Epithelial Dysplasia Research Articles

“Vaai Ganam” - a screening program for early detection of oral potentially malignant disorders and oral cancer among truck drivers in Chennai – a cross-sectional survey

Introduction: Truck drivers, though forming an integral part of a vital trade link for the Indian population, lack basic life insurance and health care benefits offered by other organized sectors in Indian Industries. This paper aims to present the initial findings of the “VaaiGanam” program which proposes to identify tobacco use and the prevalence of Oral potentially malignant disorders (OPMDs) among truck drivers who are stationed or passing via Chennai and provide cessation services by behavioral therapy. Methods: This cross-sectional study was conducted by a dental screening team who were involved in data collection and screening of the 747 truck drivers who fulfilled the inclusion and exclusion criteria between Jan to Oct 2022. After data collection, oral examinations were done and suspicious lesions were sought for expert opinion. A standard punch biopsy was taken from those lesions requiring confirmation. Results: Among the 747 subjects who participated in this program, 704 (94.2%) were current users of various tobacco products, with 235 (31.4%) preferring smoking and the rest 469(62.8%) using smokeless tobacco products. Oral mucosal lesions were recorded in 49 (6.5%) of the study population, mostly among tobacco users. Punch/incisional biopsies were taken among 17 of the 49 subjects and oral dysplasia was histopathologically confirmed in 9 (mild epithelial dysplasia = 5; moderate epithelial dysplasia = 4) subjects. Conclusion: Truck drivers with tobacco and substance abuse are at high risk of developing oral cancer and hence this study emphasizes the importance of periodic oral cancer screening programs for this vulnerable population to identify potentially malignant oral lesions at an early stage.

Diagnosis of differentiated dysplasia as a variant of oral epithelial dysplasia.

The World Health Organization's definition of oral epithelial dysplasia includes differentiated dysplasia, which is defined by purely architectural abnormalities of oral mucosa without cytological changes. We analysed differentiated dysplasia's frequency, progression risk and correlation with oral brush cytology. Cytoarchitectural criteria and expression patterns of keratin 13/17 and ki67 were studied in oral biopsies clinically diagnosed with leukoplakia. Biopsies were assessed for dysplasia and its grade. Available brush cytology findings were obtained from clinical records. We included 159 biopsies from 112 patients (33% differentiated dysplasia; 27% keratosis without dysplasia; oral epithelial dysplasia with atypia of mild, moderate and severe degree including invasive cancers in 9%, 8% and 7%, respectively). Keratin 13 loss and keratin 17 gain were higher in differentiated-dysplasia cases (p < 0.0001), which had the highest hypergranulosis frequency. Keratin 17 expression was associated with higher malignant-transformation rates (p = 0.0028). The transformation rate and time were comparable between dysplasia with atypia and differentiated-dysplasia cases, which had higher progression rates and shorter time periods than keratosis cases without dysplasia (p = 0.08). Cytology prior to differentiated dysplasia all indicated normal oral mucosa. Keratin 17 but not oral brush cytology can help identify patients with differentiated dysplasia with higher risk for malignant transformation.

Hemorrhagic Primary Squamous Cell Carcinoma of the Stomach : A Case Report

Introduction: Primary squamous cell carcinoma of the stomach is an extremely rare malignancy. The pathogenesis of this tumor remains obscure, and the optimal treatment strategy is controversial. Presentation of case: Here, we describe a case of gastric SCC complicated by multiple hemorrhagic episodes. Discussion: The origin of primary squamous cell carcinoma of the stomach is unclear. there are several hypotheses; arising from the squamous metaplasia of the gastric mucosa; arising from multipotent stem cells; arising from the ectopic squamous epithelium; squamous differentiation from a pre-existing adenocarcinoma; and arising from the vascular endothelium of the stomach. It is probably is related to HPV, EBV, and HP infections. Under chronic inflammatory exposure, tissue stem cell transformation causes epithelial metaplasia and dysplasia, then epithelial carcinoma occurs. The treatment paradigm for this rare disease is the same as for other gastric malignancies. Surgery followed by chemotherapy and/or radiotherapy remain the optimum pick for the management of the primary squamous cell carcinoma of the stomach, regardless of evolutivity of the primary tumor. Conclusion: Primary squamous cell carcinoma of the stomach generally has a poor prognosis. Surgery remains the primary treatment, and adjuvant therapy is unclear. The clinical treatment is basically the same as that of adenocarcinoma.

Challenges in the assessment of epithelial dysplasia in oral lichen planus and oral lichenoid lesion: Inter and intra-observer variability of the WHO criteria and binary system.

Assessment of oral epithelial dysplasia is the gold standard for investigating the risk of malignant progression. The World Health Organization (WHO) methods and the binary system have limitations. This study assess the inter- and intra-observer variability of the architectural and cytological criteria and the classification of the presence and degree of epithelial dysplasia in oral lichen planus (OLP) and oral lichenoid lesion (OLL), using both the 2017 WHO criteria and the binary system. The sample consisted of 65 biopsies from lesions classified as OLP and OLL according to the American Academy of Oral and Maxillofacial Pathology (AAOMP) criteria. The histological slides were reevaluated by two oral pathologists. The individual alterations with most inter-observer disagreement were atypical mitotic figures (43.1%), loss of cohesion between epithelial cells (38.5%) and drop shape rete ridges ridges (38.5%). Inter-observer agreement analysis did not show statistically significant agreement regarding the classification of epithelial dysplasia grade by WHO criteria, only regarding the binary system classification (k=0.257; p=0.035). Intra-observer agreement analysis by evaluator 1 showed that the classification of epithelial dysplasia grade according to both methods had statistically significant agreement (k=0.546; p=0.004, k=0.861; p<0.001). Considering evaluator 2, only the evaluation of the WHO system classification showed statistically significant agreement (k=0.593; p=0.010). The evaluation of epithelial dysplasia is subjective and focal changes and inflammatory infiltrate, characteristic of OLP and OLL, can increase the degree of disagreement among evaluators. The binary system presents better inter-observer agreement, while the WHO system presents better intra-observer agreement. Key words:Oral lichen planus, oral lichenoid lesion, oral lichenoid disease, dysplasia, inter-observer variation.

Topical Chemotherapeutic Effect of Thymoquinone, Epigallocatechin-3-gallate, and Curcumin on Chemically Induced Oral Epithelial Dysplasia in Hamsters.

Topical Chemotherapeutic Effect of Thymoquinone, Epigallocatechin-3-gallate, and Curcumin on Chemically Induced Oral Epithelial Dysplasia in Hamsters.

Leukoplakia and erythroplakia in youngers versus older individuals: a clinicopathological retrospective study.

The incidence of oral cancer has exhibited a rise within the young population. Considering that oral potentially malignant disorders (OPMDs) can precede the development of oral cancer, it is imperative to conduct studies in this particular younger population. This study aimed to evaluate the frequency and conduct a comparative analysis of the clinical-demographic characteristics of OPMDs in two distinct age groups. A retrospective analysis was conducted with patients diagnosed with leukoplakia, erythroplakia, and leukoerythroplakia between 1965 and 2020. The individuals were categorized into two groups: those aged up to 40 years (Group Younger) and those aged 41 years and above (Group Older). A total of 640 lesions were subjected to analysis. Among these, patients aged up to 40 years constituted 10.63% of the sample, however, this proportion decreased significantly to 6.9% between 2010 and 2020. A predominant male representation was observed in both groups, with white lesions being the most common in both as well. However, the frequency of red or mixed lesions was significantly higher (p=0.034) in the older group, along with a higher prevalence of dysplastic lesions (26.9% versus 11.8%, p=0.01). Moreover, the older group exhibited a relatively higher percentage of smokers/ex-smokers (78.6%), compared to the younger group (61.5%, p=0.085) and alcohol consumers/ex-consumers (54.9% versus 22.7%, p=0.028). Elderly individuals exhibited an unfavorable progression (p=0.028). However, a logistic regression analysis identified as significant variables associated with malignant transformation, the presence of epithelial dysplasia, and red lesions diagnosed as erythroplakia. A declining frequency of OPMDs in young adults was observed over the years, whereas in older adults, these disorders exhibited an unfavorable progression.

Oral health of an indigenous population in northeastern Brazil: a cross-sectional Study of the Fulni-ô ethnic group.

There is a lack of studies evaluating the oral health of traditional indigenous communities in Brazil. Thus, the objective of this study was to describe the oral health characteristics of the indigenous Fulni-ô ethnic group in Northeast Brazil. A cross-sectional observational investigation was conducted within the Project on Atherosclerosis among Indigenous Populations. This study included participants of both sexes from the Fulni-ô ethnic group. The participants included in this investigation underwent a comprehensive oral health evaluation by a registered and experienced dentist to assess oral health and identify potentially malignant oral lesions. Participants with suspicious lesions were referred for biopsy. Shapiro-Wilk, Mann-Whitney, and Student's t-tests were used, and measures of central tendency and dispersion were described. Statistical significance was 5%. A total of 104 individuals were included in this study. The prevalence of the use of tobacco derivatives was 94.0%, with similarities between sexes. The prevalence of oral changes in this study population was 84.4%. Fifty-one individuals who underwent oral reassessment were referred for oral lesion biopsy. This study demonstrated a high prevalence of oral alterations in the Fulni-ô population. Histopathological analyses indicated the presence of mild oral epithelial dysplasia in five cases.

Oral leukoplakia and erythroplakia in young patients: a southern Brazilian multicenter study.

The objective of the present study was to investigate the frequency of oral leukoplakia and oral erythroplakia among young patients from three Brazilian reference centers in Oral and Maxillofacial Pathology. A retrospective study was carried out from 2011 to 2021 on 861 patients diagnosed with oral leukoplakia and oral erythroplakia. Demographic and clinicopathological data were evaluated. Fisher's exact test was used to evaluate the association among sex, age, anatomical location, and histopathological diagnosis. A total of 83 (9.64%) cases involved young patients (aged <40 years). Among these, biopsy records were included in 31 (37.34%) cases, all of which received a clinical diagnosis of oral leukoplakia. Seventeen (54.84%) patients were female, mostly in their fourth decade of life (n = 22/70.97%), and their mean age at diagnosis was 32.61(± 5.21) years. Among informed cases, seven (22.58%) patients were smokers. The lateral border of the tongue (n = 9/29.03%) was the most affected site. In 13 (41.94%) cases, oral leukoplakias showed a homogeneous appearance. The mean size of the lesions was 1.47 cm (0.2-3.0 cm) and the mean time of disease progression was 64.37 (± 65.90) months. The histopathological analysis showed that 11 cases (35.48%) exhibited some degree of epithelial dysplasia. Acanthosis and/or hyperkeratosis were observed in 20 cases (64.52%). No significant associations were observed between sex and anatomical location, age and anatomical location, nor between sex and histological diagnosis (p > 0.05). Oral leukoplakia and oral erythroplakia are uncommon diseases in young patients. In this population, oral leukoplakia shows a slight predilection for women aged between 30 and 39 years.

The expression of Cox-2 and Cyclin D1 with clinicopathological characteristics in oral epithelial dysplasia: A retrospective study

Background: Oral mucosal cancers are often preceded by potentially malignant diseases that may exhibit diverse morphological and histological alterations. The expression of COX 2 has been related to tumor vascularization, dissemination, and survival in oral cancer studies. High levels of cyclin D1 expression to precancerous lesions and oral malignancies. This study was designed to evaluate and compare the immunohistochemical expression of the above-mentioned markers. Materials and Methods: 50 retrospective formalin fixed-paraffin embedded histopathologically confirmed blocks of oral epithelial dysplasia. Immunohistochemical staining was performed using monoclonal antibodies against COX-2 and Cyclin D1. Using a standard camera, photomicrographs of the slides were taken. Results: No significant difference in the age distribution of the patients studied, as well as age pivoting at the fifth and sixth decades with mean and standard deviation (53.36 2.63). There was no significant difference in gender among the studied patients. Furthermore, there was a highly significant difference in grade distribution. Conclusions: The COX-2 and Cyclin D1 markers may assist in diagnosing oral epithelial dysplasia based on severity. It's easy to gather image-analytic data on the stained tissue specimens.

A case report on the simultaneous occurrence of cancer in The Tongue and Breast

Squamous cell carcinoma (SCC) affecting the tongue commonly emerges along its lateral border, yet occurrences specifically on the dorsum, especially at the midline, are notably rare. This study delves into the incidence rates of SCC localized on the tongue, alongside an investigation into simultaneous lesions of the breast. 50-year-old female presented with an ulcerative growth on the left side of the tongue, accompanied by speech difficulty and chewing discomfort persisting for a month. Previous history included breast surgery five years prior, along with ongoing diabetes medication. No history of habits, trauma, or prior ulcer formation was reported. Clinical examination revealed a whitish-yellow, firm, ulcerative lesion extending on the left lateral tongue surface, measuring 7.2x3.1x2.5cm with an exophytic growth of 4.7x2.1cm. The lesion, extending to the dorsal tongue surface, displayed erythematous flooring interspersed with slough and pale mucosa. Limited tongue movement and palpable submandibular nodes were noted. Initial diagnostic findings indicated stage IV metastatic carcinoma of the tongue (T4aN2M1). pathology revealed severe epithelial dysplasia with an invasive pattern in the form of islands, demonstrating altered cellular features, pleomorphism, inflammatory infiltrate, vascularity, and areas of hemorrhage. Lymph nodal analysis showed metastatic deposits in one of three left level II B lymph nodes.

The effect of synergistic Candida albicans infection with P63 protein expression on the development of oral carcinom

Oral cancer accounts for 2-4% of all cancer cases. There is compelling evidence that suggest that Candida may influence the development of oral cancer by interfering with the expression of the Tp63 gene, which is crucial for tumor progression, and promotes proliferation. The goal was to assess the p63 expression, compare it qualitatively and quantitatively in a normal buccal mucosa, epithelial dysplasia, leukoplakia, and oral squamous cell carcinoma (OSCC), and also determine how does it relate to the Candida albicans infection. A retrospective cross-sectional study of 100 Formalin-Fixed Paraffin-Embedded (FFPE) cases and controls were studied, and they were divided into four groups: Group I, included 40 controls with normal oral mucosa; Group II, included 20 cases of dysplasia; Group III, included 20 cases of leukoplakia, and Group IV, included 20 cases of OSCC. C. albicans was examined by Real-Time PCR based on Erg11 gene and the immunohistochemical expression of p63 protein. Significant overexpression of p63 and positive PCR results of C. albicans were seen in noninvasive lesions (leukoplakia, epithelial dysplasia) and invasive OSCCs with an increased suprabasal expression in cases of leukoplakia and epithelial dysplasia. The mean of labeling index (LI) of p63 with C. albicans positive cases were found to be in increasing order from normal oral mucosa than leukoplakia and dysplasia to OSCC. These findings point to p63 association with oral carcinogenesis and candidal infection, and they also imply that dysplastic and leukoplakia lesions may have the ability to serve as a signal for oral premalignancy due to increased LI and higher suprabasal expression of this gene. &#x0D; KEY WORDS: Candida albicans; epithelial dysplasia; Erg11; leukoplakia; p63 protein.

Calibration improves the agreement in grading oral epithelial dysplasia-Findings from a National Workshop in Malaysia.

A major pitfall of many of the established oral epithelial dysplasia (OED) grading criteria is their lack of reproducibility and accuracy to predict malignant transformation. The main objective of this study was to determine whether calibration of practicing oral pathologists on OED grading could improve the reproducibility of the WHO 2017 and the binary OED grading systems. A nationwide online exercise was carried out to determine the influence of calibration on the reproducibility of the WHO 2017 and the binary OED grading systems. A significant improvement was observed in the inter-observer agreement for the WHO 2017 OED grading system (K 0.196 vs. 0.448; Kw 0.357 vs. 0.562) after the calibration exercise. The significant difference (p = 0.027) in the level of agreement between those with five or more years and less than 5 years of experience was no more observed (p = 0.426) after the calibration exercise. The percent agreement for binary grading was significantly higher (91.8%) for buccal mucosal lesions as compared to lesions on the tongue after the calibration exercise. This study validates the significance of calibration in improving the reproducibility of OED grading. The nationwide exercise resulted in a statistically significant improvement in the inter-observer agreement for the WHO 2017 OED grading system among a large number of oral pathologists. It is highly recommended that similar exercises should be organized periodically by professional bodies responsible for continuing education among oral pathologists to improve the reliability of OED grading for optimal treatment of oral potentially malignant disorders.

A Case of Gastric Mixed Neuroendocrine-Nonneuroendocrine Neoplasm Composed With Adenoma and Neuroendocrine Tumor

Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the gastrointestinal tract, particularly gastric MiNENs are rare, and a gastric adenoma that occurs concomitant with a neuroendocrine carcinoma (and not gastric adenocarcinoma) is extremely rare. The clinicopathologic and pathogenetic features of MiNENs remain unclear, and treatment guidelines are currently unavailable. A 75-year-old man patient was referred to our hospital for management of a gastric adenoma. Endoscopy revealed an elevated mucosal lesion (10 mm×10 mm) at the greater curvature of the lower gastric body. The patient underwent endoscopic submucosal dissection for removal of the gastric neoplasm. Histopathological evaluation revealed mixed epithelial dysplasia, low and partly high grade and a neuroendocrine tumor (grade 1). Immunohistochemical analysis showed neoplastic cells with immunopositivity for CD56, synaptophysin, and INSM1, and Ki-67 showed 2.2%. Therefore, the patient was diagnosed with a low-grade gastric MiNEN. We present a rare case of gastric MiNENs (adenoma-neuroendocrine tumor) together with a literature review.

Long-Term Natural History of Autoimmune Gastritis: Results From a Prospective Monocentric Series.

The natural history of autoimmune gastritis (AIG) has been poorly described. In this study, we report the long-term natural history and clinical clustering of the full spectrum of AIG, from the potential to the complicated stage. Prospective single-center study conducted in a tertiary referral center. Patients with AIG at any stage (0 = potential; 1 = early; 2 = florid; 3 = severe; and 4 = complicated) were enrolled (January 2000-December 2022). The histopathological evolution, the clinical presentation, and the correlates of evolution of potential AIG were assessed. Four hundred ninety-eight patients with AIG (mean age 56.7 ± 15.2 years, F:M ratio 2.5:1) were included, of whom 93 experienced potential AIG. The maximum disease duration was 27 years (median 18, interquartile range 14-23), while the overall median follow-up was 52 months (interquartile range 12-95). Age was significantly lower in stage 0 compared with that in the other stages. Accidental histologic evidence and hematologic findings were the most common clusters of diagnosis. The overall median rate of progression was 7.29 per 100 persons/yr (95% confidence interval [CI] 6.19-8.59), while the stage-specific rates of progression were 10.85 (stage 0; 95% CI 7.75-15.18), 14.83 (stages 1-2; 95% CI 11.89-18.49), and 2.68 (stage 3; 95% CI 1.88-3.84). Newly onset neoplastic complications at follow-up occurred in 41/483 patients (8.5%; 23 neuroendocrine tumors and 18 epithelial dysplasia). No cases of adenocarcinoma were noticed. Male sex was associated with a greater likelihood of evolving from potential AIG to overt AIG. AIG is a progressive disorder, with a virtually absent risk of gastric adenocarcinoma. Patients with potential AIG should be monitored because they carry a high risk of evolving into overt AIG.

Evaluation of BIRC6 Expression in Oral Squamous Cell Carcinoma, Epithelial Dysplasia, Lichen Planus with and without Dysplasia, and Hyperkeratosis

Background: BIRC6, regarded as the pivotal member of the inhibitor of the apoptosis (IAP) family, has been linked to the development of different types of cancer in humans. The objective of this study was to examine the expression of BIRC6 in various oral conditions, including OLP with dysplasia (OLPD), hyperkeratosis (HK), OLP, epithelial dysplasia (ED), and oral squamous cell carcinoma (OSCC), to investigate its potential involvement in the development of OSCC and the pathogenesis and malignant transformation of OLP, which is known as a precancerous condition. Methods: In this retrospective cross-sectional study, 99 cases, consisting of 19 cases of OSCC, 21 cases of ED, 23 cases of OLP, 20 cases of OLPD, and 16 cases of HK as the control group, were investigated regarding BIRC6 expression by immunohistochemical staining. After that, the immunohistochemical expression of BIRC6 in the epithelial compartment was analyzed. Statistical analysis was performed to investigate the relationship between the expression of BIRC6 and clinicopathological variables. The statistical analysis of the data involved the use of one-way ANOVA, post hoc Tukey, Kruskal–Wallis, Chi-square, Spearman’s correlation, and Mann–Whitney tests. The significance level was set at p &lt; 0.05. Results: Positive BIRC6 staining was found in 91.7% of the subjects of OLP, 88.1% of HK, 86.1% of ED, 93% of OLPD, and 94.7% of OSCC. OSCC showed the highest BIRC6 expression (p = 0.00). The average total staining score was remarkably greater in OSCC and dysplastic lesions compared with HK (p = 0.00, p = 0.00). Conclusions: While the current study suggested that BIRC6 may play a role in the tumorigenesis of OSCC, its role in the malignant transformation of OLP has yet to be definitively established.

Validity of nomograms for predicting cancer risk in oral leukoplakia and oral lichen planus.

This study assessed the validity of nomograms for predicting malignant transformation (MT) among patients with oral leukoplakia (OL) and oral lichen planus (OLP). Two nomograms were identified following a systematic search. Variables to interrogate both nomograms were obtained for a retrospective OL/OLP cohort. Then, the nomograms were applied to estimate MT probabilities twice and their average was used to calculate the discriminatory performance, calibration, and potential net benefit of the models. Subgroup analyses were performed for patients with OL, OLP, and oral epithelial dysplasia. Predicted probabilities were mostly significantly higher among OL/OLP patients who developed MT compared to those who did not (p = <0.001-0.034). AUC values and Brier scores of the nomograms were 0.644-0.844 and 0.040-0.088 among OL patients and 0.580-0.743 and 0.008-0.072 among OLP patients. Decision curve analysis suggested that the nomograms had some net benefit for risk stratification. However, the models did not best binary dysplasia grading in discriminatory validity and net benefit among patients with OL and oral epithelial dysplasia. Nomograms for predicting MT may have satisfactory validity among patients with OL than OLP, but they do not outperform binary dysplasia grading in risk stratification of OL.

Searching for new early detection markers of oral epithelial dysplasia and oral squamous cell carcinoma using oral liquid-based cytology

ObjectiveOral squamous cell carcinomas (SCCs) arise from oral potentially malignant disorders (OPMDs), including oral epithelial dysplasia (OED); however, useful detections markers for early detection of OED and oral SCC are lacking. In this study, we aimed to evaluate the sequential mRNA and protein expression patterns of BRD4, c-MYC, TP53, and MUC21 in human oral samples by liquid-based cytology (LBC) and determine whether these markers are useful for early detection of OED and oral SCC when combined with oral cytological screening. MethodsA total 200 patients were obtained from our hospital between 2020 and 2022. These are samples from same cases with oral cytology and corresponding histological diagnosis. The expression of these markers was examined by immunocytochemistry and mRNA analysis. The percentages of cells with nuclear or cytoplasmic immunostaining were calculated using the labeling index (LI). BRD4, c-MYC, and TP53 mRNA expression levels were upregulated in tissue during progression from a status of negative for intraepithelial lesions or malignancy (NILM) to positive for SCC. BRD4-LI and c-MYC-LI significantly increased in low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL) and SCC samples, whereas the expression of MUC21 mRNA and MUC21-LI gradually decreased. TP53-LI increased only in SCC samples. ConclusionsWe conclude that monitoring BRD4 and c-MYC expression with immunocytochemistry could improve the early detection of OED and oral SCC.

Oral Lichen Planus with Mild Epithelial Dysplasia: A Case Report and Literature Review

Oral Lichen Planus with Mild Epithelial Dysplasia: A Case Report and Literature Review

Architectural and cytological features of epithelial dysplasia associated with transformation risk.

This study explored associations between histological features of dysplasia and malignant transformation, as well as genomic copy number alterations. Overall, 201 samples were collected from patients of oral leukoplakia. The associations of dysplastic features with malignant transformation and copy number alterations were investigated by Cox proportional hazards regression analysis and the Mann-Whitney U-test. Eight individual histological features, such as irregular epithelial stratification (p = 0.001), mitoses high in epithelium (p = 0.033), extension of changes along minor gland ducts (p < 0.001), etc., were associated with greater risk of malignant transformation. A model including histological features and age showed good performance for predicting malignant transformation (area under receiver operating characteristic curve: 0.806). Irregular epithelial stratification (p = 0.007), abnormal nuclear shape (p = 0.005), abnormal cell size (p = 0.004), etc. were associated with greater genomic instability. A Cox proportional hazards model using eight histological features and patient age reliably predicted the malignant potential of oral epithelial dysplasia. Identification of these histological features closely related to malignant transformation may aid the management of oral potentially malignant disorders and early detection of oral squamous cell carcinoma.

Endoscopic submucosal dissection for oesophageal cavernous haemangioma accompanied by squamous epithelial dysplasia

Endoscopic submucosal dissection for oesophageal cavernous haemangioma accompanied by squamous epithelial dysplasia