Diagnostic Accuracy of DNA Ploidy for Oral Potentially Malignant Disorders: A Systematic Review and Meta Analysis

Kar, Soubhagya Ranjan; N.C, Sangamesh; Bhuvaneswari, S; Mishra, Silpiranjan; Bajoria, Atul Anand; Pathi, Jugajyoti

doi:10.31557/APJCP.2025.26.4.1155

Diagnostic Accuracy of DNA Ploidy for Oral Potentially Malignant Disorders: A Systematic Review and Meta Analysis

Document Type : Systematic Review and Meta-analysis

Authors

¹ Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Kiit Deemed to be University Bhubaneswar, India.

² Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, Kiit Deemed to be University Bhubaneswar, India.

10.31557/APJCP.2025.26.4.1155

Abstract

Objective: to compare the diagnostic accuracy of DNA ploidy compared to biopsy followed by histopathological investigation in patients with oral potentially malignant disorders (OPMDs). Method: The review protocol is registered under PROSPERO(CRD42024524656) and performed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis – Diagnostic Test Accuracy (PRISMA- DTA) checklist. Databases like PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2024 to identify the diagnostic potential of DNA ploidy for various OPMDs. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were calculated manually if not present for each study. Quality assessment of included studies was evaluated based on Quality assessment of diagnostic accuracy studies (QUADAS)- 2 tool using review manager (RevMan ver. 5.3). Meta-analysis was performed in Meta-Disc 1.4 software for pooled sensitivity and specificity. Additional analysis was performed in terms of positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (SROC) with Area Under Curve (AUC) and p<0.05 as statistically significant. Results: Nine studies were included for qualitative synthesis and seven studies for meta-analysis. Included studies reported low risk of bias (ROB). Various OPMDs (oral leukoplakia (OL), oral lichen planus (OLP), erythroplakia (OE), oral erythro-leukoplakia and other oral dysplastic lesions were evaluated. The meta-analysis revealed an overall pooled sensitivity of 0.71 (CI 0.28- 0.96) and pooled specificity of 0.31 (CI 0.03- 0.79) with +PLR 0.99 (0.49 – 2.02) and -NLR 0.99 (0.18 – 5.48) and a DOR of 1.05 (0.07 – 16.14) with an overall diagnostic accuracy (AUC) of 0.49. Conclusion: This study findings provide evidence on ability of DNA ploidy for various OPMDs for early screening and diagnosis. DNA ploidy can be taken for secondary level of prevention for OPMD under early diagnosis and prompt treatment.

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