Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate.

Abstract

This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates. This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs. The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs. Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.