Dataset Information

Development and validation of a multivariable model for prediction of malignant transformation and recurrence of oral epithelial dysplasia.

ABSTRACT:

Background

Oral epithelial dysplasia (OED) is the precursor to oral squamous cell carcinoma which is amongst the top ten cancers worldwide. Prognostic significance of conventional histological features in OED is not well established. Many additional histological abnormalities are seen in OED, but are insufficiently investigated, and have not been correlated to clinical outcomes.

Methods

A digital quantitative analysis of epithelial cellularity, nuclear geometry, cytoplasm staining intensity and epithelial architecture/thickness is conducted on 75 OED whole-slide images (252 regions of interest) with feature-specific comparisons between grades and against non-dysplastic/control cases. Multivariable models were developed to evaluate prediction of OED recurrence and malignant transformation. The best performing models were externally validated on unseen cases pooled from four different centres (n = 121), of which 32% progressed to cancer, with an average transformation time of 45 months.

Results

Grade-based differences were seen for cytoplasmic eosin, nuclear eccentricity, and circularity in basal epithelial cells of OED (p < 0.05). Nucleus circularity was associated with OED recurrence (p = 0.018) and epithelial perimeter associated with malignant transformation (p = 0.03). The developed model demonstrated superior predictive potential for malignant transformation (AUROC 0.77) and OED recurrence (AUROC 0.74) as compared with conventional WHO grading (AUROC 0.68 and 0.71, respectively). External validation supported the prognostic strength of this model.

Conclusions

This study supports a novel prognostic model which outperforms existing grading systems. Further studies are warranted to evaluate its significance for OED prognostication.

SUBMITTER: Mahmood H

PROVIDER: S-EPMC10645879 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Development and validation of a multivariable model for prediction of malignant transformation and recurrence of oral epithelial dysplasia.

Mahmood Hanya H Shephard Adam A Hankinson Paul P Bradburn Mike M Araujo Anna Luiza Damaceno ALD Santos-Silva Alan Roger AR Lopes Marcio Ajudarte MA Vargas Pablo Agustin PA McCombe Kris D KD Craig Stephanie G SG James Jacqueline J Brooks Jill J Nankivell Paul P Mehanna Hisham H Rajpoot Nasir N Khurram Syed Ali SA

British journal of cancer 20230927 10

<h4>Background</h4>Oral epithelial dysplasia (OED) is the precursor to oral squamous cell carcinoma which is amongst the top ten cancers worldwide. Prognostic significance of conventional histological features in OED is not well established. Many additional histological abnormalities are seen in OED, but are insufficiently investigated, and have not been correlated to clinical outcomes.<h4>Methods</h4>A digital quantitative analysis of epithelial cellularity, nuclear geometry, cytoplasm staining ...[more]

PMID: 37758836

Similar Datasets

Project description:Oral epithelial dysplasia (OED) is a precursor state usually preceding oral squamous cell carcinoma (OSCC). Histological grading is the current gold standard for OED prognostication but is subjective and variable with unreliable outcome prediction. We explore if individual OED histological features can be used to develop and evaluate prognostic models for malignant transformation and recurrence prediction. Digitised tissue slides for a cohort of 109 OED cases were reviewed by three expert pathologists, where the prevalence and agreement of architectural and cytological histological features was assessed and association with clinical outcomes analysed using Cox proportional hazards regression and Kaplan-Meier curves. Within the cohort, the most prevalent features were basal cell hyperplasia (72%) and irregular surface keratin (60%), and least common were verrucous surface (26%), loss of epithelial cohesion (30%), lymphocytic band and dyskeratosis (34%). Several features were significant for transformation (p < 0.036) and recurrence (p < 0.015) including bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses and nuclear pleomorphism. This led us to propose two prognostic scoring systems including a '6-point model' using the six features showing a greater statistical association with transformation and recurrence (bulbous rete pegs, hyperchromatism, loss of epithelial cohesion, loss of stratification, suprabasal mitoses, nuclear pleomorphism) and a 'two-point model' using the two features with highest inter-pathologist agreement (loss of epithelial cohesion and bulbous rete pegs). Both the 'six point' and 'two point' models showed good predictive ability (AUROC ≥ 0.774 for transformation and 0.726 for recurrence) with further improvement when age, gender and histological grade were added. These results demonstrate a correlation between individual OED histological features and prognosis for the first time. The proposed models have the potential to simplify OED grading and aid patient management. Validation on larger multicentre cohorts with prospective analysis is needed to establish their usefulness in clinical practice.

Dataset Information

Development and validation of a multivariable model for prediction of malignant transformation and recurrence of oral epithelial dysplasia.

Background

Methods

Results

Conclusions

Publications

Development and validation of a multivariable model for prediction of malignant transformation and recurrence of oral epithelial dysplasia.

Similar Datasets

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