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Combination of Binary System With Ki67 Immunohistochemical Staining: A Reliable Grading Method for Oral Epithelial Dysplasia Publisher



Akafzadeh N1 ; Baghaei F2 ; Derakhshan S2 ; Khiavi MM2 ; Kharazifard M3 ; Aminishakib P2
Authors
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Authors Affiliations
  1. 1. Postgraduate Student of Pediatric Dentistry, Dept. of Pediatric Dentistry, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
  2. 2. Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Dentistry (Iran) Published:2022


Abstract

Statement of the Problem: Oral epithelial dysplasia (OED) is a common potentially malignant lesion of oral cavity that should be managed to prevent likely malignant transformation. Purpose: Here, we present a combination of binary grading system with complementary immunohistochemical (IHC) staining for Ki67 biomarker to provide a reproducible OED grading system. Materials and Method: In this cross-sectional study, seventy out of one hundred OED specimens, which were accompanied by IHC stained microscopic slides for Ki67 antigen were evaluated by four independent oral pathologists. Both three-tier and binary grading systems based on WHO microscopic criteria were employed, blindly in a four-step method with at least two-week interval between each observation. Intra-and inter-observational reliability was assessed using Kappa statistical analysis. Results: OED diagnosis based on binary system showed significant intra-observer reliability comparing to three-tier system without biomarker. Moreover, OED diagnosis based on binary system using Ki67 biomarker showed significant inter-observer reliability comparing to diagnosis in three tier system and based on binary system without Ki67 biomarker showed significant inter-observer reliability comparing to diagnosis based on three-tier system without Ki67. Conclusion: Here, we found that application of IHC staining for Ki67 biomarker in binary system might provide a more reliable grading method for oral pathologist form different educational background. © Journal of Dentistry.