{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:56:40Z","timestamp":1794333400789,"version":"4.9.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]},{"name":"EU Cost Action","award":["CA21140"],"award-info":[{"award-number":["CA21140"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head and Neck Pathol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Oral epithelial dysplasia (OED) is the principal histopathological marker for malignant risk stratification in oral potentially malignant disorders (OPMDs). Current World Health Organisation (WHO) three-tier and other binary grading systems are limited by modest inter-observer reproducibility and suboptimal prognostic discrimination, particularly for architecture-predominant lesions where cytological atypia is inconspicuous. The most clinically consequential failure of current practice is not mis-grading but non-recognition of dysplasia altogether, with direct implications for patient surveillance and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This position paper, arising from Working Group 2 of COST Action CA21140 INTERCEPTOR, synthesises evidence from inter-observer reproducibility studies, feature-based prognostic models, under-recognition studies, outcome data and computational pathology analyses to propose and contextualise a pattern-anchored, grade-retaining diagnostic framework for OED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five recognisable histological patterns are proposed: conventional\/basaloid, keratinising\/differentiated, verrucous, papillomatous, and HPV-associated, functioning as diagnostic anchors that capture the full morphological spectrum of OED, including architecture-predominant phenotypes that are disproportionately under-recognised in routine practice. Feature-based prognostic models demonstrate that architectural traits characterising these patterns (bulbous rete ridges, AUROC 0.74; cohesion loss, AUROC 0.73) predict malignant transformation more effectively than grade alone. Independent computational pathology analyses identify corresponding immune microenvironment and architectural signals as the strongest prognostic variables, providing convergent support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A two-step approach i.e. first identifying the dominant morphological pattern and then assigning grade within that pattern using existing WHO or binary criteria, offers a pragmatic, grade-retaining refinement compatible with current diagnostic frameworks and clinical pathways. The proposal is hypothesis-driven and requires prospective multicentre validation before wider adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12105-026-01963-7","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:30:45Z","timestamp":1788445845000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pattern-Anchored Diagnosis of Oral Epithelial Dysplasia: A Position Paper From COST Action INTERCEPTOR Working Group 2"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0378-9380","authenticated-orcid":false,"given":"Syed Ali","family":"Khurram","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D.","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward W.","family":"Odell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merva Soluk","family":"Tekke\u015fin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lingen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Agust\u00edn","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Kujan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Elena","family":"Costea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Saintigny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senada","family":"Koljenovi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"1963_CR1","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1111\/odi.13704","volume":"27","author":"S Warnakulasuriya","year":"2021","unstructured":"Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, Gonzalez-Moles MA, Kerr AR et al (2021) Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification. Oral Dis 27:1862\u20131880","journal-title":"Oral Dis"},{"key":"1963_CR2","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/j.1600-0714.2007.00584.x","volume":"37","author":"S Warnakulasuriya","year":"2008","unstructured":"Warnakulasuriya S, Reibel J, Bouquot J, Dabelsteen E (2008) Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med 37:127\u2013133","journal-title":"J Oral Pathol Med"},{"key":"1963_CR3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/odi.15160","volume":"31","author":"D Gopinath","year":"2025","unstructured":"Gopinath D, On C, Veettil SK, Tilakaratne WM (2025) Is binary grading better than WHO system for grading epithelial dysplasia? A systematic review and meta-analysis. Oral Dis 31:59\u201368","journal-title":"Oral Dis"},{"key":"1963_CR4","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1111\/jop.13056","volume":"49","author":"K Ranganathan","year":"2020","unstructured":"Ranganathan K, Kavitha L, Sharada P, Bavle RM, Rao RS, Pattanshetty SM et al (2020) Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: a multi-centre study in India. J Oral Pathol Med 49:948\u2013955","journal-title":"J Oral Pathol Med"},{"key":"1963_CR5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.pathol.2023.10.002","volume":"56","author":"P Hankinson","year":"2024","unstructured":"Hankinson P, Mahmood H, Walsh H, Speight PM, Khurram SA (2024) Demystifying oral epithelial dysplasia: a histological guide. Pathology 56:11\u201323","journal-title":"Pathology"},{"key":"1963_CR6","doi-asserted-by":"publisher","first-page":"8315","DOI":"10.1038\/s41598-022-12441-9","volume":"12","author":"M Nevanp\u00e4\u00e4","year":"2022","unstructured":"Nevanp\u00e4\u00e4 M, Terava AE, Laine HK, Rautava J (2022) Malignant transformation of oral epithelial dysplasia in Southwest Finland. Sci Rep 12:8315","journal-title":"Sci Rep"},{"key":"1963_CR7","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1111\/odi.13810","volume":"27","author":"JM Aguirre-Ur\u00edzar","year":"2021","unstructured":"Aguirre-Ur\u00edzar JM, Lafuente-Ib\u00e1\u00f1ez de Mendoza I, Warnakulasuriya S (2021) Malignant transformation of oral leukoplakia: systematic review and meta-analysis of the last 5 years. Oral Dis 27:1881\u20131895","journal-title":"Oral Dis"},{"key":"1963_CR8","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1002\/hed.26006","volume":"42","author":"O Iocca","year":"2020","unstructured":"Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, Dr Virgilio A et al (2020) Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck 42:539\u2013555","journal-title":"Head Neck"},{"key":"1963_CR9","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1111\/odi.13993","volume":"27","author":"EW Odell","year":"2021","unstructured":"Odell EW, Kujan O, Warnakulasuriya S, Sloan P (2021) Oral epithelial dysplasia: recognition, grading and clinical significance. Oral Dis 27:1947\u20131976","journal-title":"Oral Dis"},{"key":"1963_CR10","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1038\/s41379-019-0444-0","volume":"33","author":"LJ Wils","year":"2020","unstructured":"Wils LJ, Poell JB, Evren I, Koopman MS, Bronus EREA, Visscher JGAM et al (2020) Incorporation of differentiated dysplasia improves prediction of oral leukoplakia at increased risk of malignant progression. Mod Pathol 33:1033\u20131040","journal-title":"Mod Pathol"},{"key":"1963_CR11","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/jop.13501","volume":"53","author":"TG Kallarakkal","year":"2024","unstructured":"Kallarakkal TG, Zaini ZM, Ghani WMN, Karen-Ng LP, Siriwardena BSMS, Cheong SC et al (2024) Calibration improves the agreement in grading oral epithelial dysplasia: findings from a National workshop in Malaysia. J Oral Pathol Med 53:53\u201360","journal-title":"J Oral Pathol Med"},{"key":"1963_CR12","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s12105-021-01402-9","volume":"16","author":"S M\u00fcller","year":"2022","unstructured":"M\u00fcller S, Tilakaratne WM (2022) Update from the 5th edition of the World Health Organisation classification of head and neck tumours: Tumours of the oral cavity and mobile tongue. Head Neck Pathol 16:54\u201362","journal-title":"Head Neck Pathol"},{"issue":"1","key":"1963_CR13","doi-asserted-by":"publisher","first-page":"e62","DOI":"10.4317\/jced.61073","volume":"16","author":"L-C Marques","year":"2024","unstructured":"Marques L-C, P-dP M, Goncalves L-S, Cunha K-S, Junior A-S, Conde D-C (2024) Challenges in the assessment of epithelial dysplasia in oral lichen planus and oral lichenoid lesion: Inter and intra-observer variability of the WHO criteria and binary system. J Clin Exp Dent 16(1):e62\u2013e70","journal-title":"J Clin Exp Dent"},{"key":"1963_CR14","volume-title":"WHO classification of head and neck tumours","year":"2017","unstructured":"El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ (eds) (2017) WHO classification of head and neck tumours, 4th edition. IARC Press, Lyon","edition":"4th edition"},{"key":"1963_CR15","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/j.oraloncology.2006.03.009","volume":"43","author":"O Kujan","year":"2007","unstructured":"Kujan O, Khattab A, Oliver RJ, Roberts SA, Thakker N, Sloan P (2007) Why oral histopathology suffers inter-observer variability on grading oral epithelial dysplasia: an attempt to understand the sources of variation. Oral Oncol 43:224\u2013231","journal-title":"Oral Oncol"},{"key":"1963_CR16","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.oooo.2012.10.015","volume":"115","author":"P Nankivell","year":"2013","unstructured":"Nankivell P, Williams H, Matthews P, Suortamo S, Snead D, McConkey C et al (2013) The binary oral dysplasia grading system: validity testing and suggested improvement. Oral Surg Oral Med Oral Pathol Oral Radiol 115:87\u201394","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"1963_CR17","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","volume":"33","author":"JR Landis","year":"1977","unstructured":"Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159\u2013174","journal-title":"Biometrics"},{"key":"1963_CR18","unstructured":"Smith CJ, Pindborg JJ (1969) Histological grading of oral epithelial atypia by the use of photographic standards. WHO international reference centre for oral precancerous lesions"},{"key":"1963_CR19","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.oooo.2017.12.011","volume":"125","author":"PM Speight","year":"2018","unstructured":"Speight PM, Khurram SA, Kujan O (2018) Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol 125:612\u2013627","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"1963_CR20","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1093\/jnci\/djz238","volume":"112","author":"AK Chaturvedi","year":"2020","unstructured":"Chaturvedi AK, Udaltsova N, Engels EA, Katzel JA, Yanik EL, Katki HA et al (2020) Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study. J Natl Cancer Inst 112:1047\u20131054","journal-title":"J Natl Cancer Inst"},{"key":"1963_CR21","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1038\/s41379-022-01067-x","volume":"35","author":"H Mahmood","year":"2022","unstructured":"Mahmood H, Bradburn M, Rajpoot N, Islam NM, Kujan O, Khurram SA (2022) Prediction of malignant transformation and recurrence of oral epithelial dysplasia using architectural and cytological feature specific prognostic models. Mod Pathol 35:1151\u20131159","journal-title":"Mod Pathol"},{"issue":"5","key":"1963_CR22","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1111\/odi.70173","volume":"32","author":"H Mahmood","year":"2026","unstructured":"Mahmood H, Bradburn M, Islam NM, Kujan O, Rajpoot N, Santos-Silva AR et al (2026) Independent multicentre validation of the \u2018six-point\u2019 model for malignant transformation risk in oral epithelial dysplasia. Oral Dis 32(5):1273\u20131282. https:\/\/doi.org\/10.1111\/odi.70173","journal-title":"Oral Dis"},{"key":"1963_CR23","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1111\/his.15400","volume":"86","author":"P Hankinson","year":"2025","unstructured":"Hankinson P, Clark M, Walsh H, Khurram SA (2025) A head-to-head comparison of four grading systems for oral epithelial dysplasia. Histopathology 86:933\u2013941","journal-title":"Histopathology"},{"key":"1963_CR24","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1111\/jop.13633","volume":"54","author":"AB Soares","year":"2025","unstructured":"Soares AB, Warnakulasuriya S, da Silveira Terra Junqueira L, de Freitas ALS, Schneider A, Silva ARS et al (2025) Risk assessment of oral leukoplakia by individual dysplasia features. J Oral Pathol Med 54:537\u2013546","journal-title":"J Oral Pathol Med"},{"key":"1963_CR25","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s12105-025-01754-6","volume":"19","author":"AZ Rodrigues","year":"2025","unstructured":"Rodrigues AZ, Laureano NK, Maraschin BJ, da Silva AD, da Silva VP, Rados PV et al (2025) Diagnostic criteria for oral epithelial dysplasia: predicting malignant transformation. Head Neck Pathol 19:21","journal-title":"Head Neck Pathol"},{"issue":"10","key":"1963_CR26","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1111\/jop.13483","volume":"52","author":"LJ Wils","year":"2023","unstructured":"Wils LJ, Poell JB, Peferoen LAN, Evren I, Brouns ER, de Visscher JGAM et al (2023) The role of differentiated dysplasia in the prediction of malignant transformation of oral leukoplakia. J Oral Pathol Med 52(10):930\u2013938","journal-title":"J Oral Pathol Med"},{"key":"1963_CR27","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.humpath.2022.05.010","volume":"126","author":"E Kim","year":"2022","unstructured":"Kim E, Chung M, Jeong HS, Baek CH, Cho J (2022) Histological features of differentiated dysplasia in the oral mucosa: a review of oral invasive squamous cell carcinoma cases diagnosed with benign or low-grade dysplasia on previous biopsies. Hum Pathol 126:45\u201354","journal-title":"Hum Pathol"},{"issue":"1","key":"1963_CR28","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1097\/LGT.0000000000000572","volume":"25","author":"DS Heller","year":"2021","unstructured":"Heller DS, Day T, Allbritton JI, Scurry J, Radici G, Welch K et al (2021) Diagnostic criteria for differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation. J Low Genit Tract Dis 25(1):57\u201370","journal-title":"J Low Genit Tract Dis"},{"key":"1963_CR29","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1038\/modpathol.2009.179","volume":"23","author":"AP Pinto","year":"2010","unstructured":"Pinto AP, Miron A, Yassin Y, Monte N, Woo TYC, Mehra KK et al (2010) Differentiated vulvar intraepithelial neoplasia contains Tp53 mutations and is genetically linked to vulvar squamous cell carcinoma. Mod Pathol 23:404\u2013412","journal-title":"Mod Pathol"},{"issue":"1","key":"1963_CR30","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12903-025-05565-7","volume":"25","author":"K Mohideen","year":"2025","unstructured":"Mohideen K, Ghosh S, Krithika C, Ali-Hassan M, Chole R, Dhungel S (2025) Malignant transformation of proliferative verrucous leukoplakia-systematic review & meta-analysis. BMC Oral Health 25(1):175","journal-title":"BMC Oral Health"},{"key":"1963_CR31","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1038\/s41379-022-01021-x","volume":"35","author":"L Alabudalaly","year":"2022","unstructured":"Alabudalaly L, Villa A, Chen T, Kerr A, Ross N, Abreu Alves F et al (2022) Characterization of initial\/early histologic features of proliferative leukoplakia and correlation with malignant transformation: a multicenter study. Mod Pathol 35:1034\u20131044","journal-title":"Mod Pathol"},{"issue":"16","key":"1963_CR32","doi-asserted-by":"publisher","first-page":"4085","DOI":"10.3390\/cancers13164085","volume":"13","author":"G Palaia","year":"2021","unstructured":"Palaia G, Bellisario A, Pampena R, Pippi R, Romeo U (2021) Oral proliferative verrucous leukoplakia: progression to malignancy and clinical implications. Systematic review and meta-analysis. Cancers (Basel) 13(16):4085","journal-title":"Cancers (Basel)"},{"key":"1963_CR33","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/j.oooo.2018.02.012","volume":"125","author":"S M\u00fcller","year":"2018","unstructured":"M\u00fcller S (2018) Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol 125:591\u2013602","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"9","key":"1963_CR34","doi-asserted-by":"publisher","first-page":"e24934","DOI":"10.1097\/MD.0000000000024934","volume":"100","author":"SF Chiu","year":"2021","unstructured":"Chiu SF, Ho CH, Chen YC, Wu LW, Chen YL, Wu JH et al (2021) Malignant transformation of oral potentially malignant disorders in Taiwan: an observational nationwide population database study. Med (Baltimore) 100(9):e24934","journal-title":"Med (Baltimore)"},{"issue":"1","key":"1963_CR35","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/odi.70037","volume":"32","author":"Y Maulana","year":"2026","unstructured":"Maulana Y, Wu M-H, Chiang W-F, Hsiao W-P, Mong L-C, Wang W-C (2026) A pilot genome-wide association study of malignant transformation of oral verrucous hyperplasia. Oral Dis 32(1):80\u201388","journal-title":"Oral Dis"},{"key":"1963_CR36","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.bjoms.2015.08.268","volume":"53","author":"ML Goodson","year":"2015","unstructured":"Goodson ML, Sloan P, Robinson CM, Cocks K, Thomson PJ (2015) Oral precursor lesions and malignant transformation-who, where, what, and when? Br J Oral Maxillofac Surg 53:831\u2013835","journal-title":"Br J Oral Maxillofac Surg"},{"key":"1963_CR37","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/his.15171","volume":"85","author":"IJ Stojanov","year":"2024","unstructured":"Stojanov IJ, Omari J, Akeel I, Sultan AS, Woo SB (2024) Oral epithelial dysplasia with lymphocytic immune response: clinicopathological characterisation of 44 cases. Histopathology 85:40\u201350","journal-title":"Histopathology"},{"key":"1963_CR38","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1002\/path.6094","volume":"260","author":"RMS Bashir","year":"2023","unstructured":"Bashir RMS, Shephard AJ, Mahmood H, Azarmehr N, Raza SEA, Khurram SA et al (2023) A digital score of peri-epithelial lymphocytic activity predicts malignant transformation in oral epithelial dysplasia. J Pathol 260:431\u2013442","journal-title":"J Pathol"},{"key":"1963_CR39","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1038\/s41416-024-02916-z","volume":"132","author":"AJ Shephard","year":"2025","unstructured":"Shephard AJ, Mahmood H, Raza SEA, Khurram SA, Rajpoot NMl (2025) A novel AI-based score for assessing the prognostic value of intra-epithelial lymphocytes in oral epithelial dysplasia. Br J Cancer 132:168\u2013179","journal-title":"Br J Cancer"},{"key":"1963_CR40","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1007\/s12105-012-0335-x","volume":"6","author":"M Chaudhary","year":"2012","unstructured":"Chaudhary M, Gadbail AR, Vidhale G, Gadbail MPM, Gondivkar SM, Gawande M et al (2012) Comparison of myofibroblasts expression in oral squamous cell carcinoma, verrucous carcinoma, high risk epithelial dysplasia, low risk epithelial dysplasia and normal oral mucosa. Head Neck Pathol 6:305\u2013313","journal-title":"Head Neck Pathol"},{"key":"1963_CR41","doi-asserted-by":"publisher","first-page":"275","DOI":"10.15430\/JCP.2015.20.4.275","volume":"20","author":"SS Varghese","year":"2015","unstructured":"Varghese SS, Sarojini SB, George GB, Vinod S, Mathew P, Babu A et al (2015) Evaluation and comparison of the biopathology of collagen and inflammation in the extracellular matrix of oral epithelial dysplasias and inflammatory fibrous hyperplasia using Picrosirius Red Stain and polarising microscopy: a preliminary study. J Cancer Prev 20:275\u2013280","journal-title":"J Cancer Prev"},{"key":"1963_CR42","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1111\/odi.12694","volume":"24","author":"RD Coletta","year":"2018","unstructured":"Coletta RD, Salo T (2018) Myofibroblasts in oral potentially malignant disorders: is it related to malignant transformation? Oral Dis 24:84\u201388","journal-title":"Oral Dis"},{"key":"1963_CR43","first-page":"11","volume":"12","author":"JE Bouquot","year":"2006","unstructured":"Bouquot JE, Speight PM, Farthing PM (2006) Epithelial dysplasia of the oral mucosa-Diagnostic problems and prognostic features. Diagn Histopathol 12:11\u201321","journal-title":"Diagn Histopathol"},{"key":"1963_CR44","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1007\/s12105-020-01262-9","volume":"15","author":"LDR Thompson","year":"2021","unstructured":"Thompson LDR, Fitzpatrick SG, M\u00fcller S, Eisenberg E, Upadhyaya JD, Lingen MW et al (2021) Proliferative verrucous leukoplakia: an expert consensus guideline for standardized assessment and reporting. Head Neck Pathol 15:572\u2013587","journal-title":"Head Neck Pathol"},{"key":"1963_CR45","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1007\/s12105-025-01835-6","volume":"19","author":"M Rohilla","year":"2025","unstructured":"Rohilla M, Pandiar D, Krishnan RP (2025) Correlation of newly added dysplastic features in the latest WHO diagnostic criteria of oral epithelial dysplasia with malignant transformation and recurrence. Head Neck Pathol 19:98","journal-title":"Head Neck Pathol"},{"key":"1963_CR46","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s00428-013-1412-6","volume":"462","author":"R Arsenic","year":"2013","unstructured":"Arsenic R, Kurrer MO (2013) Differentiated dysplasia is a frequent precursor or associated lesion in invasive squamous cell carcinoma of the oral cavity and pharynx. Virchows Arch 462:609\u2013617","journal-title":"Virchows Arch"},{"key":"1963_CR47","doi-asserted-by":"publisher","first-page":"4185","DOI":"10.1111\/odi.14846","volume":"30","author":"AS Becker","year":"2024","unstructured":"Becker AS, Holm M, Liese J, Engel N, Zimpfer AH (2024) Diagnosis of differentiated dysplasia as a variant of oral epithelial dysplasia. Oral Dis 30:4185\u20134194","journal-title":"Oral Dis"},{"key":"1963_CR48","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s12105-019-01020-6","volume":"13","author":"SB Woo","year":"2019","unstructured":"Woo SB (2019) Oral epithelial dysplasia and premalignancy. Head Neck Pathol 13:423\u2013439","journal-title":"Head Neck Pathol"},{"key":"1963_CR49","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s12105-007-0014-5","volume":"1","author":"PM Speight","year":"2007","unstructured":"Speight PM (2007) Update on oral epithelial dysplasia and progression to cancer. Head Neck Pathol 1:61\u201368","journal-title":"Head Neck Pathol"},{"key":"1963_CR50","doi-asserted-by":"publisher","first-page":"954567","DOI":"10.3389\/fimmu.2022.954567","volume":"13","author":"CP Gan","year":"2022","unstructured":"Gan CP, Lee BKB, Lau SH, Kallarakkal TG, Zaini ZM, Lye BKW et al (2022) Transcriptional analysis highlights three distinct immune profiles of high-risk oral epithelial dysplasia. Front Immunol 13:954567","journal-title":"Front Immunol"},{"key":"1963_CR51","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s12105-024-01624-7","volume":"18","author":"A Flores-Hidalgo","year":"2024","unstructured":"Flores-Hidalgo A, Phero J, Steward-Tharp S, Williamson M, Paquette D, Krishnan D et al (2024) Immunophenotypic and gene expression analyses of the inflammatory microenvironment in high-grade oral epithelial dysplasia and oral lichen planus. Head Neck Pathol 18:17","journal-title":"Head Neck Pathol"},{"key":"1963_CR52","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1002\/path.6449","volume":"267","author":"LJ Wils","year":"2025","unstructured":"Wils LJ, Poell JB, Brink A, Peferoen LA, Evren I, Bronus ER et al (2025) New insights into the genetic progression of cancer through longitudinal analysis of oral lesions. J Pathol 267:155\u2013167","journal-title":"J Pathol"},{"key":"1963_CR53","doi-asserted-by":"crossref","unstructured":"Shephard AJ, Bashir RMS, Mahmood H, Jahanifar M, Minhas F, Raza SEA, et al (2024) A fully automated and explainable algorithm for predicting malignant transformation in oral epithelial dysplasia. npj Precis Oncol 8:137","DOI":"10.1038\/s41698-024-00624-8"},{"key":"1963_CR54","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1038\/s43856-025-00873-z","volume":"5","author":"AJ Shephard","year":"2025","unstructured":"Shephard AJ, Mahmood H, Raza SEA, Arauo ALD, Santos-Silva AR, Lopes MA et al (2025) Development and validation of an artificial intelligence-based pipeline for predicting oral epithelial dysplasia malignant transformation. Commun Med (Lond) 5:186","journal-title":"Commun Med (Lond)"},{"issue":"1","key":"1963_CR55","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1097\/JS9.0000000000003592","volume":"112","author":"J Adeoye","year":"2026","unstructured":"Adeoye J, Su YX (2026) Artificial intelligence for predicting post-excision recurrence and malignant progression in oral potentially malignant disorders: a retrospective cohort study. Int J Surg 112(1):1392\u20131401","journal-title":"Int J Surg"}],"container-title":["Head and Neck Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-026-01963-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12105-026-01963-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-026-01963-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:18:16Z","timestamp":1788452296000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12105-026-01963-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1963"],"URL":"https:\/\/doi.org\/10.1007\/s12105-026-01963-7","relation":{},"ISSN":["1936-0568"],"issn-type":[{"value":"1936-0568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"assertion":[{"value":"9 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interests.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors give their consent for the publication.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"95"}}