Abstract 5935: Malignant risk assessment of clinical and histological subtypes of lichenoid mucositis with dysplasia
Bibliographic record
Abstract
Abstract Introduction: Oral lichen planus (OLP), a common, chronic inflammatory condition, is categorized as potentially malignant by the World Health Organization. However, some hypothesize that only lichenoid lesions with dysplasia (LLD) are at risk of progression to cancer. Others have proposed subtypes of LLD, with differing malignant risks. Objectives: To determine if subtypes of LLD exist, based on clinical and histological features, and to determine the proportion of malignant progression in these subtypes. Methods: A nested case control study was conducted using tissue samples and longitudinal data of patients enrolled in the Oral Cancer Prediction Longitudinal study. Inclusion criteria were a biopsy confirmed diagnosis of lichenoid mucositis with dysplasia, no history of head and neck cancer, at least 5 years of follow-up, and accessible clinical photographs and bio-banked tissue. A chart review was conducted, and photographs reviewed to assess for lesion features characteristic of OLP. Histological sections were examined for lichenoid inflammation, and immunohistochemical staining for collagen IV was used to evaluate the integrity of the basement membrane (BM). Two subtypes of LLD were proposed: 1) a primary lichenoid and secondary dysplastic (L1D2) type defined as a lesion with a reticular and bilateral clinical presentation, subepithelial inflammation, and evidence of BM degeneration, and 2) a primary dysplastic and secondary lichenoid type (D1L2), which may present unilaterally or bilaterally, clinically resemble OLP or leukoplakia, and exhibit subepithelial inflammation with or without evidence of BM degeneration. Association with outcome, which was defined as progression to severe dysplasia, carcinoma in situ, or squamous cell carcinoma, was tested using Fisher’s Exact test. Results: All progressing cases had a non-homogenous clinical presentation (P=0.005) and were more apt to change (in size, texture, and/or appearance) over time (P=0.002). A reticular, smooth appearance was more common in non-progressing cases (P=0.007, P=0.016, respectively). 30% of cases in the D1L2 subtype progressed to malignancy, compared to none in the L1D2 group, though this finding did not reach statistical significance (P=0.081). Conclusion: LLD with a non-homogenous, non-reticular clinical presentation are at greater risk of progression, and a high proportion of cases exhibiting primary dysplastic features progressed to malignancy, indicating that LLD should be under close clinical follow-up. Citation Format: Iris Lin, Oh Run Kim, Leigha Rock, Lewei Zhang, Miriam Rosin, Martial Guillaud, Denise Laronde. Malignant risk assessment of clinical and histological subtypes of lichenoid mucositis with dysplasia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5935.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".