Clinical and pathohistologic diagnostics of oral potentially malignant disorders and oral dysplasia: complex analysis and problematic issues (on the Minsk region example for the period of 2021—2023)

Objective. To perform a comprehensive analysis and to assess the problematic issues in clinical and pathohistologic diagnostics of oral potentially malignant disorders end oral epithelial dysplasia on the Minsk Region example in the period of 2021—2023.
Materials and methods. 185 patients underwent histopathologic examination between 2021 and 2023 from the Minsk
Regional Dental Polyclinic were included in the study. Clinical and histopathologic data were analyzed by the method of continuous selection, taking into the age and gender of patients, anatomical-topographical localization of the pathological process, technique of biopsy, clinical diagnosis and histopathologic report.
Results. The rate of patients with oral potentially malignant disorders underwent a biopsy was 6.5 %. The dentists in 21.5 % of cases incorrectly formulate the clinical diagnosis, in 13.5 % of cases do not specify and in 75.1 % of cases incorrectly specify the technique of biopsy, in 15.7 % of cases do not mention the anatomical-topographical localization of the pathological process, thus complicating the interpretation of the revealed morphological changes during histopathological examination. Morphologically oral potentially malignant disorders were verified in 1.1 %, dysplasia — in 1,6 % of all performed biopsies and accounted each for 16.7 % of all cases clinically idenificated as oral potentially malignant disorders. In 30.8 % of all performed biopsies and in 50.0 % of clinically idenificated as oral potentially malignant disorders, the morphological diagnosis was absent and was provided as a descriptive conclusion in the form of present histologic changes announcement.
Conclusion. The performed complex analysis revealed hypodiagnostics of oral potentially malignant disorders both at clinical and morphologic levels. Identified problematic issues in the diagnostic process among dentists and pathologists indicate the need to improve the professional training of specialists involved in the evaluation of oral cavity diseases, as well as the development and implementation of guidelines for medical care of patients with oral potentially malignant disorders.

1. Survival probabilities and trends for lip, oral cavity and oropharynx cancers in Northern Portugal in the period 2000—2009 / L. S. Monteiro, L. Antunes, L. L. Santos [et al.] // Ecancermedicalscience. — 2018 — Vol. 12. — DOI: 10.3332/ecancer.2018.855.

2. Warnakulasuriya, S. Global epidemiology of oral and oropharyngeal cancer / S. Warnakulasuriya // Oral Oncology. — 2009. — Vol. 45 (4—5). — Р. 309—316.

3. Bugshan, A. Oral squamous cell carcinoma: metastasis, potentially associated malignant disorders, etiology and recent advancements in diagnosis / A. Bugshan, I. Farooq // F1000Research. — 2020. — Vol. 9. — DOI: 10.12688/f1000research.22941.1.

4. Woo, Sook-Bin. Oral epithelial dysplasia and premalignancy / Sook-Bin Woo // Head and neck pathology. — 2019. — Vol. 13 (3). — Р. 423—439.

5. Is diagnostic delay related to advanced-stage oral cancer? A metaanalysis / I. Gomez, J. Seoane, P. Varela-Centelles [еt al.] // European Journal of Oral Sciences. — 2009. — Vol. 117 (5). — Р. 541—546.

6. Oral potentially malignant disorders: aconsensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer / S. Warnakulasuriya, O. Kujan, J. M. Aguirre-Urizar [et al.] // Oral Diseases. — 2021. — Vol. 27. — Р. 1862—1880.

7. Muller, S. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Tumours of the Oral Cavity and Mobile Tongue / S. Muller, W. M. Tilakaratne // Head and neck pathology. — 2021. — Vol. 16 (1). — Р. 54—62.

8. Oral epithelial dysplasia: recognition, grading and clinical significance / E. Odell, O. Kujan, S. Warnakulasuriya, Ph. Sloan // Oral Diseases. — 2021. — Vol. 27 (8). — Р. 1947—1976.

9. Oliver, R. J. Oral biopsies: methods and applications / R. J. Oliver, P. Sloan, M. N. Pemberton // British dental journal. — 2004. — Vol. 196 (6) — Р. 329—362.

10. Avon, S. L. Oral soft-tissue biopsy : an overview / S. L. Avon, H. B. Klieb // The Journal of the Canadian Dental Association. — 2012. — Vol. 78 — URL: https://pubmed.ncbi.nlm.nih.gov/22889502/ (date of access: 26.02.2025).

11. Shanti, R. M. Oral Biopsy Techniques / R. M. Shanti, T. Tanaka, D. C. Stanton // Dermatologic Clinics. — 2020. — Vol. 38 (4). — Р. 421—427.

12. Biopsy of the oral mucosa: Does size matter? / B. Lazzarotto, Ch. Garcia, C. Martinelli-Klay, T. Lombardi // Journal of Stomatology Oral and Maxillofacial Surgery. — 2022. — Vol. 123 (5). — DOI: 10.1016/j. jormas.2022.02.005.

13. Liu, W. Perspectives on oral tissue biopsy surgery for patients with oral premalignant and malignant lesions / W. Liu, H. Li, L. Shi // Journal of Dental Science. — 2024. — Vol. 19 (3) — Р. 1877—1879.

14. Ланг, Т. А. Как описывать статистику в медицине. Аннотированное руководство для авторов, редакторов и рецензентов / Т. А. Ланг, М. Сесик ; под ред. В. П. Леонова. — М. : Практическая медицина, 2011. — 480 с.

15. Oral soft tissue biopsy surgery: current principles and key tissue stabilization techniques / P. Y. Jeng, Mei-Chi Chang, Chun-Pin Chiang [еt al.] // Journal of Dental Science. — 2024. — Vol. 19 (1). — Р. 11—20.

16. The clinical characteristics of oral squamous cell carcinoma in patients attending the Medunsa Oral Health Centre, South Africa / M. Bouckaert, T. Munzhelele, L. Feller [еt al.] // Integrative Cancer Science and Therapeutics. — 2016. — Vol. 3 — Р. 575—578.

17. Prevalence of oral potentially malignant disorders : a systematic review and meta-analysis / F. W. Mello, A. F. Paza Miguel, K. L. Dutra [еt al.] // The Journal of Oral Pathology & Medicine. — 2018. — Vol. 47 (7). — Р. 633—640.

18. Interventions for treating oral leukoplakia to prevent oral cancer / G. Lodi, R. Franchini, S. Warnakulasuriya [еt al.] // Cochrane Database of Systematic Reviews. — 2016. — Vol. 7 (7). — URL: https:// doi.org/10.1002/14651858.CD001829.pub4 (date of access: 26.02.2025).

19. Worldwide prevalence of oral lichen planus : a systematic review and meta-analysis / M. A. GonzalezMoles, S. Warnakulasuriya, I. Gonzalez-Ruiz [еt al.] // Oral Diseases. — 2021. — Vol. 27 (4) — Р. 813—828.

20. Potentially malignant disorders of the oral cavity and oral dysplasia : a systematic review and metaanalysis of malignant transformation rate by subtype / O. Iocca, Th. P. Sollecito, F. Alawi [еt al.] // Head and Neck. — 2020. — Vol. 42 (3). — Р. 539—555.

21. Национальный статистический комитет Республики Беларусь : [сайт]. — Минск, 1998—2025. — URL: http://belstat.gov.by/ (дата обращения: 24.02.2025).