Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jason T.K. Hwang, Ying R. Gu, Mi Shen, Ranju Ralhan, Paul G. Walfish, Kenneth P.H. Pritzker, David Mock
ObjectiveThe standard of care for pre-malignant lesion risk assessment is dysplasia grading by histopathology. With significant overlap between dysplasia grades and high inter- and intra-observer variations, histopathology dysplasia grading alone is not a useful prognostic tool. Our aim is to investigate if a method for quantitatively assessing S100A7, a prognostic biomarker, using image analysis, can better predict clinical outcome in cases with oral dysplasia.Study DesignUsing Visiopharm image analysis system, we analyzed a cohort of 150 oral biopsy samples to build and test StraticyteTM, a model for an individualized assessment of the 5-year risk of progression of oral pre-cancerous lesions to invasive squamous cell carcinoma.ResultsStraticyte classified lesions more accurately than histopathological dysplasia grading for risk to progress to cancer over the following five years. The sensitivity of low-risk vs intermediate- and high-risk Straticyte groups was 95% compared to 75% for mild vs moderate and severe dysplasia. Further, the Negative Predictive Value for low-risk vs intermediate- and high-risk Straticyte groups was 78% compared to 59% for mild vs moderate and severe dysplasia.ConclusionBy quantitatively assessing S100A7, Straticyte better defines the risk for developing oral squamous cell carcinoma then histopathological dysplasia grading alone.