The binary oral dysplasia grading system: validity testing and suggested improvement

Nankivell, Paul; Williams, H.; Matthews, Paul; Suortamo, Sari; Snead, David; McConkey, Christopher C.; Mehanna, Hisham

doi:10.1016/j.oooo.2012.10.015

Cited by 82 publications

(95 citation statements)

References 20 publications

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“…Although no histological classification system exists that can accurately predict which determining factors lead OED to progress to OSCC, there is a consensus among pathologists that the binary system proposed by Kujan et al 20 is the best prognostic indicator currently available with respect to risk of malignant transformation. 22 The signaling pathways involved in embryonic development are normally maintained in an inactive state in nonneoplastic adult tissues, and it is known that reactivation may lead to tumor development. 6,7 Recently published evidence indicates that the HH pathway appears to play an important role in the pathogenesis of OSCC [16][17][18]23 ; however, to the best of our knowledge, no studies have investigated this signaling pathway in any cases of OED.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Expression of Hedgehog Pathway Proteins in Oral Epithelial Dysplasia

Dias

Valverde

Sales

et al. 2016

Applied Immunohistochemistry &Amp; Molecular Morphology

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The aim of this study was to characterize the profile of the proteins involved in the Hedgehog signaling pathway to aid in the understanding of the pathogenesis of oral epithelial dysplasia (OED). The proteins SHH, PTCH1, HHIP, SUFU, GLI1, and cyclin D1 were evaluated by immunohistochemistry in 25 cases of OED, 4 of non-neoplasic oral mucosa, 8 of inflammatory fibrous hyperplasia and 5 of hyperkeratosis. SHH proteins were predominant in OED cases. Although PTCH1 protein was observed in all cases, this molecule was more highly expressed in OED. The inhibitor protein SUFU was present in OED and HHIP protein was overexpressed in OED. GLI1 proteins were predominantly found in the nuclei of epithelial cells in OED. Basal and suprabasal cells in the epithelial lining were positive for cyclin D1 only in OED. In conclusion, comparative analysis of the proteins involved in the Hedgehog pathway suggests that enhanced expression of these proteins can play an important role in the biological behavior of OED.

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Section: Discussionmentioning

confidence: 99%

Enhanced Expression of Hedgehog Pathway Proteins in Oral Epithelial Dysplasia

Dias

Valverde

Sales

et al. 2016

Applied Immunohistochemistry &Amp; Molecular Morphology

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“…For OPMD, epithelial dysplasia was graded independently by two pathologists (M. Robinson and P. Sloan) using a binary system (low-grade vs. high-grade; refs. 7,8). Discordant cases were reviewed, and a grade was assigned by consensus.…”

Section: Pathology Methodsmentioning

confidence: 99%

“…6). However, the histologic features of OPMD do not reliably predict their clinical behavior (7,8). There is consequently a need to develop biomarkers that enhance prognostication and direct treatment (9).…”

Section: Introductionmentioning

confidence: 99%

Changes in Epidermal Growth Factor Receptor Gene Copy Number during Oral Carcinogenesis

Bates

Kennedy

Diajil

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Oral squamous cell carcinoma (OSCC) is a global healthcare problem associated with poor clinical outcomes. Early detection is key to improving patient survival. OSCC may be preceded by clinically recognizable lesions, termed oral potentially malignant disorders (OPMD). As histologic assessment of OPMD does not accurately predict their clinical behavior, biomarkers are required to detect cases at risk of malignant transformation. Epidermal growth factor receptor gene copy number (EGFR GCN) is a validated biomarker in lung non-small cell carcinoma. We examined EGFR GCN in OPMD and OSCC to determine its potential as a biomarker in oral carcinogenesis.Methods: EGFR GCN was examined by in situ hybridization (ISH) in biopsies from 78 patients with OPMD and 92 patients with early-stage (stages I and II) OSCC. EGFR ISH signals were scored by two pathologists and a category assigned by consensus.

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“…Nankivell et al [9] observed that the binary system, proposed by Kujan et al [7] has similar prognostic ability but superior reproducibility compared with the WHOdysplasia system, and that prognostication is improved by using a two-grade.…”

Section: Oral Cavitymentioning

confidence: 99%

“…Preference depends on a pathologist's training, bias and local custom [5]. Numerous articles have reported attempts to evaluate the reliability and inter-observer agreement of these grading systems for oral and laryngeal SILs [6][7][8][9][10][11][12][13]. Some of them have also compared WHO grading systems with new proposals, such as a binary grading system and other classifications for oral lesions or, more widely, for the whole head and neck region (Table 1) [2,7,9,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Current Views and Perspectives on Classification of Squamous Intraepithelial Lesions of the Head and Neck

Gale

Zidar

Poljak

et al. 2014

Head and Neck Pathol

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The current state in the field of classifying oral and laryngeal precursor lesions, as proposed in the WHO 2005 Blue Book is not ideal. The results of various interobserver studies have shown that the currently used grading systems, with different basic concepts and different terminology, cannot continue to be reliably used in the future. The different etiology of cervical and head and neck precursor lesions requires a classification designed to cater to the specificities of the head and neck region. Trying to harmonize different classifications of the oral and laryngeal precursor lesions, we have proposed four crucial steps to set up a unified classification of squamous intraepithelial lesions (SILs): (a) the classification should contain two grades, low-grade and high-grade lesions and, specifically for the larynx, an additional grade-carcinoma in situ (CIS) which must be separated from high-grade laryngeal SILs; (b) the terminology should be unified; our preference is for the term SIL over squamous intraepithelial neoplasia; (c) all leading morphological criteria for low-and highgrade lesions, as well as for CIS, should be clearly defined; (d) agreement between clinicians and pathologists should be achieved on the most appropriate choice of treatment of different grades of SILs in separate head and neck areas.

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The binary oral dysplasia grading system: validity testing and suggested improvement

Cited by 82 publications

References 20 publications

Enhanced Expression of Hedgehog Pathway Proteins in Oral Epithelial Dysplasia

Enhanced Expression of Hedgehog Pathway Proteins in Oral Epithelial Dysplasia

Changes in Epidermal Growth Factor Receptor Gene Copy Number during Oral Carcinogenesis

Current Views and Perspectives on Classification of Squamous Intraepithelial Lesions of the Head and Neck

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