{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:39:45Z","timestamp":1788593985426,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023452","name":"Hanarth Fonds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023452","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Oral Pathology Medicine"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Oral leukoplakia is the most common oral potentially malignant disorder. Malignant transformation of oral leukoplakia occurs at an annual rate of 1%\u20137%. WHO\u2010defined classic epithelial dysplasia is an important predictor of malignant transformation of oral leukoplakia, but we have previously shown in a proof of concept study that prediction improves by incorporation of an architectural pattern of dysplasia, also coined as differentiated dysplasia. We aimed to analyze this finding in a larger cohort of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>For this retrospective study 176 oral leukoplakia patients were included. Biopsies for all patients were assessed for the presence of dysplasia and analyzed for cytokeratin 13 and 17 expression. Moreover, the inter\u2010observer agreement for the diagnosis of differentiated dysplasia was determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 33 of 176 patients developed oral squamous cell carcinoma during follow\u2010up. Presence of classic epithelial dysplasia increased cancer risk two\u2010fold (HR\u2009=\u20092.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). Lesions without classic epithelial dysplasia could be further risk\u2010stratified by the presence of differentiated dysplasia (HR\u2009=\u20097.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Combined classic epithelial and differentiated dysplasia imparted a seven\u2010fold increased risk of malignant transformation (7.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Inter\u2010observer agreement for the diagnosis of dysplasia, including differentiated dysplasia, was moderate (\u03ba\u2009=\u20090.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study emphasizes the importance of the recognition of the architectural pattern of differentiated dysplasia as a separate entity for risk prediction of malignant transformation of oral leukoplakia. Presence of any pattern of dysplasia results in accurate prediction of malignant transformation risk of oral leukoplakia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jop.13483","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T23:19:05Z","timestamp":1695683945000},"page":"930-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The role of differentiated dysplasia in the prediction of malignant transformation of oral leukoplakia"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-3751","authenticated-orcid":false,"given":"Leon J.","family":"Wils","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Surgery and Oral Pathology Amsterdam UMC Location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology  Amsterdam The Netherlands"},{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam (CCA)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1776-3779","authenticated-orcid":false,"given":"Jos B.","family":"Poell","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam (CCA)  Amsterdam The Netherlands"},{"name":"Otolaryngology and Head &amp; Neck Surgery Amsterdam UMC Location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A. N.","family":"Peferoen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-3300","authenticated-orcid":false,"given":"Ilkay","family":"Evren","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery and Oral Pathology Amsterdam UMC Location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth R.","family":"Brouns","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery and Oral Pathology Amsterdam UMC Location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan G. 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