Architectural and cytological features of epithelial dysplasia associated with transformation risk

Author:

Cai Xinjia12ORCID,Zhang Jianyun12,Zhang Heyu3ORCID,Zhou Xuan12ORCID,Zhou Zheng1,Jing Fengyang12,Luo Haiyan1ORCID,Li Tiejun12ORCID

Affiliation:

1. Department of Oral Pathology Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices Beijing China

2. Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions Chinese Academy of Medical Sciences (2019RU034) Beijing China

3. Central Laboratory Peking University School and Hospital of Stomatology Beijing China

Abstract

AbstractObjectivesThis study explored associations between histological features of dysplasia and malignant transformation, as well as genomic copy number alterations.Materials and MethodsOverall, 201 samples were collected from patients of oral leukoplakia. The associations of dysplastic features with malignant transformation and copy number alterations were investigated by Cox proportional hazards regression analysis and the Mann–Whitney U‐test.ResultsEight individual histological features, such as irregular epithelial stratification (p = 0.001), mitoses high in epithelium (p = 0.033), extension of changes along minor gland ducts (p < 0.001), etc., were associated with greater risk of malignant transformation. A model including histological features and age showed good performance for predicting malignant transformation (area under receiver operating characteristic curve: 0.806). Irregular epithelial stratification (p = 0.007), abnormal nuclear shape (p = 0.005), abnormal cell size (p = 0.004), etc. were associated with greater genomic instability.ConclusionsA Cox proportional hazards model using eight histological features and patient age reliably predicted the malignant potential of oral epithelial dysplasia. Identification of these histological features closely related to malignant transformation may aid the management of oral potentially malignant disorders and early detection of oral squamous cell carcinoma.

Publisher

Wiley

Subject

General Dentistry,Otorhinolaryngology

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