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Meta-Analysis
. 2024 Nov;30(8):4821-4829.
doi: 10.1111/odi.15052. Epub 2024 Jun 30.

Histopathological risk assessment in multisite epithelial dysplasia: A meta-analysis

Daniel Lobato Ferreira Ferraz  1 , Erison Santana Dos Santos  1 , Caique Mariano Pedroso  1 , Brunno Santos de Freitas Silva  2 , Omar Kujan  3 , Tuula Anneli Salo  4   5   6   7   8 , Mohammed I Malki  9 , Susanna Juteau  10 , Pablo Agustin Vargas  1 , Marcio Ajudarte Lopes  1 , Alan Roger Santos-Silva  1
Affiliations
Meta-Analysis

Histopathological risk assessment in multisite epithelial dysplasia: A meta-analysis

Daniel Lobato Ferreira Ferraz et al. Oral Dis. 2024 Nov.

Abstract

Objective: Histopathological grading of oral epithelial dysplasia (OED) is the current standard for stratifying cancer progression risk but is associated with subjectivity and variability. This problem is not commonly seen regarding the grading of epithelial dysplasia in other sites. This systematic review aims to compare grading systems for oral, anal, penile, and cervical epithelial dysplasia to determine their predictive accuracy for recurrence and malignant transformation (MT) outcomes.

Methods: The review protocol was registered in PROSPERO (CRD42023403035) and was reported according to the PRISMA checklist. A comprehensive search was performed in the main databases and gray literature. The risk of bias in individual studies was analyzed using the Joanna Briggs Institute checklist for each study design.

Results: Forty-six studies were deemed eligible and included in this systematic review, of which 45 were included in the quantitative analysis. Meta-analysis revealed that the binary system demonstrated a higher predictive ability for MT/recurrence of OED compared to multilevel systems. Higher predictive accuracy of MT was also observed for binary grading systems in anal intraepithelial neoplasia.

Conclusions: No significant difference was found between the current grading systems of epithelial dysplasia in different body parts. However, binary grading systems have shown better clinical outcomes.

Keywords: epithelial dysplasia; histopathological grading; intraepithelial neoplasia; precancerous conditions; systematic review.

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References

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