APPLICABILITY OF ORAL EPITHELIAL DYSPLASIA GRADING IN POTENTIALLY MALIGNANT DISORDERS OF ORAL CAVITY-AN INSTITUTIONAL REVIEW

Abstract

Oral cancer may be preceded by Potentially malignant lesions such as leukoplakia, erythroplakia, stomatitis nicotina, oral submucous fibrosis (OSMF) and erosive lichen planus(LP). Oral Epithelial dysplasia (OED) is an important predictor of malignant potential. According to WHO 2017, the three tiered grading reliability can be improved by Binary grading system of high & low risk. So the aim of this retrospective study was verify the applicability of the binary grading system for OED in our institution. Objective Comparison of the Binary grading system with WHO three tiered grading system in Oral Epithelial Dysplasia. Findings 116 cases reported as OED from the period 2008 to 2017, were reevaluated and graded according to WHO 2005 & the Binary system. 81.03% of cases were clinically diagnosed as oral leukoplakia, 10.34% as oral LP and 8.62% as OSMF. The frequency of distribution of cases according to WHO grading system were mild (19), moderate (55) and severe (42), whereas according to binary system 85 cases are high risk and 31 cases low risk. On comparison, all 42 cases of severe dysplasia were graded as high risk. Out of 55 cases of moderate dysplasia, 41 were graded as high risk and 14 as low risk. Among 19 cases of mild dysplasia, 2 cases were designated as high risk and 17 cases as low risk. Out of 116 cases, 11(9.48%) cases were of recurrence as OED. 9 cases (10.58%) out of 85 high risk cases showed recurrence in comparison to two (2.35%) out of 31 low risk cases. Analysis of Binary system in relation to clinical features is also attempted. Conclusion In the present analysis, though majority of the high risk cases occurred on buccal mucosa, recurrence was more on tongue. The binary system helped in defining the prognostic group by providing the histologic criteria.