结构；（b）角化过度伴上皮萎缩；（c）鳞状上皮增生；（d）边界性角化过度和“跳跃”段。这里定义的结构改变与目前用于 ED 诊断的标准一样重要。在准确诊断口腔 ED 时，临床病理相关性也非常重要。
