COMPARISON OF WORLD HEALTH ORGANIZATION AND BINARY GRADING SYSTEMS IN ACTINIC CHEILITIS

Objective To compare the role of histologic epithelial changes of epithelial dysplasia (ED) in actinic cheilitis (AC) in 2 grading systems: World Health Organization (WHO) and binary (BS). Study Design Cytologic and architectural changes of ED, proposed by WHO, were microscopically evaluated in 26 AC by 2 observers. Data correlation was performed using kappa and chi-square tests (P Results Most cases were graded as moderate ED (41.7%) and low risk in BS (58.3%). There was a positive interobserver correlation in WHO grading (k = 0.515; P = .001) and between WHO and BS grading systems (k = 0.385; P = .017). Intense ED and high-risk cases were statistically associated with 3 architectural changes: irregular stratification, dyskeratosis, and loss of cell polarity (P Conclusions The presence of both architectural and cytologic changes is necessary for the 2 grading systems. However, our results suggest that architectural changes were more significant to indicate high risk in BS in actinic cheilitis.