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Published on: November 2, 2013
Oral premalignant lesions: is a biopsy reliable?
P Holmstrup1, P Vedtofte, J Reibel
1Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark. ph@odont.ku.dk
Summary
Biopsies of oral premalignant lesions like leukoplakia and erythroplakia may not fully represent the entire lesion. Histopathological findings of the whole lesion did not predict future malignant development after surgery.
Area of Science:
- Oral pathology
- Oncology
- Surgical pathology
Background:
- Oral premalignant lesions, including leukoplakia and erythroplakia, require accurate histopathological assessment for risk stratification.
- Understanding the representativeness of biopsy findings is crucial for predicting malignant transformation.
Purpose of the Study:
- To evaluate if biopsy histopathology accurately reflects the entire surgically removed oral premalignant lesion.
- To determine if histopathological characteristics of the whole lesion predict post-surgical malignant development.
Main Methods:
- Retrospective analysis of 101 oral lesions (leukoplakia, erythroplakia) from 96 patients.
- Comparison of biopsy histology with the entire surgical specimen.
- Long-term follow-up (mean 6.8 years) to monitor for malignant transformation.
Main Results:
- Carcinoma was found in 7% of whole lesions; 69% showed dysplasia or carcinoma in situ.
- 12% of lesions developed carcinoma during follow-up.
- Biopsy diagnosis agreed with whole lesion diagnosis in 49% of cases, and 79% when considering a one-degree variation in dysplasia.
Conclusions:
- Biopsy findings may not always represent the entire oral premalignant lesion.
- Histopathological features of the whole lesion, site, demarcation, and smoking status did not significantly influence the risk of malignant development in this study.
