Brunno Santos de Freitas Silva1,2, Danielle Coelho Ribeiro Batista3, Camila Ferro de Souza Roriz3, Lorena Rosa Silva4, Ana Gabriela Costa Normando5, Alan Roger Dos Santos Silva5, Maria Alves Garcia Silva4, Fernanda Paula Yamamoto-Silva4. 1. Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Av. Primeira Avenida, s/n. Setor Leste Universitário, Goiânia, GO, CEP 74605-020, Brazil. brunno.santosfreitas@gmail.com. 2. University of Anápolis, Anápolis, GO, Brazil. brunno.santosfreitas@gmail.com. 3. School of Dentistry, University of Anápolis, Anápolis, GO, Brazil. 4. Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Av. Primeira Avenida, s/n. Setor Leste Universitário, Goiânia, GO, CEP 74605-020, Brazil. 5. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Abstract
OBJECTIVES: The aim of this systematic review was to examine the evidence of the binary histologic grading system capacity for predicting malignant transformation and to compare it with that of the WHO systems. MATERIAL AND METHODS: A systematic review was conducted, using PubMed, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO databases without any language or timeframe restrictions. Studies were included if they compared the binary and the WHO histologic grading systems in the prediction of malignant transformation of oral epithelial dysplasia (OED). RESULTS: The capacity of the WHO and binary grading systems to predict malignant transformation ranged from 16 to 80% and from 5 to 80%, respectively. The pooled malignant transformation rate of lesions classified as severe dysplasia or carcinoma in situ by the WHO grading was 40% (95% confidence interval (CI), 0.02-0.87; I2 = 92%; P = 0.00), while the corresponding value for lesions classified as high-risk by the binary grading system was 31% (95% CI, 0.00-0.84; I2 = 97%; P = 0.00). Overall, there was no significant difference in prognostication accuracy between the WHO and the binary systems (odds ratio = 2.02; 95% CI, 0.88-4.64). CONCLUSIONS: Although some studies suggest that the binary system is associated with lower inter-rater variability when grading OED, the evidence remains inconclusive on whether this system is superior to that of the WHO at predicting malignant transformation. CLINICAL RELEVANCE: The reproducibility of the binary system has the potential to be better for prognostic purposes. However, there is no high-quality evidence to confirm if this advantage may assist clinicians in decision-making.
OBJECTIVES: The aim of this systematic review was to examine the evidence of the binary histologic grading system capacity for predicting malignant transformation and to compare it with that of the WHO systems. MATERIAL AND METHODS: A systematic review was conducted, using PubMed, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO databases without any language or timeframe restrictions. Studies were included if they compared the binary and the WHO histologic grading systems in the prediction of malignant transformation of oral epithelial dysplasia (OED). RESULTS: The capacity of the WHO and binary grading systems to predict malignant transformation ranged from 16 to 80% and from 5 to 80%, respectively. The pooled malignant transformation rate of lesions classified as severe dysplasia or carcinoma in situ by the WHO grading was 40% (95% confidence interval (CI), 0.02-0.87; I2 = 92%; P = 0.00), while the corresponding value for lesions classified as high-risk by the binary grading system was 31% (95% CI, 0.00-0.84; I2 = 97%; P = 0.00). Overall, there was no significant difference in prognostication accuracy between the WHO and the binary systems (odds ratio = 2.02; 95% CI, 0.88-4.64). CONCLUSIONS: Although some studies suggest that the binary system is associated with lower inter-rater variability when grading OED, the evidence remains inconclusive on whether this system is superior to that of the WHO at predicting malignant transformation. CLINICAL RELEVANCE: The reproducibility of the binary system has the potential to be better for prognostic purposes. However, there is no high-quality evidence to confirm if this advantage may assist clinicians in decision-making.
Authors: Paul Nankivell; Hazel Williams; Paul Matthews; Sari Suortamo; David Snead; Christopher McConkey; Hisham Mehanna Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2013-01
Authors: Nikolaos G Nikitakis; Monica Pentenero; Maria Georgaki; Catherine F Poh; Douglas E Peterson; Paul Edwards; Mark Lingen; John J Sauk Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2018-04-04
Authors: Barnaby G Ellis; Conor A Whitley; Asterios Triantafyllou; Philip J Gunning; Caroline I Smith; Steve D Barrett; Peter Gardner; Richard J Shaw; Peter Weightman; Janet M Risk Journal: PLoS One Date: 2022-03-25 Impact factor: 3.240