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Dysplasia of the upper aerodigestive tract squamous epithelium.

Eversole LR - Head Neck Pathol (2009)

Bottom Line: Cytologically atypical cells are considered to represent precancerous changes predicting an increase risk for carcinomatous transformation.Inter- and intra-rater reliability studies among pathologists have disclosed low correlation coefficients for four part grading systems, whereas improved agreement is achieved (kappa correlation values) using the Ljubljana systems.Loss of heterozygosity (LOH) at 3p and 9p microsatellite domains, DNA ploidy analysis and nuclear image analyses may have predictive value as molecular and histomorphological biomarkers.

View Article: PubMed Central - PubMed

Affiliation: Oral Pathology Diagnostic Services, 4945 Mercury Street, San Diego, CA 92111, USA. lrebge@aol.com

ABSTRACT
Dysplasia of the oral, laryngeal and oropharyngeal stratified squamous epithelia is a microscopically defined change that may occur in clinically identifiable lesions including erythroplakia, leukoplakia and erythroleukoplakia, lesions that convey a heightened risk for carcinomatous progression. Dysplastic lesions have been classified microscopically according to degree of cytologic atypia and changes in architectural patterns, usually on a three part or four part gradation scale. Vocal cord epithelial lesions are graded according to either the Ljubljana or the World Health Organization (WHO) system whereas oral dysplasias are generally classified according to WHO criteria. Cytologically atypical cells are considered to represent precancerous changes predicting an increase risk for carcinomatous transformation. Inter- and intra-rater reliability studies among pathologists have disclosed low correlation coefficients for four part grading systems, whereas improved agreement is achieved (kappa correlation values) using the Ljubljana systems. Evidence forwarded by some studies supports the prognostic value of progressively severe dysplastic changes for carcinomatous transformation; however, some studies indicate that the presence of a clinically defined lesion without microscopic evidence of dysplasia also connotes increased risk for carcinomatous transformation. Loss of heterozygosity (LOH) at 3p and 9p microsatellite domains, DNA ploidy analysis and nuclear image analyses may have predictive value as molecular and histomorphological biomarkers.

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Related in: MedlinePlus

The WHO grading system for oral and laryngeal precancerous lesions. a. Benign hyperplasia (benign keratosis), b. mild dysplasia, c. moderate dysplasia, d. severe dysplasia, e. carcinoma in situ
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Fig1: The WHO grading system for oral and laryngeal precancerous lesions. a. Benign hyperplasia (benign keratosis), b. mild dysplasia, c. moderate dysplasia, d. severe dysplasia, e. carcinoma in situ

Mentions: Low grade dysplasia is defined as cytologic and architectural atypia confined to the basal/parabasal layer; moderate dysplasia is characterized by atypical changes progressing into the mid spinous layer and severe dysplasia progresses into the upper spinous layer (Fig. 1). Carcinoma in situ is characterized by atypical changes from top to bottom. Many pathologists collapse severe dysplasia and carcinoma-in situ into a single category. Some pathologists have applied the cervical dysplasia paradigm to upper airway lesions: oral intraepithelial neoplasia (OIN 1, 2 and 3) or squamous intraepithelial neoplasia (SIN 1, 2 and 3) [7].Fig. 1


Dysplasia of the upper aerodigestive tract squamous epithelium.

Eversole LR - Head Neck Pathol (2009)

The WHO grading system for oral and laryngeal precancerous lesions. a. Benign hyperplasia (benign keratosis), b. mild dysplasia, c. moderate dysplasia, d. severe dysplasia, e. carcinoma in situ
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2807542&req=5

Fig1: The WHO grading system for oral and laryngeal precancerous lesions. a. Benign hyperplasia (benign keratosis), b. mild dysplasia, c. moderate dysplasia, d. severe dysplasia, e. carcinoma in situ
Mentions: Low grade dysplasia is defined as cytologic and architectural atypia confined to the basal/parabasal layer; moderate dysplasia is characterized by atypical changes progressing into the mid spinous layer and severe dysplasia progresses into the upper spinous layer (Fig. 1). Carcinoma in situ is characterized by atypical changes from top to bottom. Many pathologists collapse severe dysplasia and carcinoma-in situ into a single category. Some pathologists have applied the cervical dysplasia paradigm to upper airway lesions: oral intraepithelial neoplasia (OIN 1, 2 and 3) or squamous intraepithelial neoplasia (SIN 1, 2 and 3) [7].Fig. 1

Bottom Line: Cytologically atypical cells are considered to represent precancerous changes predicting an increase risk for carcinomatous transformation.Inter- and intra-rater reliability studies among pathologists have disclosed low correlation coefficients for four part grading systems, whereas improved agreement is achieved (kappa correlation values) using the Ljubljana systems.Loss of heterozygosity (LOH) at 3p and 9p microsatellite domains, DNA ploidy analysis and nuclear image analyses may have predictive value as molecular and histomorphological biomarkers.

View Article: PubMed Central - PubMed

Affiliation: Oral Pathology Diagnostic Services, 4945 Mercury Street, San Diego, CA 92111, USA. lrebge@aol.com

ABSTRACT
Dysplasia of the oral, laryngeal and oropharyngeal stratified squamous epithelia is a microscopically defined change that may occur in clinically identifiable lesions including erythroplakia, leukoplakia and erythroleukoplakia, lesions that convey a heightened risk for carcinomatous progression. Dysplastic lesions have been classified microscopically according to degree of cytologic atypia and changes in architectural patterns, usually on a three part or four part gradation scale. Vocal cord epithelial lesions are graded according to either the Ljubljana or the World Health Organization (WHO) system whereas oral dysplasias are generally classified according to WHO criteria. Cytologically atypical cells are considered to represent precancerous changes predicting an increase risk for carcinomatous transformation. Inter- and intra-rater reliability studies among pathologists have disclosed low correlation coefficients for four part grading systems, whereas improved agreement is achieved (kappa correlation values) using the Ljubljana systems. Evidence forwarded by some studies supports the prognostic value of progressively severe dysplastic changes for carcinomatous transformation; however, some studies indicate that the presence of a clinically defined lesion without microscopic evidence of dysplasia also connotes increased risk for carcinomatous transformation. Loss of heterozygosity (LOH) at 3p and 9p microsatellite domains, DNA ploidy analysis and nuclear image analyses may have predictive value as molecular and histomorphological biomarkers.

Show MeSH
Related in: MedlinePlus