Figure 1 - available via license: Creative Commons Attribution 4.0 International
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Overview of the workflow of oral potentially malignant disorder (OPMD) patients. (A) The sketch map of the current study. (B) Representative clinical manifestation. The outside DNA index (DI) values determined by DNA-image cytometry, and histopathology of 2 cases of OPMD. A case of a non-homogenous OPMD lesion with DI ≥ 3.5 was determined to be an oral carcinoma. (C) A case of a homogenous
Source publication
Objective:
To elucidate whether DNA aneuploidy was an independent discriminator for carcinoma within oral potentially malignant disorders (OPMDs), and further establish and validate a risk model based on DNA aneuploidy for the detection of oral cancer.
Methods:
A total of 810 consecutive patients with OPMD were prospectively enrolled from March...
Contexts in source publication
Context 1
... DNA-ICM device and cytobrush kit are shown in Supplementary Figure S1. The DNA content status was analyzed using ICM as previously described 17,18 and in accordance with the manufacturer's protocol (MotiSavant). ...
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Background
Oral cancer encompasses all malignancies that originate in the oral tissues and remains a major public health problem throughout the world as an important case of poor health and illness. Head and neck cancer accounts for 9.8% of the estimated 6,44,600 incidental cancer cases in India. Oral Squamous Cell Carcinoma (SCC) is a serious and...
Citations
... 4 Furthermore, we established a risk model based on DNA aneuploidy that consisted of a noninvasive strategy with lateral/ventral tongue and non-homogeneous features. 5 Currently, the relationship between DNA aneuploidy and the clinicopathological risk factors of OPMDs, including smoking, patient age, lesion site, and dysplasia, are unclear. 6 To date, reports in the literature should be considered preliminary due to the small sample sizes and different methods (image cytometry or flow cytometry) used to measure aneuploidy. ...
... The clinical and histological diagnoses of the enrolled OPMD patients were based on the definition and criteria described previously. 4,5 Our series enrolled 810 patients, including 748 cases of general OPMDs and 62 cases of OPMD concomitant OSCCs. 4,5 The current study focused on the 748 cases of general OPMDs and excluded the 62 cases of OPMD concomitant OSCCs. ...
... 4,5 Our series enrolled 810 patients, including 748 cases of general OPMDs and 62 cases of OPMD concomitant OSCCs. 4,5 The current study focused on the 748 cases of general OPMDs and excluded the 62 cases of OPMD concomitant OSCCs. As our described previously, 4,5 oral brushing (Oral cytobrush kits; CytoSavant, Motic Inc., Xiamen, China) and biopsy samples taken from each subject were processed by DNA image cytometer (MotiSavant, Motic Inc., Xiamen, China) and histopathological examination, respectively. ...
Our previous study reported that clinical features, including the lateral/ventral tongue and non-homogeneous lesions, were associated with increased risk of malignant changes in cytological samples from oral potentially malignant disorders (OPMDs). This cross-sectional study aimed to evaluate the frequency and risk of DNA aneuploidy in the series of 748 patients with OPMD. The cut-off value of aneuploidy was defined as DNA index ≥3.5. We found that the frequency of DNA aneuploidy was higher in OPMD patients >60 years old, and in those with lateral/ventral tongue sites, non-homogeneous lesions, and high-grade dysplasia, than in control group (P < 0.01). Consistently, the risk of aneuploidy occurrence was higher in patients >60 years old (1.69-fold; P = 0.022), in those with lateral/ventral tongue sites (2.35-fold; P < 0.001), and in those with high-grade dysplasia (3.19-fold; P < 0.001). Collectively, increased frequency and risk of DNA aneuploidy occurred in OPMD patients aged over 60 years with high-grade dysplasia located at the lateral/ventral tongue. These patients should be required to intensive management and follow-up.
A BSTRACT
Malignant and potentially malignant epithelial lesions are often associated with various abnormalities such as epithelial dysplasia, abnormal DNA content, loss of heterozygosity, and chromosomal number aberrations. Screening and early detection of such abnormalities facilitates proper care and also helps to prevent further progression of potentially malignant lesions to malignancy. In such way, the presence of DNA aneuploidy in oral potentially malignant disorders (OPMDs) may serve as an indicator for the malignant transforming potential. Various assessment methods have been proposed to find the DNA ploidy status of cells. This current systematic review is mainly designed to assess the importance of ploidy status in OPMD while measuring the feasibility of using this biomarker for evaluating the hazard of malignant transformation. As an upshot of this systematic review, we can conclude that use of DNA ploidy status can serve as an independent bio-marker for predicting the malignant transformation of lesions. Furthermore, as a future scope the use of DNA ploidy analysis in normal mucosa of smokers will help to assess the malignancy risk and this technique might also help to predict the genetic predisposition of patients with malignancy.
Background
There is few longitudinal study on oral potentially malignant disorder (OPMDs) focusing on oral leukoplakia (OLK) with clinical endpoints to investigate the role of autofluorescence imaging (AFI) for surveilling the malignant transformation.
Methods
Based on our previous prospective diagnostic study enrolled 517 OPMD patients, 184 OLK patients were retrieved to further investigate the role of AFI using VELscope in predicting malignant transformation. During a median follow-up period of 44 months, 19 (10.33%) developed into oral cancer.
Results
OLK patients were divided into loss of autofluorescence (LAF, n = 124) and retention of autofluorescence (RAF, n = 60) groups according to the results of AFI. Interestingly, difference between malignant transformation rate (MTR, 14.52%) of group LAF and overall MTR (10.33%) was not significant, but MTR (1.67%) of group RAF was significantly lower than overall MTR. Kaplan-Meier and Cox-regression analyses revealed that LAF could not directly distinguish the high-risk lesions, but RAF significantly discriminate the low-risk lesions. Importantly, time-dependent ROC curve analysis found that the sensitivity and negative predictive value (NPV) of AFI for the prediction of malignant transformation was 100% and 100% (2-year follow-up), 94.7% and 98.3% (5-year follow-up), respectively. Also, calibration curve and decision curve analyses showed high levels of predictive value and clinical relevance.
Conclusion
This follow-up cohort study firstly evaluated AFI using VELscope for risk stratification of OLK malignant transformation. Whether conservative management is appropriate for OLK patients with RAF imaging due to minimal rate and risk of malignant transformation and great specificity and NPV is required to be further investigated.
Background: Early identification of the stage of oral cancer development can lead to better treatment outcomes and avoid malignant transformation. Therefore, this review aims to provide a comprehensive overview that describes the development of standardized procedures for oral sample collection, characterization, and molecular risk assessment. This can help investigators to choose the appropriate sampling method and downstream analyses for different purposes. Methods: This systematic review was conducted according to the PRISMA guidelines. Using both PubMed and Web of Science databases, four independent authors conducted a literature search between 15 and 21 June 2021. We used key search terms to broaden the search for studies. Non-conforming articles were removed using an EndNote-based and manual approach. Reviewers used a designed form to extract data. Results: This review included a total of 3574 records, after eliminating duplicate articles and excluding papers that did not meet the inclusion criteria. Finally, 202 articles were included in this review. We summarized the sampling methods, biopsy samples, and downstream analysis. The biopsy techniques were classified into tissue and liquid biopsy. The common sequential analysis of tissue biopsy includes histopathological examination such as H&E or IHC to identify various pathogenic features. Meanwhile, liquid samples such as saliva, blood, and urine are analyzed for the purpose of screening to detect mutations in cancer. Commonly used technologies are PCR, RT-PCR, high-throughput sequencing, and metabolomic analysis. Conclusions: Currently, tissue biopsies provide increased diagnostic value compared to liquid biopsy. However, the minimal invasiveness and convenience of liquid biopsy make it a suitable method for mass screening and eventual clinical adoption. The analysis of samples includes histological and molecular analysis. Metabolite analysis is rising but remains scarce.
We read with interest the recent review article by Odell (2021) entitled “Aneuploidy and loss of heterozygosity as risk markers for malignant transformation in oral mucosa”. The author clearly summarized the association of DNA aneuploidy in formalin‐fixed paraffin‐embedded biopsy samples with the development of oral squamous cell carcinomas (OSCCs) in oral potentially malignant disorders (OPMDs). The author also suggested that using DNA aneuploidy from cytological samples in combination with dysplasia grading and clinical features might be a good indicator of OPMD progression. However, whether DNA‐aneuploidy cytology significantly correlates with distinctive features of OPMDs remains unclear.
