Brouns Elisabeth R, Evren Ilkay, Wils Leon J, Poell Jos B, Brakenhoff Ruud H, Bloemena Elisabeth, de Visscher Jan G A M
Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
Department of Otolaryngology / Head & Neck Surgery, Amsterdam UMC, Location VUmc and Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands.
Oral Dis. 2023 Oct;29(7):2667-2676. doi: 10.1111/odi.14295. Epub 2022 Jul 7.
A classification and staging system for oral leukoplakia (OL) was introduced to promote uniform reporting. In this system, size and the histopathologic diagnosis are assessed and combined in a staging system. The various stages could be predictive for malignant transformation of OL. Differentiated dysplasia (DD) was recently recognized as an important architectural pattern of dysplasia and is highly associated with malignant transformation (MT) of OL. In the present study, DD was incorporated in the OL-system. The aim of the present study was to test the adapted system on a cohort of patients with OL.
The group consisted of 140 patients. The size, absence or presence and degree of classic dysplasia (CD) and DD were incorporated into the OL-system.
In 31/140 patients, MT occurred. Size was not statistically significant with MT (p = 0.422). The presence of dysplasia was predictive for MT (p = 0.003), whereby severe CD and DD were highly statistically significant for MT (p = 0.008). Stage IV was statistically significant for MT (p = 0.011).
The present study emphasizes the value of the slightly modified OL-system with incorporation of DD in uniform reporting of OL and the value in predicting MT.
引入口腔白斑（OL）的分类和分期系统以促进统一报告。在该系统中，对大小和组织病理学诊断进行评估并结合到一个分期系统中。不同阶段可预测OL的恶性转化。分化型发育异常（DD）最近被认为是发育异常的一种重要结构模式，且与OL的恶性转化（MT）高度相关。在本研究中，DD被纳入OL系统。本研究的目的是在一组OL患者中测试该改良系统。
该组由140名患者组成。将大小、经典型发育异常（CD）和DD的有无及程度纳入OL系统。
140例患者中有31例发生MT。大小与MT无统计学意义（p = 0.422）。发育异常的存在可预测MT（p = 0.003），其中重度CD和DD对MT具有高度统计学意义（p = 0.008）。IV期对MT具有统计学意义（p = 0.011）。
本研究强调了在OL的统一报告中纳入DD的改良OL系统的价值以及在预测MT方面的价值。
