AgNOR count as objective marker for dysplastic features in oral leukoplakia

Area of Science:

• Oral pathology
• Oncology
• Histopathology

Background:

• Leukoplakia diagnosis is subjective, lacking inter-observer agreement.
• Dysplasia is a key feature of leukoplakia, necessitating objective diagnostic markers.
• Silver stainable nucleolar organizer regions (AgNORs) are replicatory markers with potential for objective dysplasia characterization.

Purpose of the Study:

• To evaluate the utility of mean AgNOR counts in objectively diagnosing oral dysplasia.
• To determine if AgNOR counts can differentiate between dysplastic and non-dysplastic leukoplakia.
• To establish a cut-point for AgNOR counts to aid in leukoplakia diagnosis.

Main Methods:

• Analysis of mean AgNOR counts in normal oral epithelia, dysplastic and non-dysplastic leukoplakia, and squamous cell carcinoma.
• Statistical analysis including Receiver Operating Characteristic (ROC) curve analysis.
• Determination of sensitivity, specificity, and area under the curve for AgNOR count cut-points.

Main Results:

• Mean AgNOR counts showed a progressive increase from normal epithelium to squamous cell carcinoma.
• A cut-point of 2.37 for mean AgNOR count was identified to distinguish dysplastic from non-dysplastic leukoplakia.
• The established cut-point demonstrated 75% sensitivity and 83% specificity, with an 88% area under the curve.

Conclusions:

• Mean AgNOR count serves as a valuable objective criterion for diagnosing oral dysplasia.
• AgNOR counts can effectively differentiate between dysplastic and non-dysplastic leukoplakia.
• This method offers improved diagnostic objectivity for oral lesions.