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Dou CB, Fu YH, Yu ZL, Jia J. Proliferative verrucous leukoplakia: Report of a case and literature review. Oral Oncol 2024; 150:106720. [PMID: 38350263 DOI: 10.1016/j.oraloncology.2024.106720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/03/2024] [Indexed: 02/15/2024]
Affiliation(s)
- Chun-Bo Dou
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079 Wuhan, China; Dongfeng Stomatological Hospital, Hubei University of Medicine, 442000 Shiyan, China
| | - Yi-Hui Fu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079 Wuhan, China
| | - Zi-Li Yu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079 Wuhan, China; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079 Wuhan, China.
| | - Jun Jia
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079 Wuhan, China; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079 Wuhan, China.
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Nissanka-Jayasuriya EH, Fenton TR, Rose-Zerilli MJJ. Molecular landscape of proliferative verrucous leukoplakia: a systematic review. Br J Oral Maxillofac Surg 2024; 62:118-127. [PMID: 38296711 DOI: 10.1016/j.bjoms.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 02/02/2024]
Abstract
Proliferative verrucous leukoplakia (PVL) is a rare oral potentially malignant disorder characterised by multifocal origin and unpredictable long-term evolution to oral squamous cell carcinoma (OSCC) or oral verrucous carcinoma (OVC). Currently no predictive biomarkers are in clinical use. We aimed to explore the genomic profile of PVL. A total of 685 cases in 26 studies were included in this review. Genomic data were presented in 15% of studies and biomarker analysis was reported in 85% of studies. At first clinical presentation, PVL is characterised by a high loss of heterozygosity (LOH), similar to OSCC, and low copy number alterations (CNA). As these progress, more CNAs and mutations in CDKN2A and alterations to ELAVL1 expression are noted, but no TP53 mutations are identified. There is significantly lower LOH at 17p in early PVL compared with OSCC (p = 0.037). Deletions in chromosomal loci 17q12, 5q31.1 and amplifications in 7q11.2, 7q22 are shared between early lesions and OVC. PVL shows CNAs at 11q31. WNT signalling pathway genes (SUZ12, CTTN and FOLR3) are enriched in CN-altered regions. PVL stroma shows significantly lower α-SMA and higher CD34 expression than OVC and OSCC. The exact genomic landscape is currently unclear, and further studies are necessary to unravel this mystery.
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Affiliation(s)
- Eranga H Nissanka-Jayasuriya
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Histopathology, William Harvey Hospital, East Kent Hospitals University NHS Trust, Ashford, Kent, UK.
| | - Tim R Fenton
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; School of Biosciences, University of Kent, Canterbury, UK
| | - Matthew J J Rose-Zerilli
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK
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Becker AS, Holm M, Liese J, Engel N, Zimpfer AH. Diagnosis of differentiated dysplasia as a variant of oral epithelial dysplasia. Oral Dis 2024. [PMID: 38191851 DOI: 10.1111/odi.14846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/22/2023] [Accepted: 12/10/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES 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. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS Keratin 17 but not oral brush cytology can help identify patients with differentiated dysplasia with higher risk for malignant transformation.
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Affiliation(s)
| | - Maximiliane Holm
- Institute of Pathology, University Medical Center, Rostock, Germany
| | - Jan Liese
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| | - Nadja Engel
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Center Rostock, Rostock, Germany
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Alsoghier A, AlBagieh H, AlSahman L, Alshagroud R, AlSahman R. Proliferative verrucous/multifocal leukoplakia: Updates and literature review "case report". Medicine (Baltimore) 2023; 102:e33783. [PMID: 37233434 PMCID: PMC10219708 DOI: 10.1097/md.0000000000033783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
RATIONALE Proliferative verrucous leukoplakia (PVL) is a multifocal, slowly evolving lesion that resists all types of treatment and has a high propensity for malignant transformation into oral squamous cell carcinoma. Lack of awareness and acquaintance with white lesions of the oral cavity makes it difficult to diagnose. Besides being rare, PVL significantly aggressive, so clinicians need to be aware of it carefully. Therefore, it is recommended to have the earliest possible diagnosis and total excision of this lesion. We report this case to present typical clinical and histologic features of PVL so a For the purpose of sensitizing clinician. PATIENT CONCERN A 61-year-old female came to the clinic concerning of recurring painless, white patch on the tongue 2 months ago, associated with oropharyngeal dryness. DIAGNOSES This case satisfies these major and minor criteria to diagnosed PVL. INTERVENTION An excisional biopsy of the lesion was done to check for the presence of dysplasia, as lesions were persisting. Hemostasis was achieved with single interrupted sutures. OUTCOME no recurrence has been observed since excisional 1 year follow-up. LESSON The key feature is early detection, precisely in cases of PVL it is critical for better treatment outcomes, lifesaving, quality-of-life enhancement. To detect and treat any potential pathologies, clinicians should meticulously examine the oral cavity and patients have to be aware and informed of the importance of regular screenings. This lesion is resistant to the presently available treatment modalities; therefore, total excision with free surgical margins is critical combined with a lifelong follow-up.
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Affiliation(s)
- Abdullah Alsoghier
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Hamad AlBagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Lujain AlSahman
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Rana Alshagroud
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Roba AlSahman
- Faculty of Dentistry, Royal College of Surgeons, Ireland, Dublin
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Brailo V, Freitas MD, Posse JL, Monteiro L, Silva LM, Fricain JC, Catros S, Fénelon M, Lodi G, Ariyaratnam R, Murthy V, Keat R, Cook RJ, Escudier MP, Horvat K, Lombardi N, Carey B, Albuquerque R. Oral potentially malignant disorders - An assessment of knowledge and attitude to future education in undergraduate dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022. [PMID: 35997549 DOI: 10.1111/eje.12849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/06/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The aim of this study was to assess the knowledge and clinical experience of oral potentially malignant disorders (OPMDs) in undergraduate dental students in six European countries (Croatia, France, Italy, Portugal, Spain and United Kingdom) and assess student's attitude and preference to future education on the topic. A secondary aim was to identify gaps in student's knowledge and clinical practice. The study was a part of the Erasmus+ project "Oral Potentially Malignant Disorders: Healthcare Professionals Training" (Grant No: 2020-1-UK01-KA202-078917). MATERIALS AND METHODS An online questionnaire was distributed to all final-year students in six partner universities. This consisted of four parts assessing: (1) knowledge on OPMDs, (2) clinical experience with this group of patients, (3) self-rated competence in the management of OPMDs and (4) preferences with regard to future education. RESULTS Two hundred and sixty final-year dental students from six partner universities responded to the questionnaire. Response rates varied from 12% to 92% between partner universities. Significant differences in clinical experience and knowledge were found between students. Students with more clinical exposure to OPMDs rated their knowledge and competence in the management of OPMDs higher than students with less clinical experience. The majority of students were interested in future education on OPMDs, preferably via short educational videos. CONCLUSION The majority of students have received theoretical knowledge of OPMDs during their undergraduate studies, however, not all had clinical exposure to this group of patients. Students were open to further education on OPMDs. Important deficiencies in knowledge were identified that need to be addressed and it is anticipated that the e-learning platform and e-book that are in development by partner institutions will help to improve overall knowledge of OPMDs.
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Affiliation(s)
- Vlaho Brailo
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marcio Diniz Freitas
- School of Medicine and Dentistry, University Santiago de Compostela, Santiago, Spain
| | - Jacobo Limeres Posse
- School of Medicine and Dentistry, University Santiago de Compostela, Santiago, Spain
| | | | | | | | | | | | | | | | - Vignesh Murthy
- Department of Oral Medicine, Guy's & St Thomas' NHS Foundation Trust (GSTT), Guy's Hospital, London, UK
| | - Ross Keat
- St Helens & Knowsley Teaching Hospitals NHS Trust, Manchester, UK
| | - Richard James Cook
- Oral Medicine, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Michael P Escudier
- Oral Medicine, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Kristina Horvat
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Barbara Carey
- Department of Oral Medicine, Guy's & St Thomas' NHS Foundation Trust (GSTT), Guy's Hospital, London, UK
| | - Rui Albuquerque
- Department of Oral Medicine, Guy's & St Thomas' NHS Foundation Trust (GSTT), Guy's Hospital, London, UK
- Oral Medicine, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Overestimated risk of transformation in oral lichen planus. Oral Oncol 2022; 133:106025. [PMID: 35858493 DOI: 10.1016/j.oraloncology.2022.106025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) was classified as an oral potentially malignant disorder due to the association with oral squamous cell carcinoma (OSCC). However, the malignant potential of OLP has been controversial. Whether epithelial dysplasia should be differentiated from OLP and lichenoid dysplasia could be identified as a pathological entity has been the subject of debate. MATERIALS AND METHODS We recruited a large retrospective cohort with 3568 patients, and 10 of them developed OSCC. These cases were reviewed retrospectively to investigate association between OLP and OSCC. RESULTS In 10 cases of OSCC, three of them were primary cancers distinct from the site with OLP, two were malignant transformation of proliferative verrucous leukoplakia, and five were malignant transformation of oral leukoplakia. All OSCC is not transformed from OLP. Therefore, previous insights into OLP might have overestimated its transformation risk. There may be the reasons: I. did not distinguish OLP from epithelial dysplasia, II. neglect of oral leukoplakia with dysplasia developed in the course after OLP, III. misdiagnosis in the early stage of proliferative verrucous leukoplakia. CONCLUSION The pathological and molecular biological features of OLP differed from those of oral leukoplakia and OSCC. Strict control of the diagnostic criteria for OLP and close surveillance during the course could contribute to correctly identify the origin of OSCC and avoid overestimating the risk of OLP transformation.
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Ghosh S, Rao RS, Upadhyay MK, Kumari K, Sanketh DS, Raj AT, Parveen S, Alhazmi YA, Jethlia A, Mushtaq S, Sarode S, Reda R, Patil S, Testarelli L. Proliferative Verrucous Leukoplakia Revisited: A Retrospective Clinicopathological Study. Clin Pract 2021; 11:337-346. [PMID: 34205902 PMCID: PMC8293104 DOI: 10.3390/clinpract11020048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Objective: To review the criteria proposed by Cerero-Lapiedra et al. and to retrospectively identify the under-diagnosed disease in patients diagnosed with proliferative verrucous leukoplakia. (2) Materials and methods: In this study, we included patients who were diagnosed with leukoplakia (histological label consistent with the clinical diagnosis, n = 95), and cases with a final diagnosis within the spectrum of proliferative verrucous leukoplakia (n = 110) as defined by Batsakis et al. We applied the criteria proposed by Cerero-Lepiedra et al. to screen for the possible cases of proliferative verrucous leukoplakia. (3) Results: Although many of our patients satisfied specific isolated criteria, only 11 cases satisfied specific combinations of the guidelines to satisfy a diagnosis of proliferative verrucous leukoplakia. However, due to the lack of follow-up data, the disease is not confirmed in these 11 cases. (4) Conclusion: A limited number of cases of proliferative verrucous leukoplakia were diagnosed using the criteria given by Cerero-Lapiedra et al. The true natural history of the disease could not be studied due to the lack of follow-up data. (5) Clinical relevance: Proliferative verrucous leukoplakia presenting as hyperkeratosis or mild epithelial dysplasia are often not followed up, and they subsequently transform into carcinoma. Thus, clinicians must be vigilant whenever they encounter leukoplakia, especially with multifocal presentations. In such cases, the follow-up data are the key to understanding the true nature of the disease entity.
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Affiliation(s)
- Snehashish Ghosh
- Department of Oral Pathology, M. B. Kedia Dental College and Teaching Hospital, Birgunj 44300, Nepal;
| | - Roopa S. Rao
- Department of Oral Pathology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bangalore 560054, India;
| | - Manoj K. Upadhyay
- Department of Conservative Dentistry and Endodontics, M. B. Kedia Dental College and Teaching Hospital, Birgunj 44300, Nepal;
| | | | | | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Sameena Parveen
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.P.); (A.J.)
| | - Yaser Ali Alhazmi
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (Y.A.A.); (S.P.)
| | - Ankur Jethlia
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.P.); (A.J.)
| | - Shazia Mushtaq
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Sachin Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, India;
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00185 Rome, Italy;
- Correspondence: ; Tel.: +91-393287353196
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (Y.A.A.); (S.P.)
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00185 Rome, Italy;
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McParland H, Warnakulasuriya S. Lichenoid morphology could be an early feature of oral proliferative verrucous leukoplakia. J Oral Pathol Med 2021; 50:229-235. [PMID: 33185900 DOI: 10.1111/jop.13129] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Recognition and differentiation of early forms of proliferative verrucous leukoplakia (PVL) could be a challenge to both clinicians and pathologists. OBJECTIVE To report on a retrospective study that was carried out on 51 cases of PVL that were initially diagnosed as frictional keratosis, oral leukoplakia or oral lichen planus. A secondary objective is to report on the outcome of malignant transformation during follow-up. METHODS Records of patients seen at an oral medicine clinic with the final clinical diagnosis of PVL were audited for early clinical and histopathologic features in their biopsy at first presentation, and for subsequent malignant transformation. RESULTS Fifty-one patients (25 men and 26 women) with a mean age 51 years (men) and 53 years (women) at initial presentation were studied. 28% men and 11.5% women were current smokers. Initial clinical diagnoses were frictional keratoses (n = 4), Leukoplakia (n = 17) and lichen planus (n = 30). Epithelial dysplasia was reported in the initial biopsy in 12 cases and lichen planus/lichenoid features in 22 cases (22/51; 43%). Malignant transformation occurred in 11/51 patients (21.5%). CONCLUSION Lichen planus or lichenoid lesions could be the initial presentation of many PVL cases that later develop multiple leukoplakic lesions with a final diagnosis of PVL.
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Affiliation(s)
- Helen McParland
- Department of Oral Medicine, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK
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Thompson LDR, Fitzpatrick SG, Müller S, Eisenberg E, Upadhyaya JD, Lingen MW, Vigneswaran N, Woo SB, Bhattacharyya I, Bilodeau EA, Carlos R, Islam MN, Leon ME, Lewis JS, Magliocca KR, Mani H, Mehrad M, Purgina B, Richardson M, Wenig BM, Cohen DM. Proliferative Verrucous Leukoplakia: An Expert Consensus Guideline for Standardized Assessment and Reporting. Head Neck Pathol 2021; 15:572-587. [PMID: 33415517 PMCID: PMC8134585 DOI: 10.1007/s12105-020-01262-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022]
Abstract
The many diverse terms used to describe the wide spectrum of changes seen in proliferative verrucous leukoplakia (PVL) have resulted in disparate clinical management. The objective of this study was to produce an expert consensus guideline for standardized assessment and reporting by pathologists diagnosing PVL related lesions. 299 biopsies from 84 PVL patients from six institutions were selected from patients who had multifocal oral leukoplakic lesions identified over several years (a minimum follow-up period of 36 months). The lesions demonstrated the spectrum of histologic features described in PVL, and in some cases, patients developed oral cavity squamous cell carcinoma (SCC). An expert working group of oral and maxillofacial and head and neck pathologists reviewed microscopic features in a rigorous fashion, in combination with review of clinical photographs when available. The working group then selected 43 single slide biopsy cases for whole slide digital imaging (WSI) review by members of the consensus conference. The digital images were then reviewed in two surveys separated by a washout period of at least 90 days. Five non-PVL histologic mimics were included as controls. Cases were re-evaluated during a consensus conference with 19 members reporting on the cases. The best inter-observer diagnostic agreement relative to PVL lesions were classified as "corrugated ortho(para)hyperkeratotic lesion, not reactive" and "SCC" (chi-square p = 0.015). There was less than moderate agreement (kappa < 0.60) for lesions in the "Bulky hyperkeratotic epithelial proliferation, not reactive" category. There was ≥ moderate agreement (> 0.41 kappa) for 35 of 48 cases. This expert consensus guideline has been developed with support and endorsement from the leadership of the American Academy of Oral and Maxillofacial Pathology and the North American Society of Head and Neck Pathologists to recommend the use of standardized histopathologic criteria and descriptive terminology to indicate three categories of lesions within PVL: (1) "corrugated ortho(para)hyperkeratotic lesion, not reactive;" (2) "bulky hyperkeratotic epithelial proliferation, not reactive;" and (3) "suspicious for," or "squamous cell carcinoma." Classification of PVL lesions based on a combination of clinical findings and these histologic descriptive categories is encouraged in order to standardize reporting, aid in future research and potentially guide clinical management.
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Affiliation(s)
- Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue Woodland Hills, CA 91364 Woodland Hills, USA
| | - Sarah G. Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Susan Müller
- Atlanta Oral Pathology, Emory University School of Medicine, Decatur, GA USA
| | - Ellen Eisenberg
- Oral Health and Diagnostic Sciences, University of Connecticut Health, Farmington, CT USA
| | - Jasbir D. Upadhyaya
- Section of Diagnostic Sciences, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL USA
| | - Mark W. Lingen
- Department of Pathology, University of Chicago Medicine, Chicago, IL USA
| | - Nadarajah Vigneswaran
- Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Elizabeth A. Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA USA
| | - Roman Carlos
- Centro Clínico de Cabeza y Cuello, Patología División, Guatemala City, Guatemala
| | - Mohammed N. Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
| | - Marino E. Leon
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL USA
| | - James S. Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kelly R. Magliocca
- Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, VA USA
| | - Mitra Mehrad
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Bibianna Purgina
- Department of Pathology, University of Ottawa, Ottawa, Ontario Canada
| | - Mary Richardson
- Department of Pathology, MUSC Health-University Medical Center, Charleston, SC USA
| | - Bruce M. Wenig
- Department of Pathology, Moffitt Cancer Center, Tampa, FL USA
| | - Donald M. Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
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Li CC, Almazrooa S, Carvo I, Salcines A, Woo SB. Architectural Alterations in Oral Epithelial Dysplasia are Similar in Unifocal and Proliferative Leukoplakia. Head Neck Pathol 2020; 15:443-460. [PMID: 32939744 PMCID: PMC8134567 DOI: 10.1007/s12105-020-01216-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/21/2020] [Indexed: 12/15/2022]
Abstract
The current WHO histopathologic criteria for oral epithelial dysplasia (ED) are based on architectural and cytologic alterations, and do not address other histopathologic features of ED. Here we propose new diagnostic criteria including architectural, organizational, and cytologic features for oral ED. Cases of unifocal leukoplakia (UL) and proliferative leukoplakia (PL) with clinical photographs and follow-up information were identified. Only cases that showed minimal cytologic atypia or mild ED were used to demonstrate critical architectural changes as defined in this study. Eight biopsies from eight UL patients and 34 biopsies from four PL patients were included. The biopsies showed (a) corrugated, verrucous or papillary architecture, (b) hyperkeratosis with epithelial atrophy, (c) bulky squamous epithelial proliferation, and (d) demarcated hyperkeratosis and "skip" segments. The architectural alterations defined here are as important as the currently used criteria for the diagnosis of ED. Clinicopathologic correlation when diagnosing oral ED is also of the utmost importance in accurate diagnosis.
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Affiliation(s)
- Chia-Cheng Li
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA USA
| | - Soulafa Almazrooa
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ingrid Carvo
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA USA
| | - Alfonso Salcines
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA USA
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA USA ,Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Boston, MA USA ,Center for Oral Pathology, StrataDx Inc, Lexington, MA USA
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Ferreira L, Peng HH, Cox DP, Chambers DW, Bhula A, Young JD, Ojcius DM, Ramos-Junior ES, Morandini AC. Investigation of foreign materials in gingival lesions: a clinicopathologic, energy-dispersive microanalysis of the lesions and in vitro confirmation of pro-inflammatory effects of the foreign materials. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:250-267. [PMID: 31300373 DOI: 10.1016/j.oooo.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/26/2019] [Accepted: 04/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to evaluate the clinical and histopathologic features of gingival lesions containing foreign material (GLFMs). In parallel, the composition of the foreign material and its effects in primary human gingival fibroblasts (HGFs) were investigated. STUDY DESIGN Eighty-six GLFMs were retrieved from an oral pathology biopsy service. Clinical and microscopic data were analyzed, and the composition of the particles was identified by using energy-dispersive X-ray spectroscopy (EDX). Furthermore, HGFs were stimulated with silica (SiO2) microparticles to investigate the production of collagen type 1 (COL-1), matrix metalloproteinase 2 (MMP2), and inflammatory cytokines. RESULTS GLFMs were most commonly found in women (60.5%) and most frequently described as white plaques. Histopathologic examination identified verrucous hyperplasia in 59% and epithelial dysplasia in 28% of the cases. EDX microanalysis revealed that Si (94%) was the most frequently detected foreign element. SiO2 microparticles induced higher COL-1 expression; higher levels of proinflammatory cytokines, such as interleukin-6 (IL-6), IL-8, and transforming growth factor-β, and increased MMP-2 activity in HGFs. CONCLUSIONS There was a strong association between the presence of foreign material in the gingiva and white verrucous clinical lesions. In addition, the most common element in the foreign material was Si, and our in vitro findings demonstrate the importance of silica-mediated effects on gingival fibroblasts.
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Affiliation(s)
- Leticia Ferreira
- Department of Diagnostic Sciences, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | - Hsin-Hsin Peng
- Center for Molecular and Clinical Immunology, Chang Gung University, Taiwan; Laboratory Animal Center, Chang Gung Memorial Hospital, Taiwan
| | - Darren P Cox
- Department of Diagnostic Sciences, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - David W Chambers
- Department of Orthodontics, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Avni Bhula
- International Dental Studies Program, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA; Department of Oral and Maxillofacial Radiology, University of California, Los Angeles, CA, USA
| | - John D Young
- Center for Molecular and Clinical Immunology, Chang Gung University, Taiwan; Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - David M Ojcius
- Department of Biomedical Sciences, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Erivan S Ramos-Junior
- Department of Biomedical Sciences, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Ana Carolina Morandini
- Department of Biomedical Sciences, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
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12
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Oliva J, Larque A, Marti C, Bodalo‐Torruella M, Nonell L, Nadal A, Castillo P, Sieira R, Ferrer A, Garcia‐Diez E, Alos L. Oral premalignant lesions of smokers and non‐smokers show similar carcinogenic pathways and outcomes. A clinicopathological and molecular comparative analysis. J Oral Pathol Med 2019; 50:280-286. [DOI: 10.1111/jop.12864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Jorge Oliva
- Department of Pathology, Hospital Clínic, IDIBAPS University of Barcelona Barcelona Spain
| | - Ana‐Belen Larque
- Department of Pathology, Hospital Clínic, IDIBAPS University of Barcelona Barcelona Spain
| | - Carles Marti
- Department of Maxillofacial Surgery Hospital Clínic Barcelona Spain
| | - Marta Bodalo‐Torruella
- Microarray Analysis Service Institut Hospital del Mar d’InvestigacionsMèdiques (IMIM) Barcelona Spain
| | - Lara Nonell
- Microarray Analysis Service Institut Hospital del Mar d’InvestigacionsMèdiques (IMIM) Barcelona Spain
| | - Alfons Nadal
- Department of Pathology, Hospital Clínic, IDIBAPS University of Barcelona Barcelona Spain
| | - Paola Castillo
- Department of Pathology, Hospital Clínic, IDIBAPS University of Barcelona Barcelona Spain
| | - Ramón Sieira
- Department of Maxillofacial Surgery Hospital Clínic Barcelona Spain
| | - Ada Ferrer
- Department of Maxillofacial Surgery Hospital Clínic Barcelona Spain
| | - Eloy Garcia‐Diez
- Department of Maxillofacial Surgery Hospital Clínic Barcelona Spain
| | - Llucia Alos
- Department of Pathology, Hospital Clínic, IDIBAPS University of Barcelona Barcelona Spain
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13
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Koh J, Kurago ZB. Expanded Expression of Toll-Like Receptor 2 in Proliferative Verrucous Leukoplakia. Head Neck Pathol 2019; 13:635-642. [PMID: 30888638 PMCID: PMC6854203 DOI: 10.1007/s12105-019-01028-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
Proliferative verrucous leukoplakia (PVL) is a premalignant condition of the oral mucosa with > 70% chance of progression to squamous cell carcinoma (SCC), while lacking the common risks and behavior seen in non-PVL oral squamous carcinogenesis. PVL follows a multi-stage slow, relentless and usually multifocal expansion of surface epithelial thickening that over time takes on a verrucous architecture, eventually leading to verrucous carcinoma and/or dysplasia followed by "conventional" SCC, a process that takes years and is notoriously difficult to manage. As mucosal surfaces and carcinomas arising at these sites, are colonized by microorganisms, host receptors for microbial products have received attention as potential contributors to carcinogenesis. Studies show that microbial pattern recognition toll-like receptor (TLR)2 in various epithelial cells is upregulated in premalignant lesions and in malignant cells and can activate oncogenic pathways. Because of the highly progressive nature of PVL, we examined TLR2 expression in well-characterized PVL samples by immunohistochemistry. We found that, similar to epithelial dysplasia and SCC, PVL keratinocytes throughout the epithelial thickness showed diffuse TLR2 expression even in early stage lesions prior to onset of dysplasia. In contrast, oral mucosal samples in the absence of hyperorothokeratosis or dysplasia, expressed TLR2 primarily in the basal and parabasal layers. Given the high rates of PVL transformation and the previously established pro-cancer role of high TLR2 expression in malignant oral squamous cells, it is important to determine how its' expression and functions are regulated in the oral squamous epithelium, and what is the specific TLR2 role in carcinogenesis.
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Affiliation(s)
- Joon Koh
- Present Address: Dental College of Georgia, Augusta University, GC2250 1430 JW Gilbert Dr., Augusta, GA 30912 USA
| | - Zoya B. Kurago
- Present Address: Dental College of Georgia, Augusta University, GC2250 1430 JW Gilbert Dr., Augusta, GA 30912 USA ,Medical College of Georgia, Georgia Cancer Center, Augusta University, Augusta, GA USA
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14
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Müller S. Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:591-602. [PMID: 29606637 DOI: 10.1016/j.oooo.2018.02.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/28/2018] [Accepted: 02/19/2018] [Indexed: 02/06/2023]
Abstract
The term oral potentially malignant disorders (OPMDs) describes a recognizable group of mucosal diseases that have a risk of progressing to squamous cell carcinoma. Oral leukoplakia, the most common OPMD, has a 1% prevalence and reported malignant transformation rates of 2% to 5%. Other OPMDs include erythroplakia, erythroleukoplakia, submucous fibrosis, lesions of reverse smokers, and inherited genetic disorders, such as Fanconi anemia. The histopathologic assessment of OPMDs is an area of subjectivity, and oral epithelial dysplasia (OED) is fraught with both interrater variability and intrarater variability. Both architectural and cytologic changes are utilized when developing criteria for grading OED. However, the concept of atypical verrucous lesions, particularly as it pertains to proliferative verrucous leukoplakia, suffers from lack of histopathologic diagnostic criteria. Histopathologic mimics of OPMDs, including reactive/regenerative epithelium, frictional keratosis, and infection, can result in patient mismanagement. This review will focus specifically on the histologic features of OED, including human papillomavirus-associated dysplasia, as well as the histologic features of atypical verrucous keratoses/hyperplasia, particularly those that arise in the setting of proliferative verrucous leukoplakia along with OPMD mimics.
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Affiliation(s)
- Susan Müller
- Emory University School of Medicine, Atlanta Oral Pathology, Decatur, GA, USA.
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15
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Abstract
Oral potentially malignant disorders (OPMDs) refer to epithelial lesions and conditions with an increased risk for malignant transformation; oral leukoplakia is the most commonly encountered. Overall, OPMDs have a low risk for malignant transformation, yet the challenge is the difficulty to reliably identify and predict which patients with OPMDs are at the highest risk for malignant transformation. Future research is needed to elucidate the molecular aspects of OPMDs, to improve current diagnostic strategies, leading to personalized management.
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16
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Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol 2017; 30:S54-S67. [PMID: 28060366 DOI: 10.1038/modpathol.2016.121] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 12/25/2022]
Abstract
Oral lichen planus is a chronic inflammatory disease of unknown etiology or pathogenesis with varied disease severity that waxes and wanes over a long period of time. Although a common oral mucosal disease, accurate diagnosis is often challenging due to the overlapping clinical and histopathological features of oral lichen planus and other mucosal diseases. Other immune-mediated mucocutaneous diseases can exhibit lichenoid features including mucous membrane pemphigoid, chronic graft-versus-host disease, and discoid lupus erythematosus. Reactive changes to dental materials or to systemic medications can mimic oral lichen planus both clinically and histologically. In these situations the clinical presentation can be useful, as oral lichen planus presents as a multifocal process and is usually symmetrical and bilateral. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially premalignant features. Proliferative verrucous leukoplakia, an unusual clinical disease, can often mimic oral lichen planus clinically, requiring careful correlation of the clinical and pathologic features.
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17
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Flores IL, Santos-Silva AR, Coletta RD, Leme AFP, Lopes MA. Low expression of angiotensinogen and dipeptidyl peptidase 1 in saliva of patients with proliferative verrucous leukoplakia. World J Clin Cases 2016; 4:356-363. [PMID: 27900324 PMCID: PMC5112355 DOI: 10.12998/wjcc.v4.i11.356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/14/2016] [Accepted: 09/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To elucidate the profile of the salivary proteome.
METHODS Unstimulated whole mouth saliva was collected from 30 volunteers [15 proliferative verrucous leukoplakia (PVL) patients and 15 controls] and proteins were submitted for mass spectrometry-based proteomics using the discovery approach, followed by analyses of variance and logistic regression tests.
RESULTS A total of two hundred and eighty-three proteins were confidently identified in saliva. By combining two low abundance proteins from the PVL group, angiotensinogen (AGT) and dipeptidyl peptidase 1 (DPP1), a model for group differentiation was built with a concordance index of 94.2%, identifying both proteins as potential etiologic biomarkers for PVL.
CONCLUSION This study suggests that both AGT and DPP1 may be involved in developmental mechanisms of PVL.
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18
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Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:332-54. [PMID: 27401683 DOI: 10.1016/j.oooo.2016.05.004] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/26/2022]
Abstract
Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA.
| | - Alan Gould
- Louisville Oral Pathology Laboratory, Louisville, KY, USA
| | - Zoya Kurago
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Augusta University, Augusta, GA, USA
| | - John Fantasia
- Department of Dental Medicine, Hofstra North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA
| | - Susan Muller
- Professor Emeritus, Emory University School of Medicine, Atlanta, GA; Atlanta Oral Pathology, Decatur, GA, USA
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19
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Pseudoadenoid dysplasia in proliferative verrucous leukoplakia. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:198-200. [PMID: 26589076 DOI: 10.1016/j.oooo.2015.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/14/2015] [Accepted: 08/21/2015] [Indexed: 11/22/2022]
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20
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Montague L, Bhattacharyya I, Islam M, Cohen D, Fitzpatrick S. Direct immunofluorescence testing results in cases of premalignant and malignant oral lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:675-83. [DOI: 10.1016/j.oooo.2015.02.478] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/19/2015] [Accepted: 02/20/2015] [Indexed: 01/03/2023]
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21
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Kolude BM, Bouquot JE. Clinical pathologic conference case 3: A thick, granular white gingival plaque in an adult male. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:e279-84. [DOI: 10.1016/j.oooo.2014.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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22
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Vigneswaran N, Williams MD. Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofac Surg Clin North Am 2015; 26:123-41. [PMID: 24794262 DOI: 10.1016/j.coms.2014.01.001] [Citation(s) in RCA: 521] [Impact Index Per Article: 57.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Head and neck squamous cell carcinoma is the sixth most common cancer worldwide predominately associated with tobacco use. Changing cause and increased incidence in oropharyngeal carcinomas is associated with high-risk types of human papilloma virus and has an improved survival. Optical devices may augment visual oral examination; however, their lack of specificity still warrants tissue evaluation/biopsy. Histologic factors of oral carcinomas are critical for patient management and prognostic determination. Clinical biomarkers are still needed to improve early detection, predict malignant transformation, and optimize therapies.
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Affiliation(s)
- Nadarajah Vigneswaran
- Oral and Maxillofacial Pathology Biopsy Service, The University of Texas School of Dentistry at Houston, 1941 East Road BBSB, Room 5320, Houston, TX 77054, USA.
| | - Michelle D Williams
- Surgical Pathology Fellowship Program, Head & Neck Section, Department of Pathology, UT MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit #085, Houston, TX 77030, USA
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23
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Hellebust A, Rosbach K, Wu JK, Nguyen J, Gillenwater A, Vigneswaran N, Richards-Kortum R. Vital-dye-enhanced multimodal imaging of neoplastic progression in a mouse model of oral carcinogenesis. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:126017. [PMID: 24362926 PMCID: PMC3869894 DOI: 10.1117/1.jbo.18.12.126017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/20/2013] [Indexed: 05/09/2023]
Abstract
In this longitudinal study, a mouse model of 4-nitroquinoline 1-oxide chemically induced tongue carcinogenesis was used to assess the ability of optical imaging with exogenous and endogenous contrast to detect neoplastic lesions in a heterogeneous mucosal surface. Widefield autofluorescence and fluorescence images of intact 2-NBDG-stained and proflavine-stained tissues were acquired at multiple time points in the carcinogenesis process. Confocal fluorescence images of transverse fresh tissue slices from the same specimens were acquired to investigate how changes in tissue microarchitecture affect widefield fluorescence images of intact tissue. Widefield images were analyzed to develop and evaluate an algorithm to delineate areas of dysplasia and cancer. A classification algorithm for the presence of neoplasia based on the mean fluorescence intensity of 2-NBDG staining and the standard deviation of the fluorescence intensity of proflavine staining was found to separate moderate dysplasia, severe dysplasia, and cancer from non-neoplastic regions of interest with 91% sensitivity and specificity. Results suggest this combination of noninvasive optical imaging modalities can be used in vivo to discriminate non-neoplastic from neoplastic tissue in this model with the potential to translate this technology to the clinic.
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Affiliation(s)
- Anne Hellebust
- Rice University, Department of Bioengineering, 6100 Main Street, Houston, MS-142, Texas 77005
| | - Kelsey Rosbach
- Rice University, Department of Bioengineering, 6100 Main Street, Houston, MS-142, Texas 77005
| | - Jessica Keren Wu
- University of Texas Dental Branch at Houston, Department of Diagnostic and Biomedical Sciences, 7500 Cambridge Street, Houston, Texas 77054
| | - Jennifer Nguyen
- University of Texas Dental Branch at Houston, Department of Diagnostic and Biomedical Sciences, 7500 Cambridge Street, Houston, Texas 77054
| | - Ann Gillenwater
- University of Texas, M.D. Anderson Cancer Center, Department of Head and Neck Surgery, 1515 Holcombe Boulevard, Unit 441, Houston, Texas 77030
| | - Nadarajah Vigneswaran
- University of Texas Dental Branch at Houston, Department of Diagnostic and Biomedical Sciences, 7500 Cambridge Street, Houston, Texas 77054
| | - Rebecca Richards-Kortum
- Rice University, Department of Bioengineering, 6100 Main Street, Houston, MS-142, Texas 77005
- Address all correspondence to: Rebecca Richards-Kortum, E-mail:
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