%0 Journal Article
%T Oral cancer detection and progression prediction using noninvasive cytology-based DNA ploidy approach.
%A Liu KYP
%A Ng S
%A Taleghani M
%A Zhu SY
%A Carraro A
%A Chen Z
%A Palcic B
%A Poh CF
%A Guillaud M
%J J Oral Pathol Med
%V 53
%N 7
%D 2024 Aug 2
%M 38825828
%F 3.539
%R 10.1111/jop.13562
%X <B>BACKGROUND: </B>Despite the oral cavity being readily accessible, oral cancer (OC) remains a significant burden. The objective of this study is to develop a DNA ploidy-based cytology test for early detection of high-risk oral lesions.<BR><B>METHODS: </B>This retrospective study was conducted using 569 oral brushing samples collected from 95 normal and 474 clinically abnormal mucosa with biopsy diagnosis of reactive, low-grade or high-grade precancer or cancers. Brushing cells were processed to characterize DNA ploidy. A two-step DNA ploidy-based algorithm, the DNA ploidy oral cytology (DOC) test, was developed using a training set, and verified in test and validation sets to differentiate high-grade lesions (HGLs) from normal. The prognostic value of the test was evaluated by an independent outcome cohort, including progressed and non-progressing normal, reactive and low-grade lesions. Classification performance was assessed by accuracy, sensitivity, and specificity, while the prognostic value was evaluated by using the Cox proportional hazards analysis on 3-year progression-free survival (PFS).<BR><B>RESULTS: </B>The developed DOC test exhibited high accuracy for detecting HGLs in the test and validation sets, with a sensitivity of 0.97 and 0.96, respectively. Its application to the Outcome cohort demonstrated significant prognostic value for 3-year PFS (log rank, p < 0.001). Multivariate analysis showed that high-grade pathology was the only variable explaining positive DOC test, not age, smoking, or lesional site.<BR><B>CONCLUSIONS: </B>Clinical implementation of the DOC test could provide an effective screening method for detecting HGLs for biopsy and lesions at risk of progression.