[Analysis of relationship between risk factors of malignant transformation of oral leukoplakia and the LSCP system]

Abstract

Objective: To explore the clinical significance of the LSCP (lesion size, site of lesion, clinical aspects, pathological aspects) classification and staging system through a comprehensive analysis of relationships between the risk factors of malignant transformation of 209 cases with oral leukoplakia and the LSCP classification and staging system.

Methods: Single factor Chi-square test was first performed to examine the associations between LSCP stages (I, II, III, IV) of oral leukoplakia and each of risk factors, including sex, site, size, numbers of lesion, alcohol and tobacco consumption, clinical classification and histopathological classification respectively, to select the most significant factors which influence the LSCP classification and staging. Then, the association of these selected factors with LSCP stages of oral leukoplakia (stage IV vs. I, II and III) was evaluated using multiple logistic regression analysis.

Results: Sex, site of lesions, clinical aspect and histopathological features of lesions were chosen as risk factors incorporated into the multiple logistic regression models. The results demonstrated that the risk of oral leukoplakia of the female patients classified as LSCP stage IV was 2.49 times as high as that of the male patients. The risk of lesions occurring in tongue and/or that floor of mouth was higher than that in other sites. Among the different clinical subtypes of lesions, the verrucous leukoplakia was the highest and 10.00 times as high as that of the homogeneous one. Among the different histopathological types, when hyperplasia and mild dysplasia were set as the basic level, the risk of severe dysplasia classified as LSCP stage IV was the highest and 499.55 times as high as the basic level, while that of moderate dysplasia was 276.48 times as high as the basic level. Pathological features with moderate and severe dysplasia were the most important contributory factors to the LSCP staging.

Conclusions: The LSCP classification and staging system provides a comprehensive description of the features of oral leukoplakia, which is helpful in evaluating the overall risk of malignant transformation of oral lesion, and is valuable in clinical follow-up and developing the best treatment plan.