Abstract：
OBJECTIVE: Histopathological grading of oral epithelial dysplasia (OED) is the current standard for stratifying cancer progression risk but is associated with subjectivity and variability. This problem is not commonly seen regarding the grading of epithelial dysplasia in other sites. This systematic review aims to compare grading systems for oral, anal, penile, and cervical epithelial dysplasia to determine their predictive accuracy for recurrence and malignant transformation (MT) outcomes.
METHODS: The review protocol was registered in PROSPERO (CRD42023403035) and was reported according to the PRISMA checklist. A comprehensive search was performed in the main databases and gray literature. The risk of bias in individual studies was analyzed using the Joanna Briggs Institute checklist for each study design.
RESULTS: Forty-six studies were deemed eligible and included in this systematic review, of which 45 were included in the quantitative analysis. Meta-analysis revealed that the binary system demonstrated a higher predictive ability for MT/recurrence of OED compared to multilevel systems. Higher predictive accuracy of MT was also observed for binary grading systems in anal intraepithelial neoplasia.
CONCLUSIONS: No significant difference was found between the current grading systems of epithelial dysplasia in different body parts. However, binary grading systems have shown better clinical outcomes.
METHODS: The review protocol was registered in PROSPERO (CRD42023403035) and was reported according to the PRISMA checklist. A comprehensive search was performed in the main databases and gray literature. The risk of bias in individual studies was analyzed using the Joanna Briggs Institute checklist for each study design.
RESULTS: Forty-six studies were deemed eligible and included in this systematic review, of which 45 were included in the quantitative analysis. Meta-analysis revealed that the binary system demonstrated a higher predictive ability for MT/recurrence of OED compared to multilevel systems. Higher predictive accuracy of MT was also observed for binary grading systems in anal intraepithelial neoplasia.
CONCLUSIONS: No significant difference was found between the current grading systems of epithelial dysplasia in different body parts. However, binary grading systems have shown better clinical outcomes.
摘要：
目的：口腔上皮异型增生（OED）的组织病理学分级是目前癌症进展风险分层的标准，但与主观性和变异性相关。对于其他部位的上皮异型增生的分级，这个问题并不常见。这篇系统的综述旨在比较口腔的分级系统，肛门,阴茎,和宫颈上皮异型增生，以确定其对复发和恶变（MT）结局的预测准确性。
方法：审查方案已在PROSPERO（CRD42023403035）中注册，并根据PRISMA检查表进行报告。在主要数据库和灰色文献中进行了全面搜索。对于每个研究设计，使用JoannaBriggs研究所检查表分析了个别研究中的偏倚风险。
结果：46项研究被认为是合格的，并被纳入本系统综述，其中45例纳入定量分析。荟萃分析显示，与多水平系统相比，二元系统对MT/OED复发具有更高的预测能力。对于肛门上皮内瘤变的二元分级系统，也观察到了更高的MT预测准确性。
结论：目前不同身体部位上皮异型增生的分级系统没有发现显著差异。然而,二元分级系统显示出更好的临床结果。
方法：审查方案已在PROSPERO（CRD42023403035）中注册，并根据PRISMA检查表进行报告。在主要数据库和灰色文献中进行了全面搜索。对于每个研究设计，使用JoannaBriggs研究所检查表分析了个别研究中的偏倚风险。
结果：46项研究被认为是合格的，并被纳入本系统综述，其中45例纳入定量分析。荟萃分析显示，与多水平系统相比，二元系统对MT/OED复发具有更高的预测能力。对于肛门上皮内瘤变的二元分级系统，也观察到了更高的MT预测准确性。
结论：目前不同身体部位上皮异型增生的分级系统没有发现显著差异。然而,二元分级系统显示出更好的临床结果。
