Malignant Transformation Rate of Non-reactive Oral Hyperkeratoses Suggests an Early Dysplastic Phenotype

Overview

Journal Head Neck Pathol

Specialties Oncology
Pathology

Date 2021 Jul 13

PMID 34255278

Citations 6

Authors

Ivan J Stojanov

Sook-Bin Woo

Affiliations

Soon will be listed here.

Abstract

The presence of epithelial dysplasia (ED) in oral leukoplakia is the single most important predictor of malignant transformation (MT). The majority of leukoplakias, however, do not show evidence of ED and yet MT of these lesions is well-recognized. These lesions have been referred to as "hyperkeratosis/hyperplasia, no dysplasia," "keratosis of unknown significance" and "hyperkeratosis, not reactive (HkNR)." This study evaluates the MT rate of such leukoplakias. A literature review was performed to identify cohort studies on leukoplakias where (1) there was a recorded histopathologic diagnosis, (2) cases of "hyperkeratosis/hyperplasia, no dysplasia" comprised part of the cohort, and (3) follow-up information was available. There were 9,358 leukoplakias, of which 28.5% exhibited ED while 37.7% consisted of HkNR. Follow-up ranged from 15 to 73 months. The incidence of MT in leukoplakia exhibiting HkNR was 4.9%, compared to 15.3% for ED. Among oral squamous cell carcinomas (SCC) with previously biopsied, site-specific precursor lesions, 55.7% arose from ED/carcinoma in situ and 28.0% arose from HkNR. Leukoplakia exhibiting HkNR has a substantial MT rate, similar to that of mild ED, and must be recognized and managed appropriately to reduce oral SCC incidence.

Citing Articles

Immunophenotypic and Gene Expression Analyses of the Inflammatory Microenvironment in High-Grade Oral Epithelial Dysplasia and Oral Lichen Planus.

Flores-Hidalgo A, Phero J, Steward-Tharp S, Williamson M, Paquette D, Krishnan D Head Neck Pathol. 2024; 18(1):17.

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New insights into the role of the oral leukoplakia microenvironment in malignant transformation.

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Total RNA sequencing reveals gene expression and microbial alterations shared by oral pre-malignant lesions and cancer.

Khan M, Frustino J, Villa A, Nguyen B, Woo S, Johnson W Hum Genomics. 2023; 17(1):72.

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Chemoprevention in oral leukoplakia: challenges and current landscape.

de Mello Palma V, Laureano N, Frank L, Rados P, Visioli F Front Oral Health. 2023; 4:1191347.

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Total RNA sequencing reveals gene expression and microbial alterations shared by oral pre-malignant lesions and cancer.

Khan M, Frustino J, Villa A, Nguyen B, Woo S, Johnson W bioRxiv. 2023; .

PMID: 36993637 PMC: 10055367. DOI: 10.1101/2023.03.24.534064.

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