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Prognostic Classifier for Oral Potentially Malignant Disorders: An Integrated Histopathological and Molecular approach

Lookup NU author(s): Dr Hans Sathasivam, Professor Philip Sloan, Dr Ralf KistORCiD, Dr Max RobinsonORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


ObjectivesOral squamous cell carcinoma (OSCC) is associated with a high degree of morbidity and mortality. OS-CCs are often preceded by oral potentially malignant disorders (OPMD) which have a higher propensity to undergo malignant transformation (MT) compared to clinically normal oral mucosa. Currently there is no reliable method to determine which OPMD cases will undergo MT. This study was performed to construct a prognostic classifier for patients with OPMD by integrating clinical, histopathological and molecular factors and to discover a gene expression signature that characterises OPMD with a high risk of undergoing MT.FindingsStatistical analysis of an OPMD patient cohort (23 MT vs. 25 with no MT) showed that site of initial OPMD (p = 0.043), binary oral epithelial dysplasia (OED) grading (p = 0.009) and loss of heterozygosity at 3p/9p/17p (p = 0.026) were statistically significant. Other demographic factors, clinical features and the WHO 3-tiered OED grading system were not statistically significant. Gene expression experiments revealed several genes that were differentially expressed between OPMD that underwent MT and those that did not [false discovery rate of < 0.05]. Statistical model building was performed, and the outputs were used to construct a prognostic classifier.ConclusionsOur findings show that a classifier combining histopathological and molecular factors outperforms conventional methods for prognosticating clinical outcome in patients with OPMD. We have also shown that formalin-fixed paraffin-embedded tissue can be used to generate a molecular classification with clinical utility.

Publication metadata

Author(s): Sathasivam HP, Sloan P, Kist R, Robinson M

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: American Academy of Oral & Maxillofacial Pathology / International Association of Oral & Maxillofacial Pathologists Joint Meeting 2018

Year of Conference: 2019

Pages: e79

Online publication date: 12/06/2019

Acceptance date: 12/06/2019

Date deposited: 30/07/2019

ISSN: 2212-4403

Publisher: Elsevier


DOI: 10.1016/j.oooo.2019.02.198

Series Title: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology