Sudbo et al identified prognostic factors in patients with oral leukoplakia. This can help identify patients at high risk for development of oral squamous cell carcinoma. The authors are from the University of Oslo and the Norwegian Radium Hospital.


NOTE: This study and a subsequent on in 2004 (NEJM 2004; 350: 1405-1413) were withdrawn from the New England Journal of Medicine on November 2, 2006 (355; 1927), because data in the study was called into question.


Prognostic factors:

(1) DNA content in a biopsy of an area with leukoplakia

(2) smoking status


DNA content was classified according to the following table, using the most abnormal criterion used.

DNA Content in Oral Leukoplakia


1 peak at 2c in G0 or G1

nuclei with 4c in G2 < 10% total number

nuclei with > 5c is <= 1% total number


peak at 4c in G0/G1 AND peak at 8c in G2

nuclei with 4c in G2 >= 10% total nuclei


peaks at 3c, 5c, 7c or 9c

nuclei with > 5c is > 1% total nuclei


from page 1272


Risk for progression to squamous cell carcinoma correlates with:

(1) DNA content, with risk aneuploid > tetraploid > diploid

(2) current tobacco use


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