Malignant development in patients with oral potentially malignant disorders detected through nationwide screening: Outcomes of 5‐year follow‐up at a single hospital

Chiang, Wei‐Fan; Liu, Shyun‐Yeu; Lin, Jen-Fen; Chiu, Sheng‐Fu; Gou, Shin‐Bin; Chiou, Chang‐Ta; Chang, Chi-Hua

doi:10.1002/hed.25973

Cited by 30 publications

(37 citation statements)

References 38 publications

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“…The oral cavity, which serves as a point of entry, a site for breakdown and tasting of food, and a sound resonance chamber, is unavoidably destroyed by surgery, possibly compromising the functions of swallowing, pronunciation, and chewing. Early diagnosis of OSCC is of paramount importance since patients who receive early treatment may show less functional morbidity, less cosmetic disfiguration, and lower cost of care and have a better outcome and higher quality of life postoperatively [ 5 – 7 ]. Although OSCC can develop de novo, various studies have established that most oral cancers are preceded by some visible clinical changes on the oral mucosa, or potentially malignant lesions [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

et al. 2021

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Objectives The tongue is identified as a high-risk site for oral leukoplakia and malignant transformation. The purpose of this study is to investigate the clinicopathological characteristics and treatment outcomes of tongue leukoplakia and assess the factors related to recurrence and malignant transformation. Materials and methods One hundred and forty-four patients who received carbon dioxide laser surgery for tongue leukoplakia from 2002 to 2019 were analyzed statistically. Results The follow-up period was 54.90 ± 54.41 months. Thirty patients showed postoperative recurrence (20.83%), and 12 patients developed malignant transformation (8.33%). The annual transformation rate was 2.28%. Univariate analysis showed that a history of head and neck cancer, size of lesion area, clinical appearance, and pathology were significant factors for both recurrence and malignant transformation. In the multivariate logistic regression, a history of head and neck cancer and size of lesion area were independent prognostic factors for recurrence, and a history of head and neck cancer was the only independent factor for postoperative malignant change. Conclusions Clinicians should adopt more aggressive strategies for tongue leukoplakia patients with a history of head and neck cancer. Clinical relevance These results may help clinicians gain a better understanding of oral tongue leukoplakia.

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Section: Introductionmentioning

confidence: 99%

Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

et al. 2021

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“…Another study was conducted in a high-occurrence region within a single hospital in southern Taiwan, in which 555 individuals with OPMDs during a 5 year-period were examined for the relationship of its clinicopathological features and transformation. In this study, the annual malignant transformation rate was 1.16%, specifically for OSF, and that for homogenous leukoplakia and nonhomogenous leukoplakia was 5.7%, 4.6%, and 12.1%, respectively [39]. A well-designed surveillance program could lead to early malignancy detection and reduced mortality and morbidity.…”

Section: Plos Onementioning

confidence: 60%

“…Risk factors for OPMDs differ by country and region, and in Taiwan, the most common OPMDs are leukoplakia, erythroplakia, and oral submucous fibrosis [11][12][13]. The majority of these disorders may be asymptomatic in the early years but can be detected by dental clinicians during routine oral examinations [14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the accuracy of diagnoses of oral potentially malignant disorders with dysplasia by a general dental clinician and a specialist using the Taiwanese Nationwide Oral Mucosal Screening Program

Chiang

Lin

et al. 2021

PLoS ONE

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Screening for oral potentially malignant disorders (OPMDs) with dysplasia in high-risk groups is suggested in countries with a high prevalence of the disorders. This study aimed to compare the accuracy of diagnoses of OPMDs with dysplasia made by a primary examiner (general dental clinician) and a specialist (oral and maxillofacial surgeon) using the current Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP). A total of 134 high-risk participants were enrolled for oral mucosal screening via the TNOMSP. A primary examiner and a specialist examined each participant. Mucosal biopsies were obtained and subjected to histopathological analysis. The OPMD most frequently diagnosed by the primary examiner was thin homogeneous leukoplakia (48/134; 35.8%), and in 39/134 participants (29.1%) the diagnosis was uncertain, but abnormalities were suggested. The OPMDs most frequently diagnosed by the specialist were erythroleukoplakia (23/134; 17.2%) and thin homogeneous leukoplakia (21/134; 15.7%), and 51/134 participants (38.1%) were diagnosed with other diseases. Via histopathology, 70/134 participants (52.3%) were diagnosed with dysplasia, and 58/134 (43.3%) were diagnosed with benign conditions. The specialist’s diagnoses exhibited a higher specificity, positive predictive value, and accuracy than the primary examiners. A specialist using the current TNOMSP for high-risk participants diagnosed OPMDs with dysplasia more accurately than a primary examiner. Early diagnosis of high-risk OPMDs is crucial in countries with a high prevalence of the disorders. Proficient examination via the current TNOMSP by trained clinician is effective for the management of OPMDs with dysplasia.

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“…OPMD describes a diverse group of conditions, including leukoplakia, erythroplakia, oral submucous brosis, and oral verrucous hyperplasia (OVH), that may precede OSCC development [6]. The presence of OPMD signi es a risk of malignant transformation, though the transformation rate varies, ranging from less than 1% to over 30% [6,7]. Smoking, alcohol, and betel quid chewing are major risk factors [8].…”

Section: Introductionmentioning

confidence: 99%

“…Smoking, alcohol, and betel quid chewing are major risk factors [8]. OVH is one of the most common precancers observed in the oral cavity of betel quid chewers and has the highest transformation rate (up to 21.3%) [6,7]. Therefore, it is crucial to identify prognostic factors for OSCC development in OPMDs, and saliva can serve as a non-invasive source of biological signatures for OSCC [9].…”

Section: Introductionmentioning

confidence: 99%

Functional Profiling of Saliva Microbiome is Essential for Oral Cancer Prediction

Chen¹,

Chiang²,

Wu³

et al. 2020

Preprint

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Background: The association between microbiome and host disease has been documented in oral cancer, one of the leading cancers worldwide. Huge efforts are made to use the profile of oral microbiome and distinct signature species as markers to distinguish oral cancer patients from healthy individuals. The previous results, however, remain inconclusive. The assembly mechanisms of oral microbiome and their response to changes in oral carcinogenesis also have not been characterized. Here, using 16S rRNA gene amplicon sequencing and in-silico function prediction approaches, we analyzed the saliva microbiome in cohorts of orally healthy, oral verrucous hyperplasia, and oral cancer at taxon and function levels, and compared their corresponding predictive performance of oral cancer using machine learning algorithms.Results: Analyses of diversity and phylogenetic profiles of bacterial communities in saliva showed that microbiome dysbiosis was significantly linked to oral health status. As oral health deteriorated, the number of core species (>75% prevalence) as a percentage of overall species richness declined. In line with the null model-based analysis, taxonomic and functional assemblies of saliva microbiomes were primarily governed by the stochastic processes. Correspondingly, the quantitative assessment of partitioned beta-diversity suggested extremely high species turnover but low function turnover, revealing a functional redundancy of the oral ecosystem. Functional beta-diversity in salvia microbiome shifted from turnover to nestedness during carcinogenesis of oral verrucous hyperplasia, but this pattern was not observed at the taxon level. Moreover, using both taxon and function data as training features for machine learning-aided prediction on host health status supports a superior predictive performance when using functional profiling. Similar results were also obtained and validated using publicly accessible data.Conclusions: Our results suggest that altered oral bacterial communities are highly associated with carcinogenesis of oral verrucous hyperplasia. Partly owing to high taxonomic turnover and stochastic assembly processes of the oral ecosystem, discovering oral microbial consortia as universal biomarkers for oral cancer may prove difficult and arduous. Functional profiles are relatively stable and evolve a nestedness pattern during oral carcinogenesis, serving as a new benchmark to study the interplay of the oral microbiome and host health in the future.

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Malignant development in patients with oral potentially malignant disorders detected through nationwide screening: Outcomes of 5‐year follow‐up at a single hospital

Cited by 30 publications

References 38 publications

Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

Comparison of the accuracy of diagnoses of oral potentially malignant disorders with dysplasia by a general dental clinician and a specialist using the Taiwanese Nationwide Oral Mucosal Screening Program

Functional Profiling of Saliva Microbiome is Essential for Oral Cancer Prediction

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