{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T23:57:17Z","timestamp":1770163037958,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences","award":["2019RU034"],"award-info":[{"award-number":["2019RU034"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: This study aimed to evaluate phenotypic associations between preoperative alkaline phosphatase (ALP) levels and clinical characteristics, and explore clinical factors associated for postoperative regrowth in craniofacial fibrous dysplasia. Methods: In this retrospective cohort (2003\u20132024), 71 surgically treated fibrous dysplasia patients were analyzed. Relationships between preoperative ALP (using age-stratified reference ranges) and key phenotypes (age at surgery, onset age, laterality, lesion type) were assessed via nonparametric tests. Associations with postoperative regrowth were assessed using Mann\u2013Whitney U or Kruskal\u2013Wallis tests for non-normally distributed continuous variables and \u03c72 or Fisher\u2019s exact tests for categorical variables. Results: Preoperative ALP levels significantly correlated with younger surgical age (16\u201319 vs. \u226519 years: 244.0 vs. 107.0 U\/L, p &lt; 0.001), earlier onset (0\u201316 vs. &gt;16 years: 114.0 vs. 83.0 U\/L, p = 0.030), bilateral lesions (176.0 vs. 106.2 U\/L, p = 0.006), and polyostotic subtype (polyostotic fibrous dysplasia vs. monostotic fibrous dysplasia: 162.0 vs. 87.5 U\/L, p &lt; 0.001). However, neither ALP levels (p = 0.061) nor abnormal ALP rates (p = 0.090) predicted regrowth. Crucially, bilateral lesions were significantly associated with regrowth (83.3% (5\/6) vs. 21.5% (14\/65); p = 0.005). The overall regrowth rate was 8.5% (6\/71). Conclusions: Bilateral lesions demonstrate significant association with postoperative regrowth risk, potentially guiding surveillance intensity. ALP correlates with phenotypic burden but shows limited prognostic utility. These findings, interpreted considering retrospective constraints, warrant validation in larger cohorts.<\/jats:p>","DOI":"10.3390\/diagnostics16030472","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:48:01Z","timestamp":1770115681000},"page":"472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Lesions Are Linked to Postoperative Regrowth in Craniofacial Fibrous Dysplasia: Alkaline Phosphatase as a Marker of Clinical Phenotype"],"prefix":"10.3390","volume":"16","author":[{"given":"Jiang","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, China"},{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Longping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, China"},{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, China"},{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, China"},{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisha","family":"Sun","sequence":"additional","affiliation":[{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"},{"name":"Central Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiejun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, China"},{"name":"National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00223-019-00550-z","article-title":"Fibrous Dysplasia of Bone and McCune-Albright Syndrome: A Bench to Bedside Review","volume":"104","author":"Hartley","year":"2019","journal-title":"Calcif. 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