Observations on the clinical characteristics of oral lesions showing histologic epithelial dysplasia

Mincer, Harry H.; Coleman, Sidney A.; Hopkins, Kenneth P.

doi:10.1016/0030-4220(72)90468-9

Cited by 166 publications

(65 citation statements)

References 15 publications

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“…Some studies have reported that the tongue, floor of the mouth, and the lower lip were the most common sites for OED [13,16,23]. The supposed areas of greatest risk for malignant changes when exposed to carcinogenic factorsthe floor of mouth and tongue [24]-accounted for only 11.3% and 4.8%, respectively, of OED lesions in the present study.…”

Section: Discussioncontrasting

confidence: 37%

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Pereira

Carvalho

Henriques

et al. 2011

Annals of Diagnostic Pathology

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Oral epithelial dysplasias (OEDs) are potentially malignant disorders characterized by diverse degrees of cellular atypia. The early and careful diagnosis has extreme importance, allowing prevention of the progression to the oral squamous cell carcinoma. This study aimed to determine the epidemiology and then correlate it with the clinicopathological features of OED. One hundred seventy-three cases of oral lesions retrieved from the files of a Service of Pathological Anatomy, covering a 38-year period, were submitted to descriptive statistical analysis through the Pearson χ 2 test. The majority of cases were from affected females (57.9%), with a peak of occurrence in the age group of 41 and 55 years (37.3%), white patients (64.8%), and those with lesions located on the gingiva/alveolar ridge (25.1%). The lesions predominantly presented with white color (56.8%) and were described as nodules (27.4%), with a rough surface (76.7%), an exophytic growth (79.1%), and a sessile base (95.6%). The majority of the lesions with degree of mild (34.6%) and moderate (34.9%) OED had clinical diagnosis of leukoplakia, whereas 33.3% of the lesions with degree of severe had clinical diagnosis of squamous cell carcinoma (P b .05). Tobacco use was the risk habit more related with OED (42.6%) (P N .05). The knowledge of OED epidemiology and clinical features provide a better understanding of the factors that possibly are associated with the malignant transformation of OED. Furthermore, these results contribute to supporting a prompt and accurate recognition of these lesions in clinical practice.

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Section: Discussioncontrasting

confidence: 37%

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Pereira

Carvalho

Henriques

et al. 2011

Annals of Diagnostic Pathology

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“…Many oral SCCs are preceded by white or red lesions showing varying degrees of epithelial dysplasia from mild to severe (20,(31)(32)(33) Although an important risk factor for oral cancer is the presence of epithelial dysplasia, many dysplasias will not progress to malignancy (34). We found that higher levels of MMP-9 mRNA are significantly associated with oral dysplasias that progress to oral cancer compared with those that did not progress.…”

Section: Discussionmentioning

confidence: 86%

Overexpression of Matrix Metalloproteinase-1 and -9 mRNA Is Associated with Progression of Oral Dysplasia to Cancer

Jordan

Macabeo-Ong

Shiboski

et al. 2004

Clinical Cancer Research

108

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Purpose: Although an important risk factor for oral cancer is the presence of epithelial dysplasia, many lesions will not progress to malignancy. Matrix metalloproteinases (MMPs) are zinc-dependent proteinases capable of digesting various structural components of the extracellular matrix. Because MMPs are frequently overexpressed in oral squamous cell carcinoma (SCC), we hypothesized that they are also overexpressed in oral dysplasias; we also hypothesized that those dysplasias that progress to oral cancer express higher levels of MMPs than those lesions that do not progress.Experimental Design: In this retrospective study, we examined changes in MMP-1, -2, and -9 mRNA expression using quantitative TaqMan reverse transcription-polymerase chain reaction in 34 routinely processed oral dysplasias and 15 SCCs obtained from 34 patients. After several years of close follow-up, 19 dysplasias progressed to oral SCC and 15 did not.Results: Overall, MMP-1 mRNA was overexpressed (>2-fold) in 24 of 34 (71%) dysplasias and 13 of 15 (87%) oral SCCs. MMP-2 overexpression was seen in 11 of 34 (32%) dysplasias and 7 of 15 (47%) cancers; for MMP-9, overexpression was identified in 29 of 34 (85%) dysplasias and 15 of 15 (100%) cancers. MMP-1 and -9 levels were significantly higher in the SCCs compared with all oral dysplasias (P ‫؍‬ 0.004 and P ‫؍‬ 0.01, respectively). MMP-1 and -9 mRNA levels were significantly higher in the oral dysplasias that progressed to oral cancer compared with those that did not (P ‫؍‬ 0.04 and P ‫؍‬ 0.002, respectively).Conclusions: Levels of MMP-1 and -9 mRNA may be markers of malignant transformation of oral dysplasia to oral cancer.

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“…The literature reports a wide range (11-36%) for the overall risk of malignant transformation, depending on the type of lesions being followed and the length of follow-up (3,4). Leukoplakia with dysplasia are more likely to progress to oral SCC than those without dysplasia (4); however, many studies have reported that for the individual lesion, the grade of dysplasia provides little indication of whether or not it will progress to cancer (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Potential Use of Quantitative Tissue Phenotype to Predict Malignant Risk for Oral Premalignant Lesions

et al. 2008

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The importance of early diagnosis in improving mortality and morbidity rates of oral squamous cell carcinoma (SCC) has long been recognized. However, a major challenge for early diagnosis is our limited ability to differentiate oral premalignant lesions (OPL) at high risk of progressing into invasive SCC from those at low risk. We investigated the potential of quantitative tissue phenotype (QTP), measured by highresolution image analysis, to identify severe dysplasia/ carcinoma in situ (CIS; known to have an increased risk of progression) and to predict progression to cancer within hyperplasia or mild/moderate dysplasia. We generated a nuclear phenotype score (NPS), a combination of five nuclear morphometric features that best discriminate 4,027 ''normal'' nuclei (selected from 29 normal oral biopsies) from 4,298 ''abnormal'' nuclei (selected from 30 SCC biopsies). This NPS was then determined for a set of 69 OPLs. Severe dysplasia/CIS showed a significant increase in NPS compared with hyperplasia or mild/moderate dysplasia. However, within the latter group, elevated NPS was strongly associated with the presence of high-risk loss of heterozygosity (LOH) patterns. There was a statistical difference between NPS of hyperplasia or mild/ moderate dysplasia that progressed to cancer and those that did not. Individuals with a high NPS had a 10-fold increase in relative risk of progression. In the multivariate Cox model, LOH and NPS together were the strongest predictors for cancer development. These data suggest that QTP could be used to identify lesions that require molecular evaluation and should be integrated with such approaches to facilitate the identification of hyperplasia or mild/moderate dysplasia OPLs at high risk of progression. [Cancer Res 2008;68(9):3099-107]

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Observations on the clinical characteristics of oral lesions showing histologic epithelial dysplasia

Cited by 166 publications

References 15 publications

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Overexpression of Matrix Metalloproteinase-1 and -9 mRNA Is Associated with Progression of Oral Dysplasia to Cancer

Potential Use of Quantitative Tissue Phenotype to Predict Malignant Risk for Oral Premalignant Lesions

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