title: A comparative study using WHO and binary oral epithelial dysplasia grading systems in actinic cheilitis.
abstract: OBJECTIVE
  To evaluate comparatively the influence of histopathological features on epithelial dysplasia (ED) and the effectiveness in usage of WHO and binary grading systems in actinic cheilitis (AC).
  
  
  METHODS
  Cytological and architectural alterations established by WHO for ED were evaluated in 107 cases of AC. Epithelial dysplasia was graded using WHO and binary systems. The comparisons were performed using kappa, chi-square, and phi coefficient tests (P < 0.05).
  
  
  RESULTS
  Most cases were classified as mild ED (44.5%) in the WHO system and as low risk for malignant transformation (64.5%) in the binary system. There was a positive correlation between WHO and binary systems (k = 0.33; P < 0.0002). Loss of basal cell polarity (P < 0.001) was associated with severity of ED grade in the WHO system. Anisonucleosis (P < 0.0001), nuclear pleomorphism (P < 0.0001), anisocytosis (P = 0.03), cell pleomorphism (P = 0.002) increased nuclear/cytoplasm ratio (P < 0.0001), increased nuclear size (P < 0.0001), increased number of mitotic figures (P = 0.0006), and dyskeratosis (P = 0.008) were associated with severity of ED grade in the binary system.
  
  
  CONCLUSIONS
  It seems that usage of binary ED grading system in AC may be more precise because there is correlation between many of cytological and some of architectural microscopic alterations with increased grade of ED.
authors.affiliation: Patologia Oral, Faculdade de Odontologia, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil.
authors.forename: P R
authors.initials: PR
authors.lastname: Câmara
authors.affiliation: Oral Pathology, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
authors.forename: S N
authors.initials: SN
authors.lastname: Dutra
authors.affiliation: Estomatologia, Faculdade de Odontologia, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Takahama Júnior
authors.affiliation: Estomatologia, Faculdade de Odontologia, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil.
authors.forename: Kbfc
authors.initials: K
authors.lastname: Fontes
authors.affiliation: Patologia Oral, Faculdade de Odontologia, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil.
authors.forename: R S
authors.initials: RS
authors.lastname: Azevedo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D002613:Cheilitis / Q000473:pathology*; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014944:World Health Organization; D055815:Young Adult
keywords: WHO; actinic cheilitis; binary; classification; epithelial dysplasia