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The Pathologist / Issues / 2026 / July / The Hidden Signals of Oral Cancer Risk
Oncology Digital and computational pathology Bioinformatics Digital Pathology Research and Innovations Technology and innovation

The Hidden Signals of Oral Cancer Risk

AI-derived biomarkers could help pathologists identify high-risk lesions more consistently than traditional grading alone

By Jessica Allerton 07/20/2026 Discussion 4 min read
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Objective:

To explore the use of AI applications in the diagnosis and risk assessment of oral epithelial dysplasia (OED) within the context of a Cancer Research UK-funded project.

Approach:
  • Research Background: Adam Shephard discusses his transition from neuroimaging to computational pathology, focusing on OED as part of a Cancer Research UK-funded project.
  • Challenges in Grading OED: The subjective nature of histological grading leads to variability among pathologists and does not reliably predict clinical outcomes.
  • AI Model Development: HoVer-Net+ was developed to analyze histology images at the nuclear level, extracting biologically meaningful features for predicting cancer risk.
  • Risk Prediction Importance: AI models aim to improve early detection and treatment by providing consistent risk assessments to support clinical decision-making.
  • Biomarkers Identification: The study identified new biomarkers, such as increased lymphocyte infiltration, linked to malignant progression.
  • Performance Comparison: AI-derived biomarkers showed strong agreement with expert pathologists, though performance varied with external datasets.
  • Multimodal AI Models: Combining histology with clinical data offers a more comprehensive understanding of patient risk factors.
Key Findings:
  • AI models can provide more consistent risk predictions than traditional histological grading.
  • New biomarkers linked to cancer risk were identified, enhancing understanding of disease progression.
  • AI-derived tools achieved performance comparable to expert pathologists in risk assessment.
Interpretation:

AI applications in OED diagnostics may enhance risk assessment and support clinical decision-making.

Limitations:
  • Variability in performance when tested on external datasets due to differences in clinical practices.
  • Challenges in collecting consistent clinical data across multiple sites for multimodal studies.
Conclusion:

AI has the potential to improve risk assessment in OED.

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.

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References

  1. AJ Shephard et al., Commun Med (Lond), 5, 186 (2025). PMID: 40394272.
  2. AJ Shephard et al., Br J Cancer, 132 (2025). PMID: 39616233.
  3. AJ Shephard et al., NPJ Precis Oncol, 8, 137 (2024). PMID: 38942998.
  4. H Mahmood et al., BR J Cancer, 129 (2023). PMID: 37758836.
  5. R Muhammad et al., J Pathol, 260, 4 (2023). PMID: 37294162.

About the Author(s)

Jessica Allerton

Deputy Editor, The Pathologist

More Articles by Jessica Allerton

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