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Tekin B, Xie F, Lehman JS. Lichen Planus: What is New in Diagnosis and Treatment? Am J Clin Dermatol 2024; 25:735-764. [PMID: 38982032 DOI: 10.1007/s40257-024-00878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/11/2024]
Abstract
Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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2
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Czerninski R, Awadieh Z, Feldman S, Keshet N, Zlotogorski A, Ramot Y. Familial oral lichen planus: A new risk group for oral cancer? Oral Dis 2024; 30:3018-3027. [PMID: 37983887 DOI: 10.1111/odi.14805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The familial type of oral lichen planus (OLP) is rare, with a paucity of data regarding its clinical significance. Our objective was to characterize patients with familial OLP. METHODS Families with at least two members diagnosed with OLP were included. Clinical and demographic data and medical history were recorded. RESULTS Twenty families, 19 Jewish and 1 Arab, were identified. Of the Jewish families, 57.8% were non-Ashkenazi, originating mainly from central Asia. Of those with OLP there were 14 males and 23 females with an average age of 49.1. Dyslipidemia, cardiovascular, and thyroid disorders (27.7%, 22.2%, and 16.6%, respectively) were the most common comorbidities. Five patients from five distinct families had oral cancer, two with second primary. CONCLUSIONS To the best of our knowledge, this is the largest study describing familial OLP. The predominant and common ethnicity of the families with multiple members diagnosed with OLP may imply an ethnic tendency. The higher tendency of hypothyroidism and the high percentage of OSCC among familial OLP patients might be connected to familial OLP and the latter suggests that this population is predisposed to malignant transformation. Thus, this group should be considered as a high-risk group.
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Affiliation(s)
- Rakefet Czerninski
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Zinat Awadieh
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Svetlana Feldman
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Keshet
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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3
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Ghazi N, Saghravanian N, Mirhashemi M, Shahabi H. Histologic and Histomorphometric Comparative Study of Oral Lichen Planus Versus Oral Lichenoid Reaction. Indian J Otolaryngol Head Neck Surg 2024; 76:1785-1790. [PMID: 38566645 PMCID: PMC10982157 DOI: 10.1007/s12070-023-04411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 04/04/2024] Open
Abstract
Aim Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory disease classified as an oral potentially malignant disorder (OPMD) and increased transformation risk to oral cancer. Oral lichenoid reactions (OLRs) share the clinical manifestations of OLP. This study aimed to determine histomorphometric changes in OLPs and OLRs in comparison to the healthy control, which helps to plan for the establishment of diagnostic criteria. Materials and Methods This cross-sectional prospective study was conducted on a total of 75 tissue-embedded paraffin-block samples, including OLPs (n = 25), OLR cases (n = 25), and healthy control individuals (n = 25). The study groups were compared by chi-squared, Fisher's exact, and one-way ANOVA tests. A p-value less than 0.05 was considered statistically significant. Results Comparison of the nuclear area and cellular area showed a statistically significant difference between study groups in basal and parabasal layer (P < 0.05). Comparison of the nuclear-to-cytoplasm ratio showed a statistically significant difference between study groups in basal (P < 0.05) but not in the parabasal region (P = 0.681). Conclusion We showed a significant difference in the nuclear and cellular area, nuclear-to-cytoplasm ratio between OLPs and OLRs, and healthy controls, but there was no statistically significant difference between OLPs and OLRs. Thus, these parameters cannot be applied to differentiate diagnoses between OLPs and OLRs.
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Affiliation(s)
- Narges Ghazi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrollah Saghravanian
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Mirhashemi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Shahabi
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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4
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Vergier V, Czarny K, Brau JJ, Le Pelletier F, Taihi I. Proliferative Verrucous Leukoplakia Presenting as a Ring Around the Collar and Cancer: A Case Report. Cureus 2024; 16:e56077. [PMID: 38618314 PMCID: PMC11009891 DOI: 10.7759/cureus.56077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
Proliferative verrucous leukoplakia (PVL) is an oral mucosa lesion with a high rate of malignant transformation. The diagnosis is often difficult, especially when the initial lesion is a simple homogeneous white leukoplakia, and when located only on the gingiva or palate. Moreover, the anatomopathological analysis is non-specific in the initial stages. The gingival PVL localisation (gPVL) is described as the most aggressive form with the highest rate of malignant transformation. Cases with a unique gingival localisation are rare, described with a "ring around the collar" clinical form. Considering the difficulty of early diagnosis of gPVL, we report the case of a 72-year-old woman, who presented "white lesions on her gingiva" with a slight discomfort in February 2019. The lesion was initially limited to the buccal part of the mandibular right gingiva, but rapidly extended to all the lingual and buccal mandibular gingiva during follow-up, leading to a diagnosis of gPVL. Two biopsies were performed, which concluded a verrucous hyperplasia and papilloma with a lichenoid part. The diagnosis of gPVL was made after a six-month follow-up based on clinical and anatomopathological factors. The gPVL transformed into a squamous cell carcinoma (SCC) after 18 months of follow-up. A surgical right mandibular bone excision with an autologous left fibula graft associated with radiotherapy was performed. Three years after the surgery, the patient remains under monitoring, with several gPVL and SCC recurrences treated. This case highlights that gPVL is a rare and aggressive form of PVL, with a high risk of fast malignant transformation. Knowledge about its aetiology, anatomic pathology, and biological markers is highly needed to speed up the diagnosis and develop specific follow-up and treatment.
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Affiliation(s)
- Valentin Vergier
- Department of Dentistry, Faculty of Health, Université Paris Cité, Montrouge, FRA
- Department of Dentistry, Charles Foix Hospital, Assistance Publique-Hôpitaux de Paris, Ivry-sur-Seine, FRA
- Orofacial Pathologies, Imaging, and Biotherapies Laboratory (URP 2496 BRIO), Université Paris Cité, Montrouge, FRA
| | - Katarzyna Czarny
- Department of Dentistry, Faculty of Health, Université Paris Cité, Montrouge, FRA
- Department of Maxillo-facial Plastic Surgery and Stomatology, Gonesse Hospital, Gonesse, FRA
| | - Jean-Jacques Brau
- Odontology and Maxillofacial Prosthesis Unit, Department of Cervicofacial Cancerology, Gustave Roussy Cancer Center, Villejuif, FRA
| | - François Le Pelletier
- Department of Pathology, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FRA
| | - Ihsène Taihi
- Department of Dentistry, Faculty of Health, Université Paris Cité, Montrouge, FRA
- Orofacial Pathologies, Imaging, and Biotherapies Laboratory (URP 2496 BRIO), Université Paris Cité, Montrouge, FRA
- Department of Oral Surgery, Rothschild Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FRA
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5
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Pimolbutr K, Lim WT, Leeson R, Hopper C, Kalavrezos N, Liew C, Schilling C, Sinha D, Jay A, Agrawal R, Porter S, Fedele S. Prognosis of oral epithelial dysplasia in individuals with and without oral lichen planus. Oral Dis 2024; 30:504-517. [PMID: 36648368 DOI: 10.1111/odi.14503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To investigate the role of oral lichen planus (OLP) on the long-term prognosis of oral epithelial dysplasia (OED). METHODS Retrospective single-centre cohort study using the 2007-2019 database of the Head and Neck Cancer and Oral Medicine units of University College London Hospital. The exposure of interest was the presence of OLP, and the prognostic outcomes included the development of new primary episodes of OED, progression to malignancy and mortality. Cox proportional hazard and Poisson regression models were performed. RESULTS A total of 299 patients, of whom 144 had OED arising on the background of OLP (OLP/OED) and 155 had OED without underlying OLP (non-OLP/OED), were included. A pre-existing diagnosis of OLP was significantly associated with a twofold increased risk of subsequent primary OED events (HR = 2.02, p = 0.04), which also developed faster (1.46 vs. 2.96 years, p = 0.04) and with more involvement of non-cancer-prone sites (p = 0.001) than in the non-OLP/OED group. There was no difference between groups in the progression to malignancy or mortality. CONCLUSIONS Oral lichen planus/OED patients are at higher risk of multiple episodes of primary OED, which can develop faster and at non-cancer-prone sites as compared to non-OLP/OED individuals. Further research is needed to clarify the effects of OLP upon progression to OSCC and mortality.
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Affiliation(s)
- Kununya Pimolbutr
- UCL Eastman Dental Institute, University College London, London, UK
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Woei Tatt Lim
- Oral and Maxillofacial Surgery Department, Sarawak General Hospital, Kuching, Malaysia
| | - Rachel Leeson
- UCL Eastman Dental Institute, University College London, London, UK
| | - Colin Hopper
- UCL Eastman Dental Institute, University College London, London, UK
| | - Nicholas Kalavrezos
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Colin Liew
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Clare Schilling
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Deepti Sinha
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Amrita Jay
- Department of Cellular Pathology, University College London Hospitals (UCLH), London, UK
| | - Reshma Agrawal
- Department of Cellular Pathology, University College London Hospitals (UCLH), London, UK
| | - Stephen Porter
- UCL Eastman Dental Institute, University College London, London, UK
- NIHR UCLH Biomedical Research Centre, London, UK
| | - Stefano Fedele
- UCL Eastman Dental Institute, University College London, London, UK
- NIHR UCLH Biomedical Research Centre, London, UK
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Louisy A, Humbert E, Samimi M. Oral Lichen Planus: An Update on Diagnosis and Management. Am J Clin Dermatol 2024; 25:35-53. [PMID: 37713153 DOI: 10.1007/s40257-023-00814-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease whose pathogenesis involves a T-cell mediated, epithelium-directed inflammation in response to unknown antigen(s). The disease evolves by intermittent flares and displays polymorphous clinical features (reticular, erosive, atrophic, plaque, papular, bullous, etc.). When present, symptoms vary depending on the clinical form and range from discomfort to severe pain. Topical superpotent corticosteroids constitute the first-line treatment of symptomatic flares, whereas a wide range of second/third-line treatments are available among topical calcineurin inhibitors, systemic corticosteroids, systemic retinoids, topical/systemic immunomodulators, etc. Follow-up of patients is necessary to detect transformation into squamous cell carcinoma, occurring in approximately 1% of patients.
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Affiliation(s)
- Agathe Louisy
- Université François Rabelais, Tours, France
- Maxillofacial Surgery and Stomatology Department, CHU Tours, Tours, France
| | - Eiryann Humbert
- Université François Rabelais, Tours, France
- Department of Dermatology, CHU Tours, Avenue de la République, 37170, Tours, France
| | - Mahtab Samimi
- Université François Rabelais, Tours, France.
- Department of Dermatology, CHU Tours, Avenue de la République, 37170, Tours, France.
- INRA, UMR 1282, Tours, France.
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7
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Che Y, Zhang H, Li H, Wu X. CIP2A interacts with AKT1 to promote the malignant biological behaviors of oral squamous cell carcinoma by upregulating the GSK‑3β/β‑catenin pathway. Exp Ther Med 2023; 26:514. [PMID: 37840566 PMCID: PMC10570767 DOI: 10.3892/etm.2023.12213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most common malignancies worldwide, which is associated with a poor prognosis. The present study aimed to investigate the role of cancerous inhibitor of protein phosphatase 2A (CIP2A) in OSCC and its regulatory effect on AKT1. Firstly, CIP2A and AKT1 expression in OSCC cells was detected by western blotting. After silencing CIP2A, cell viability and cell proliferation were assessed using the Cell Counting Kit-8 assay and 5-ethynyl-2'-deoxyuridine staining. Cell apoptosis was evaluated by TUNEL staining and the expression of apoptosis-related proteins was assessed using western blotting. Wound healing, Transwell and tube formation assays were performed to evaluate CAL-27 cell migration, invasion and human umbilical vein endothelial cell (HUVEC) tube formation. The interaction between CIP2A and AKT1 was identified by co-immunoprecipitation (co-IP). In addition, AKT1 was overexpressed in CIP2A-silenced CAL-27 cells to perform rescue experiments to analyze the malignant biological functions of CAL-27 cells. Finally, the expression of proteins in the glycogen synthase kinase (GSK)-3β/β-catenin pathway was determined by western blot analysis. Markedly elevated CIP2A and AKT1 expression was observed in OSCC cells. CIP2A knockdown inhibited the viability, proliferation, migration and invasion, and promoted the apoptosis of CAL-27 cells. Concurrently, CIP2A loss-of-function attenuated tube formation. Results of Co-IP confirmed there was an interaction between CIP2A and AKT1. Rescue experiments suggested that AKT1 overexpression alleviated the inhibitory effects of CIP2A knockdown on the viability, proliferation, migration and invasion of CAL-27 cells, as well as tube formation in HUVECs . Additionally, CIP2A silencing significantly downregulated phosphorylated-GSK-3β and β-catenin expression, which was reversed by AKT1 overexpression. In conclusion, CIP2A could interact with AKT1 to promote the malignant biological behaviors of OSCC cells by upregulating the GSK-3β/β-catenin pathway. These findings may provide a targeted therapy for OSCC treatment.
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Affiliation(s)
- Yilei Che
- Department of Stomatology, Aerospace Center Hospital, Beijing 100049, P.R. China
| | - Hui Zhang
- Department of Stomatology, Aerospace Center Hospital, Beijing 100049, P.R. China
| | - Hui Li
- Department of Stomatology, Aerospace Center Hospital, Beijing 100049, P.R. China
| | - Xiaozhen Wu
- Department of Stomatology, Aerospace Center Hospital, Beijing 100049, P.R. China
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González-Moles MÁ, Ramos-García P. Oral lichen planus and related lesions. What should we accept based on the available evidence? Oral Dis 2023; 29:2624-2637. [PMID: 36371653 DOI: 10.1111/odi.14438] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/13/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
Recent new terminologies have been proposed for lesions in the sphere of oral lichen planus (OLP) that theoretically present unique aetiological, clinical, prognostic or management characteristics different from those of the so-called typical forms of OLP. We aimed to critically analyse what concepts and terminologies related to OLP should we accept based on the available evidence. A review of the literature was carried out in order to critically analyse the concepts and terminologies related to OLP. New concepts and terminologies include oral lichenoid lesions; contact lichenoid reactions, drug lichenoid reactions or those in the context of graft-versus-host disease; chronic ulcerative stomatitis; lichen planus pemphigoid; and some lesions that are difficult to categorise, such as OLP with features of proliferative verrucous leukoplakia and lichenoid lesions of the upper labial mucosa. A multidisciplinary, multicontinent working group has recently published a guideline with recommendations for modifying definitions and terminologies associated with a disease, among which a reasoned, evidence-based justification for the proposed change is considered essential. An in-depth analysis of the newly proposed terms for OLP-related lesions shows that many of them are not justified. In this paper, we set out our position on the basis of the existing evidence on the appropriateness of the use of these new terms.
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Affiliation(s)
| | - Pablo Ramos-García
- School of Dentistry, Biohealth Research Institute (Ibs.Granada), University of Granada, Granada, Spain
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González-Ruiz I, Ramos-García P, Ruiz-Ávila I, González-Moles MÁ. Early Diagnosis of Oral Cancer: A Complex Polyhedral Problem with a Difficult Solution. Cancers (Basel) 2023; 15:3270. [PMID: 37444379 DOI: 10.3390/cancers15133270] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Oral and oropharyngeal cancers are a growing problem, accounting for 377,713 and 98,412 new cases per year all over the world and 177,757 and 48,143 deaths annually, respectively. Despite the substantial improvement in diagnostic procedures and treatment techniques in recent years, the mortality rate has not decreased substantially in the last 40 years, which is still close to 50% of cases. The major cause responsible for this high mortality is associated with the high percentage of oral cancers diagnosed in advanced stages (stages III and IV) where the treatment harbors poor efficacy, resulting in challenges, mutilations, or disability. The main reason for cancer to be diagnosed at an advanced stage is a diagnostic delay, so it is critical to reduce this delay in order to improve the prognosis of patients suffering from oral cancer. The causes of oral cancer diagnostic delay are complex and concern patients, healthcare professionals, and healthcare services. In this manuscript, oral cancer diagnostic delay is critically reviewed based on current evidence, as well as their major causes, main problems, and potential improvement strategies.
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Affiliation(s)
- Isabel González-Ruiz
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Isabel Ruiz-Ávila
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Hospital Universitario San Juan de Reus, CAP Marià Fortuny, 43204 Tarragona, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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10
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Xie F, Gleue CA, Deschaine M, Dasari S, Sartori-Valinotti JC, Charlesworth MC, Meves A, Lehman JS. Differential proteomic expression in indolent versus transforming oral lichen planus. Exp Dermatol 2023; 32:502-510. [PMID: 36587284 DOI: 10.1111/exd.14738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/06/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
Oral lichen planus (OLP) confers an approximately 1% risk of transformation to oral squamous cell carcinoma (OSCC). Early identification of high-risk OLP would be very helpful for optimal patient management. We aimed to discover specific tissue-based protein biomarkers in patients with OLP who developed OSCC compared to those who did not. We used laser capture microdissection- and nanoLC-tandem mass spectrometry to assess protein expression in fixed lesional mucosal specimens in patients with indolent OLP (no OSCC after at least 5-year follow-up, n = 6), transforming OLP (non-dysplastic epithelium with lichenoid inflammation marginal to OSCC, n = 6) or normal oral mucosa (NOM, n = 5). Transforming OLP protein profile was enriched for actin cytoskeleton, mitochondrial dysfunction and oxidative phosphorylation pathways. CA1, TNNT3, SYNM and MB were overexpressed, and FBLN1 was underexpressed in transforming OLP compared with indolent OLP. Integrin signalling and antigen presentation pathways were enriched in both indolent and transforming OLP compared with NOM. This proteomic study provides potential biomarkers, such as CA1 overexpression, for higher-risk OLP. While further validation studies are needed, we propose that epithelial-mesenchymal transition may be involved in OLP carcinogenesis.
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Affiliation(s)
- Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Casey A Gleue
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria Deschaine
- Department of Dermatology, Florida State University, Pensacola, Florida, USA
| | - Surendra Dasari
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Alexander Meves
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
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11
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Zhang S, Deng Y, Ji T, Wang Y, Liu W. Overestimated risk of transformation in oral lichen planus: In reply with emphasis on natural history of proliferative verrucous leukoplakia. Oral Oncol 2023; 136:106263. [PMID: 36444802 DOI: 10.1016/j.oraloncology.2022.106263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shijian Zhang
- Department of Oral and Maxillofacial Surgery, Zhang Zhiyuan Academician Workstation, Hainan Western Central Hospital, Shanghai Ninth People's Hospital, Danzhou, Hainan, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yiwen Deng
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yufeng Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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12
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González-Moles MÁ, Keim-del Pino C, Ramos-García P. Hallmarks of Cancer Expression in Oral Lichen Planus: A Scoping Review of Systematic Reviews and Meta-Analyses. Int J Mol Sci 2022; 23:13099. [PMID: 36361889 PMCID: PMC9658487 DOI: 10.3390/ijms232113099] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 09/05/2023] Open
Abstract
Oral lichen planus (OLP) is a common chronic inflammatory disease of unknown etiology and likely autoimmune nature that is currently considered an oral potentially malignant disorder, implying that patients suffering from this process are at risk of developing oral cancer in their lifetime. The molecular alterations that develop in OLP and that make the affected oral epithelium predisposed to malignancy are unknown, although, as in other autoimmune diseases (ulcerative colitis, primary biliary cirrhosis, etc.), they may be linked to oncogenesis-promoting effects mediated by the inflammatory infiltrate. So far there is no in-depth knowledge on how these hallmarks of cancer are established in the cells of the oral epithelium affected by OLP. In this scoping review of systematic reviews and meta-analyses the state of evidence based knowledge in this field is presented, to point out gaps of evidence and to indicate future lines of research. MEDLINE, Embase, Cochrane Library and Dare were searched for secondary-level studies published before October 2022. The results identified 20 systematic reviews and meta-analyses critically appraising the hallmarks tumor-promoting inflammation (n = 17, 85%), sustaining proliferative signaling (n = 2, 10%), and evading growth suppressors (n = 1, 5%). No evidence was found for the other hallmarks of cancer in OLP. In conclusion, OLP malignization hypothetically derives from the aggressions of the inflammatory infiltrate and a particular type of epithelial response based on increased epithelial proliferation, evasion of growth-suppressive signals and lack of apoptosis. Future evidence-based research is required to support this hypothesis.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Carmen Keim-del Pino
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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13
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Challenges in the Early Diagnosis of Oral Cancer, Evidence Gaps and Strategies for Improvement: A Scoping Review of Systematic Reviews. Cancers (Basel) 2022; 14:cancers14194967. [PMID: 36230890 PMCID: PMC9562013 DOI: 10.3390/cancers14194967] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Oral cancer presents a worldwide incidence of 377,713 new cases and 177,757 deaths per year (GLOBOCAN, IARC, WHO). Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of oral malignancies and has a 5-year mortality rate close to 50%. We aim to better understand, based on the evidence, and to discuss in depth, the reasons for the diagnostic delay of oral cancer by reviewing systematic reviews and meta-analyses. We also aim to, identify gaps in evidence, recommend future lines of research that should be implemented, and formulate strategies for improvement. Abstract Oral cancer is a growing problem, accounting for 377,713 worldwide new cases per year, and 177,757 deaths annually and representing a 5-year mortality rate close to 50%, which is a considerable mortality that has not decreased substantially in the last 40 years. The main cause of this high mortality is related to the diagnosis of a high percentage of oral cancers in advanced stages (stages III and IV) in which treatment is complex, mutilating or disabling, and ineffective. The essential cause of a cancer diagnosis at a late stage is the delay in diagnosis, therefore, the achievement of the objective of improving the prognosis of oral cancer involves reducing the delay in its diagnosis. The reasons for the delay in the diagnosis of oral cancer are complex and involve several actors and circumstances—patients, health care providers, and health services. In this paper, we present the results of a scoping review of systematic reviews on the diagnostic delay in oral cancer with the aim to better understand, based on the evidence, and discuss in depth, the reasons for this fact, and to identify evidence gaps and formulate strategies for improvement.
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14
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González-Moles MÁ, Warnakulasuriya S, López-Ansio M, Ramos-García P. Hallmarks of Cancer Applied to Oral and Oropharyngeal Carcinogenesis: A Scoping Review of the Evidence Gaps Found in Published Systematic Reviews. Cancers (Basel) 2022; 14:cancers14153834. [PMID: 35954497 PMCID: PMC9367256 DOI: 10.3390/cancers14153834] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary This scoping review of systematic reviews aims to accurately assess the degree of existing scientific evidence on the cancer hallmarks proposed in 2011 by Hanahan and Weinberg, in the form of systematic reviews and meta-analyses, applied to oral potentially malignant disorders, oral cavity and oropharyngeal squamous cell carcinomas, in order to point out gaps in evidence and lines of research that should be implemented in the future to improve the malignant transformation prediction, diagnosis and/or prognosis of these diseases. Abstract In 2000 and 2011, Hanahan and Weinberg published two papers in which they defined the characteristics that cells must fulfil in order to be considered neoplastic cells in all types of tumours that affect humans, which the authors called “hallmarks of cancer”. These papers have represented a milestone in our understanding of the biology of many types of cancers and have made it possible to reach high levels of scientific evidence in relation to the prognostic impact that these hallmarks have on different tumour types. However, to date, there is no study that globally analyses evidence-based knowledge on the importance of these hallmarks in oral and oropharyngeal squamous cell carcinomas. For this reason, we set out to conduct this scoping review of systematic reviews with the aim of detecting evidence gaps in relation to the relevance of the cancer hallmarks proposed by Hanahan and Weinberg in oral and oropharyngeal cancer, and oral potentially malignant disorders, and to point out future lines of research in this field.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE1 9RT, UK
- WHO Collaborating for Oral Cancer, King's College London, London SE1 9RT, UK
| | - María López-Ansio
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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15
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Yang X, Yang X, Ji T, Zhou Q, Liu W. A bibliometric analysis of the papers on oral potentially malignant disorder in Oral Oncology. Oral Oncol 2022; 132:105996. [PMID: 35767931 DOI: 10.1016/j.oraloncology.2022.105996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial Surgery, Zhang Zhiyuan Academician Workstation, Hainan Western Central Hospital, Shanghai Ninth People's Hospital, Danzhou, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiujuan Yang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Zhou
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Liu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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16
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Sanches ACB, Pires ALPV, Medrado ARAP, de Almeida Reis SR, Freitas VS, Martins GB. Oral Lichen Planus: Associations Between Histomorphometric Characteristics and White and Red Lesions. Head Neck Pathol 2022; 16:969-979. [PMID: 35579856 PMCID: PMC9729480 DOI: 10.1007/s12105-022-01442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Histomorphometry seems to provide more rigid quantitative elements for histological analysis and to bring less subjectivity to the diagnosis of oral lichen planus lesions (OLP). This study aimed to verify the association between white and red lesions and histomorphometric characteristics of OLP lesions. This retrospective cross-sectional study assessed 48 hematoxylin- and eosin-stained histological sections from incisional biopsies obtained from OLP cases. A single previously calibrated evaluator performed the light microscopy analyses to evaluate morphological and morphometric parameters. Analyses of associations among variables were performed using the Fisher's exact test. Morphometric variables were assessed using the Mann-Whitney non-parametric test. Comparisons among the three groups (age range) were performed using the Kruskal-Wallis test. In this study, 81.2% of the participants were women aged < 50 years. Keratosis, acanthosis, and inflammatory infiltrates were noted in 10.4, 10.4, and 37.5% of moderate/severe cases, respectively. Inflammatory infiltrate (52.1%), papillary projections (54.2%), saw teeth (12.5%), basal layer degeneration (39.6%), and Civatte bodies (68.8%) were also observed. There was no significant association between lesion type and clinicopathological variables (p > 0.05) or between lesion type and histological (p > 0.05) and morphometric variables (p > 0.05). Furthermore, the morphometric variables analyzed did not differ between white and red lesions (p > 0.05) or in their associations with clinicopathological variables (p > 0.05). The results of this investigation showed no associations between white and red OLP lesions and the histomorphometric characteristics evaluated.
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Affiliation(s)
- Ana Carla Barletta Sanches
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Laboratório de Bioquímica Oral, Instituto de Ciências da Saúde (UFBA), Av. Reitor Miguel Calmon, s/n. Sala 410. Vale do Canela, Salvador, Brazil
| | | | | | - Silvia Regina de Almeida Reis
- Bahiana School of Medicine and Public Health, Salvador, Bahia Brazil ,Pathology, Berlin’s Free University, Berlin, Germany
| | - Valéria Souza Freitas
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Brazil ,Dentistry Course, State University of Feira de Santana, Feira de Santana, Brazil ,Postgraduate Program in Public Health, State University of Feira de Santana, Bahia, Brazil
| | - Gabriela Botelho Martins
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Clinical Stomatology, PUCRS, Porto Alegre, Brazil ,Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
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17
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Xie F, Meves A, Lehman JS. The genomic and proteomic landscape in oral lichen planus versus oral squamous cell carcinoma: a scoping review. Int J Dermatol 2022; 61:1227-1236. [PMID: 35575880 DOI: 10.1111/ijd.16273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/24/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral lichen planus (OLP), a World Health Organization (WHO)-classified oral potentially malignant condition, confers a 1% risk of transformation to oral squamous cell carcinoma (OSCC). There does not appear to be a consensus understanding of the underlying molecular events. This scoping review aimed to identify critical molecular pathways and highlight gaps in existing knowledge on malignant transformation in OLP. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines, a comprehensive literature search and methodical screening identified 61 relevant studies detailing molecular differences between OLP and OSCC. RESULTS Molecular changes shared between OLP and OSCC included those affecting cellular proliferation (altered p53 expression, hypermethylation of p16/CDKN2A, MYC gains, increased ki-67), apoptosis (increased bcl-2 and survivin expression), extracellular matrix (ECM) remodeling (increased matrix metalloproteinase [MMP] expression), and transcriptional control (altered bmi1 and microRNA [miRNA] expression). In addition, some molecular alterations accumulated incrementally from control to OLP to OSCC or were present in higher-risk erosive variants of OLP or transformed OLP. Few studies included rigorous diagnostic inclusion criteria or unbiased discovery methods. CONCLUSIONS Results of this review support the potentially malignant nature of OLP and imply that molecular events associated with malignant transformation may be heterogeneous. In addition, findings in this review highlight the need for additional studies using rigorous diagnostic inclusion criteria and unbiased discovery methods to further understand this process.
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Affiliation(s)
- Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Alexander Meves
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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18
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Faustino ISP, de Pauli Paglioni M, Mariz BALDA, Normando AGC, Pérez-de-Oliveira ME, Georgaki M, Nikitakis NG, Vargas PA, Santos-Silva AR, Lopes MA. Prognostic outcomes of OSCC derived from proliferative verrucous leukoplakia: a systematic review. Oral Dis 2022; 29:1416-1431. [PMID: 35199416 DOI: 10.1111/odi.14171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to evaluate prognostic outcomes of PVL-derived oral squamous cell carcinomas (P-OSCC) based on recurrence, new primary tumour, metastasis and survival information. STUDY DESIGN Five databases and grey literature were searched electronically with the following main keywords (proliferative verrucous leukoplakia, squamous cell carcinoma and malignant transformation) to answer the following review question: 'Are survival outcomes for P-OSCC worse?' based on the PECOS principle. The Joanna Briggs Institute Critical Appraisal tool was used to identify possible biases and assess the quality of each of the primary studies. RESULTS A total of 21 articles met the inclusion criteria, and the results of this systematic review suggest that P-OSCC can recur and generate new primary tumours; however, metastases are rare. Thus, most patients remain alive for an average period of 5 years. CONCLUSION Apparently, P-OSCC has better clinical prognostic characteristics than conventional OSCC. There is a lack of information on the main prognostic outcomes of P-OSCC; therefore, specific studies must be performed to achieve a better comparison between P-OSCC and conventional OSCC progression.
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Affiliation(s)
| | | | | | | | | | - Maria Georgaki
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Nikolaos G Nikitakis
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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19
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Xie F, Gleue CA, Deschaine M, Dasari S, Lau JS, Sartori-Valinotti JC, Meves A, Lehman JS. Whole-Exome Sequencing of Transforming Oral Lichen Planus Reveals Mutations in DNA Damage Repair and Apoptosis Pathway Genes. J Oral Pathol Med 2022; 51:395-404. [PMID: 35146808 DOI: 10.1111/jop.13284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral lichen planus confers a 1% risk of transformation to oral squamous cell carcinoma. While prior exome sequencing studies have identified multiple genetic mutations in oral squamous cell carcinoma, mutational analyses of lichen planus-derived OSCC are lacking. We sought to clarify genomic events associated with oral lichen planus transformation. METHODS Using rigorous diagnostic criteria, we retrospectively identified patients with non-transforming oral lichen planus (i.e. known to be non-transforming with 5 years of clinical follow-up; n=17), transforming oral lichen planus (tissue marginal to oral squamous cell carcinoma, n=9), or oral squamous cell carcinoma arising in lichen planus (n=17). Gene mutational profiles derived from whole-exome sequencing on fixed mucosal specimens were compared amongst the groups. RESULTS The four most frequently mutated genes in transforming oral lichen planus and oral squamous cell carcinoma (TP53, CELSR1, CASP8 and KMT2D) identified 12/17 (71%) of oral squamous cell carcinomas and 5/9 (56%) of transforming oral lichen planus but were absent in non-transforming oral lichen planus. These findings suggest alterations in DNA damage response and apoptosis pathways underlie lichen planus-related oral squamous cell carcinoma transformation and are supported by mutational signatures indicative of DNA damage. We identified other known oral squamous cell carcinoma mutations (TRRAP, OBSCN, LRP2) but also previously unreported mutations (TENM3 and ASH1L) in lichen planus-associated oral squamous cell carcinomas. CONCLUSIONS This study characterized patterns of mutational events present in oral lichen planus associated with squamous cell carcinoma, and in squamous cell carcinoma associated with oral lichen planus, but not in non-transforming oral lichen planus.
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Affiliation(s)
- Fangyi Xie
- Department of Dermatology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Casey A Gleue
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Maria Deschaine
- Department of Dermatology, Florida State University, 1115 W. Call St, Tallahassee, FL, 32304, USA
| | - Surendra Dasari
- Department of Qualitative Health Sciences, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Julie S Lau
- Medical Genome Facility, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | | | - Alexander Meves
- Department of Dermatology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
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20
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Sarode GS, Sarode SC, Yuwanati M, Gadbail A, Gondivkar S. Lichenoid infiltrate in oral submucous fibrosis: A new marker of malignant transformation. Oral Oncol 2021; 124:105671. [PMID: 34915262 DOI: 10.1016/j.oraloncology.2021.105671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Gargi S Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Sachin C Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Monal Yuwanati
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India.
| | - Amol Gadbail
- Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra State, India
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21
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Wang MY, Zhu WW, Zhang JY, Yu M, Zhai RD, Liu LK. Tertiary lymphoid structures in oral lichen planus and oral epithelial dysplasia with lichenoid features: A comparative study. Oral Dis 2021; 29:154-164. [PMID: 34897887 DOI: 10.1111/odi.14097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Tertiary lymphoid structures (TLSs) provide sites for antigen presentation and activation of lymphocytes, promoting their infiltration; thus, enhancing specific immune responses. The aim of this comparative cross-sectional study was to reveal the characteristics and influence of TLSs in oral lichen planus (OLP) and oral epithelial dysplasia (OED) with lichenoid features. METHODS Clinical information and samples of 51 OLP and 19 OED with lichenoid features were collected. Immunohistochemistry was performed, and the structures where CD20+ B cells and CD3+ T cells aggregated with peripheral lymph node addressin positive (PNAd+) vessels were defined as TLSs. The results and clinical information were analysed. RESULT TLS were found in 44 (86.3%) patients with OLP and 19 (100%) patients with OED. The TLS score was higher in OED group (p = 0.023), accompanied by an increased number of PNAd+ vessels. The TLS was significantly correlated with PNAd+ vessels (p = 0.027), CD20+ B (p < 0.001) and CD208+ dendritic cells (p = 0.001). Foxp3+ Treg cells but not CD8+ T cells infiltrated more severely in OED (p = 0.003) and increased when TLS score was high (p = 0.002). CONCLUSIONS This study revealed the widespread development of TLSs in the OLP and OED. The presence of TLSs showed a close relationship with dysplasia and may increase malignant potency by over-inducing Treg cells.
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Affiliation(s)
- Meng-Yao Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Basic Science of Stomatology, the affiliated Hospital of Stomatology, Nanjing Medical University, Jiangsu, China
| | - Wei-Wen Zhu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Basic Science of Stomatology, the affiliated Hospital of Stomatology, Nanjing Medical University, Jiangsu, China
| | - Jia-Yi Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Basic Science of Stomatology, the affiliated Hospital of Stomatology, Nanjing Medical University, Jiangsu, China
| | - Miao Yu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Periodontology, the affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Run-Dong Zhai
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Basic Science of Stomatology, the affiliated Hospital of Stomatology, Nanjing Medical University, Jiangsu, China
| | - Lai-Kui Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Jiangsu, China.,Department of Basic Science of Stomatology, the affiliated Hospital of Stomatology, Nanjing Medical University, Jiangsu, China
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22
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Risk of Malignant Transformation in 3173 Subjects with Histopathologically Confirmed Oral Lichen Planus: A 33-Year Cohort Study in Northern Italy. Cancers (Basel) 2021; 13:cancers13225740. [PMID: 34830892 PMCID: PMC8616266 DOI: 10.3390/cancers13225740] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Up to 1–4% of OLP patients could develop oral cancer, and identifying factors that could help in early detection could be extremely useful. The aim of our cohort study was to assess the clinical characteristics of one of the biggest populations ever reported with a histologically confirmed diagnosis of OLP. We identified that OLP patients who developed oral cancer usually underwent less frequent periodical follow-up visits, and older age increased the risk of death. As a significant number of OLP patients have a risk of malignant transformation, there is a critical need to review these patients preferentially, by trained clinicians, at least once a year, possibly for a lifetime. Abstract Background: Oral lichen planus (OLP) is considered an oral potentially malignant disorder. The aim of our study was to estimate the risk for oral cancer in patients diagnosed with OLP. Methods: A population-based cohort study between January 1988 and December 2020 at one hospital in Northern Italy was performed. The primary endpoint of the study was that of the histopathological diagnosis of oral cancer during the follow-up period. Results: The study population comprised 3173 patients. During the follow-up period, 32 men and 50 women developed an oral squamous cell carcinoma (2.58%), with a mean time of 103.61 months after the initial diagnosis of OLP, and 21 patients died because of oral cancer. Almost half of the deceased patients had the last follow-up visit before cancer diagnosis in a period of more than 12 months. Older age, having a red form of OLP and fewer sites of involvement, increased the risk of having cancer, while age and no treatment increased the risk of death. Conclusion: This is the largest group of OLP patients with such a long follow up ever reported. Due to the increased risk of having a malignant transformation, especially in elderly subjects, OLP patients should be regularly followed up, particularly in the Northern Italian population.
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23
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Li L, Zhou Z, Mai K, Li P, Wang Z, Wang Y, Cao Y, Ma X, Zhang T, Wang D. Protein overexpression of toll-like receptor 4 and myeloid differentiation factor 88 in oral squamous cell carcinoma and clinical significance. Oncol Lett 2021; 22:786. [PMID: 34594427 PMCID: PMC8456488 DOI: 10.3892/ol.2021.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/13/2021] [Indexed: 11/25/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most common type of malignancy of the head and neck. In the present study, the expression of Toll-like receptor 4 (TLR4) and myeloid differentiation primary response gene 88 (MyD88) was evaluated in 55 OSCC tissues and their corresponding adjacent tissues using immunohistochemistry and reverse-transcription quantitative PCR. The results indicated that TLR4 and MyD88 were overexpressed in OSCC. Furthermore, high expression of MyD88 was negatively associated with a poor degree of differentiation, recurrence and metastasis of the tumor and was positively associated with underlying disease, including hypertension, heart disease and diabetes mellitus. Furthermore, high expression of TLR4 was positively associated with a long growth time of the tumor. In conclusion, the present study evaluated the expression levels of TLR4 and MyD88 in OSCC, as well as the association between them and clinicopathological factors, to provide markers for the prognosis and treatment of OSCC. These two genes may serve as biomarkers to optimize OSCC treatment, setting a new direction for stratifying patients and developing precise and personalized treatment regimens; the TLR4/MyD88 pathway may serve as a potential therapeutic target in the future.
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Affiliation(s)
- Lili Li
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Department of Stomatology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530028, P.R. China
| | - Zhuoqian Zhou
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Khangvu Mai
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Ping Li
- Department of Pathology, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zongqi Wang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yaxi Wang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yang Cao
- Department of Pathology, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Xuemeng Ma
- Department of Pathology, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Tingting Zhang
- Department of Disease Control and Prevention, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Daiyou Wang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.,Guangxi Clinical Research Center for Craniofacial Deformity, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13194843. [PMID: 34638327 PMCID: PMC8507842 DOI: 10.3390/cancers13194843] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Proliferative verrucous leukoplakia is considered by the WHO as an oral potentially malignant disorder that presents the highest tendency to recurrence and malignant transformation rate. However, to date limited evidence-based prognostic data for oral carcinomas developed in patients with proliferative verrucous leukoplakia (PVL-OC) have been published, and these carcinomas probably perform better than conventional oral carcinomas. In this study we present a systematic review and meta-analysis to evaluate the current evidence in relation to the prognosis of oral carcinomas developed in patients PVL-OC. Abstract Proliferative verrucous leukoplakia (PVL) is contemplated by the World Health Organization (WHO) as an oral potentially malignant disorder (OPMD) with a high the highest malignant transformation ratio among all OPMD (approximately 50%). Our aim was to evaluate the current evidence in relation to the prognosis of oral carcinoma developed in patients with proliferative verrucous leukoplakia (PVL-OC). We searched PubMed, Embase, Web of Science and Scopus for published studies (upper date limit = June 2021). We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. 23 studies met inclusion criteria (505 patients with PVL, of which 288 developed a total of 504 carcinomas). The meta-analyzed overall mortality rate was 21.29% (pooled proportions [PP] = 95% confidence intervals [CI] = 8.77–36.36) for PVL-OC, clearly lower than the 34.7–50% mortality rate for conventional oral cancer reported in previous studies. In comparison with a single study reporting on conventional oral cancers, mortality was significantly lower for PVL-OC (hazard ratio = 0.29 [95%CI = 0.10–0.89], p = 0.03). Univariable meta-regression verified that case series that presented higher proportions of verrucous carcinomas showed a better survival of PVL-OC (p = 0.05), but not with higher proportion of oral squamous cell carcinomas (p = 0.74). Significant differences were not found for other relevant variables such as follow up period (p = 0.44) or multiple tumor development (p = 0.74). In conclusion, PVL-OC show favorable prognostic parameters, especially with regard to the mortality rate.
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25
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Hu X, Wu J, Xiong H, Zeng L, Wang Z, Wang C, Huang D, Zhang T, Peng Y, Chen W, Xia K, Su T. Type 2 diabetes mellitus promotes the proliferation, metastasis, and suppresses the apoptosis in oral squamous cell carcinoma. J Oral Pathol Med 2021; 51:483-492. [PMID: 34551155 DOI: 10.1111/jop.13244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Our previous study revealed that patients with oral squamous cell carcinoma and concomitant type 2 diabetes mellitus presented a lower 5-year survival rate. Hyperglycemia has been increasingly recognized as a risk factor for more advanced disease and poorer prognosis in patients with oral squamous cell carcinoma. However, its role remains unclear. METHODS The expressions of BRIP1, Ki67, E-cadherin, and cleaved caspase-3 were detected by immunohistochemistry in oral squamous cell carcinoma tissues with or without type 2 diabetes mellitus. Cell counting kit-8 assay and wound healing assay were used to determine the proliferative and migratory ability of oral squamous cell carcinoma cells cultured with or without high glucose in vitro. Flow cytometry was applied to distinguish the role of high glucose on the cell cycle and apoptosis rates. RESULTS The expression level of Ki67 was elevated while BRIP1, E-cadherin, and cleaved caspase-3 were downregulated in patients with oral squamous cell carcinoma coexisting with diabetes. The cell proliferation and migration in oral squamous cell carcinoma cell lines were significantly enhanced by high glucose. Flow cytometric analysis suggested that high glucose predisposed cancer cells to stay at S/G2 phase and to exhibit lower apoptosis rates. CONCLUSION Our results implicated that type 2 diabetes mellitus may play a crucial role in the development and progression of oral squamous cell carcinoma through hyperglycemia, affecting cancer cell proliferation, migration, and apoptosis. This finding might provide a new direction for the prevention and treatment of oral squamous cell carcinoma.
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Affiliation(s)
- Xin Hu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Jin Wu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Haofeng Xiong
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China.,Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Liujun Zeng
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Zijia Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Can Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Danni Huang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Tianyi Zhang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Ying Peng
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Weijun Chen
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Kun Xia
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Tong Su
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
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The Characteristics of Patients with Oral Lichen Planus and Malignant Transformation-A Retrospective Study of 271 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126525. [PMID: 34204361 PMCID: PMC8296493 DOI: 10.3390/ijerph18126525] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 12/25/2022]
Abstract
Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. Patients and methods: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003–2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. Results: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2–85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. Conclusions: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.
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The immunohistochemical profile of basal cell nevus syndrome-associated and sporadic odontogenic keratocysts: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:3351-3367. [PMID: 33730212 DOI: 10.1007/s00784-021-03877-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To provide a systematic review of the literature on studies comparing the immunoprofile of nevoid basal cell carcinoma syndrome (BCNS)-associated and sporadic odontogenic keratocysts (OKCs), in order to identify markers that could accurately distinguish the two OKC subtypes. MATERIALS AND METHODS We searched MEDLINE/Pubmed, Web of Science, EMBASE via OVID, and grey literature for publications until December 28th, 2019, that compared the immunohistochemical expression of the two OKC subtypes. The studies were qualitatively assessed using the Critical Appraisal Tool for Case Series (Joana Briggs Institute). Sensitivity and specificity, positive and negative likelihood ratio, diagnostic odds ratio and area under the curve, and pooled estimates were calculated, using a random-effects model. RESULTS Seventy-one studies were qualitatively analyzed; 61 markers were evaluated in one study and 32 in ≥ 2 studies. Twenty-five studies reported differential expression of 29 markers in the form of higher number of positive cells or greater staining intensity usually in BCNS-associated OKCs. Meta-analysis for bcl-2, Cyclin D1, CD56, CK18, p53, and PCNA showed that none of those markers is distinguishable between BCNS-associated and sporadic OKCs, in a 95% confidence interval. The risk of bias was high in 34 studies, moderate in 22, and low in 15. CONCLUSIONS The present systematic review and meta-analysis uncovered that, although several immunohistochemical markers might characterize the OKC phenotype, they cannot discriminate between the BCNS-associated and sporadic OKCs. CLINICAL RELEVANCE This study highlighted the requirement for additional screening for markers by immunohistochemistry, preferentially coupled to alternative diagnostic applications such as genomics technologies.
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Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview. ACTA ACUST UNITED AC 2021; 57:medicina57030271. [PMID: 33809659 PMCID: PMC8002330 DOI: 10.3390/medicina57030271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.
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29
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Takatu CM, Gabbi TVB, Nico MMS. Squamous Cell Carcinoma Arising in Ungual Lichen Planus: Report and Review. Skin Appendage Disord 2021; 7:54-57. [PMID: 33614721 DOI: 10.1159/000511094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022] Open
Abstract
Background Lichen planus (LP) can lead to severe scarring of the nail unit leading to anonychia. There are very few reports of squamous cell carcinoma (SCC) occurring in the lesions of ungual LP. Objective The aim of this study was to revise the previously reported cases of SCC appearing in ungual LP and to present a new case. Methods A PubMed search was performed with the terms "nail lichen planus" and "squamous cell carcinoma." Reported cases as well as a new case were depicted in a table. Results Only 2 indexed articles reporting 3 cases were found. All patients suffered of long-lasting scarring ungual LP. Conclusions The occurrence of SCC in nail LP is rare. LP is not "premalignant" per se, but SCC might rarely arise in LP scars.
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Affiliation(s)
- Caroline Maris Takatu
- Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil
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30
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Ramos-García P, González-Moles MÁ, Warnakulasuriya S. Oral cancer development in lichen planus and related conditions-3.0 evidence level: A systematic review of systematic reviews. Oral Dis 2021; 27:1919-1935. [PMID: 33616234 DOI: 10.1111/odi.13812] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
A systematic review of systematic reviews-aka overview of reviews, a novel type of study design providing a tertiary level of evidence-is presented on systematic reviews (SR) and meta-analyses (MTA) evaluating the cancer development in oral lichen planus (OLP), oral lichenoid lesions (OLL), and oral lichenoid reactions (OLR). We searched for SR-MTA published before January 2021. We evaluated the methodological quality of SR-MTA using AMSTAR2 and checked the quality of evidence. Inclusion criteria were met by seven SR-MTA. Oral cancer ratios ranged between 0.44% and 2.28% for OLP, between 1.88% and 3.80% for OLL, and 1.71% for OLR. Significant factors on cancer development reported in SR-MTA were the presence of epithelial dysplasia, the consumption of tobacco and alcohol, the infection by the hepatitis C virus, the presence of atrophic and erosive lesions, and the location on the tongue. Only, one of the SRs assessed the quality of evidence, and most of them were judged to be of critically low methodological quality. In conclusion, based on the reported evidence on cancer incidence in OLP, our results reaffirm classifying OLP as an oral potentially malignant disorder. In relation to OLLs and OLRs, larger studies are necessary to provide further scientific evidence in this regard. Future follow-up studies on OLP and related lesions should be carried out under stricter criteria that improve their quality of evidence and methodological quality.
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Affiliation(s)
- Pablo Ramos-García
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,WHO Collaborating Centre for Oral Cancer, London, UK
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31
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González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, González-Ruiz L, Ayén Á, Lenouvel D, Ruiz-Ávila I, Ramos-García P. Clinical interpretation of findings from a systematic review and a comprehensive meta-analysis on clinicopathological and prognostic characteristics of oral squamous cell carcinomas (OSCC) arising in patients with oral lichen planus (OLP): Author's reply. Oral Oncol 2020; 113:105036. [PMID: 33041215 DOI: 10.1016/j.oraloncology.2020.105036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | - Saman Warnakulasuriya
- Oral Medicine Department, King's College London, London, UK; WHO Collaborating Centre for Oral Cancer, London, UK.
| | | | - Lucía González-Ruiz
- Dermatology Service, Ciudad Real General University Hospital, Ciudad Real, Spain.
| | - Ángela Ayén
- Dermatology Service, San Cecilio Hospital Complex, Granada, Spain.
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32
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Jayaraj R, Shetty SS, Kumaraswamy C, Gothandam KM, Ram MR, Shaw P. Clinical interpretation of findings from a systematic review and a comprehensive meta-analysis on clinicopathological and prognostic characteristics of oral squamous cell carcinomas (OSCC) arising in patients with oral lichen planus (OLP). Oral Oncol 2020; 108:104974. [PMID: 32798186 DOI: 10.1016/j.oraloncology.2020.104974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/07/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Rama Jayaraj
- Department of Artificial Intelligence, Nanjing University of Information Science and Technology (NUIST), Jiangsu, China; Northern Territory Institute of Research and Training, Darwin, Northern Territory 0909, Australia.
| | - Sameep S Shetty
- Oral Oncology, Manipal College of Dental Sciences, Mangalore, India; Manipal Academy of Higher Education, A Constituent of MAHE, India.
| | - Chellan Kumaraswamy
- School of Public Health, The University of Adelaide, North Terrace Campus, Adelaide, SA 5005, Australia
| | - K M Gothandam
- School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - M Ravishankar Ram
- Department of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Peter Shaw
- Department of Artificial Intelligence, Nanjing University of Information Science and Technology (NUIST), Jiangsu, China.
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