Epithelial Dysplasia in Actinic Cheilitis: Microscopic Study of 70 Cases from Brazil

AbstractTo compare two grading systems of epithelial dysplasia —World Health Organization (WHO) and binary system (BS) –in actinic cheilitis (AC). Seventy cases diagnosed as AC in an Oral Pathology Laboratory from Brazil in the last 12 years were retrospectively retrieved, including the demographic data of each patient. All conventionally stained slides we re reviewed, and epithelial dysplasia was evaluated by two independent observers using both WHO and BS grading systems. Data correlation was performed using kappa and chi-square tests (p <  0.05). Most patients were white men with a mean age of 57 years old and history of chronic exposure to sunlight. Most of the lesions were clinically described as whitish plaques with irregular surface located in the lower lip semi-mucosa. Most cases were microscopically graded as severe epitheli al dysplasia and low-risk by both observers. The interobserver and intraobserver agreement between systems was slight. All reddish lesions were graded as severe epithelial dysplasia, showing an equal distribution between low and high-risk grading. Most ulcerated lesions showed severe epithelial dysp lasia but was graded as low-risk of malignant transformation. Statistical significance was observed among the presence of “irregular stratification”, severe epithelial dysplasia and high-risk lesions (p <  0.05) likewise among the presence of “loss of polarity of basal cells” and “drop-shaped ridges” (p <  0.05) ...
Source: Head and Neck Pathology - Category: Pathology Source Type: research