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Objective: The goal was to identify the lifestyle risk factors associated with benign and potentially malignant oral disorders. Method and materials: The study enrolled first-time patients from the Oral Pathology Section, volunteers from Oviedo, and first-time patients from the University of Oviedo dental clinic. Patients underwent a survey that included sociodemographic information, lifestyle habits, and medical history. A comprehensive examination of the oral mucosa was conducted. Univariate and multivariate logistic regression were conducted using R software. Results: Among the 183 participants, the most prevalent lesions were varicose veins (43.20%), cheek/lip biting (34.97%), and coated tongue (33.33%). Among the oral potentially malignant disorders (16.39%) were oral lichen planus (12.64%) and leukoplakia (3.33%). Tobacco was associated with melanotic pigmentation (OR 3.87, P = .001) and coated tongue (OR 5.90, P = .001). Longer intervals since the last check-up were associated with traumatic keratosis (OR 2.95, P = .031). Age and heavy smoking were found to have higher risk of developing an oral potentially malignant disorder (OR 1.04, P = .035, and OR 7.35, P = .028, respectively). Conclusions: These data should be considered when organizing public health programs focused on the detection and screening of heavy smokers. It is also important to strengthen the oral pathology units in universities as reference centers for students to acquire the necessary knowledge for their diagnosis and treatment, while simultaneously promoting awareness of this risk factor for oral precancer among the general population. [ABSTRACT FROM AUTHOR]

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Objectives Materials and Methods Results Conclusions To update the current evidence on the malignant transformation of oral leukoplakia (OL), including all studies published worldwide on the subject, selected with the maximum rigor regarding eligibility.MEDLINE, Embase, Web of Science and Scopus were searched for studies published before June‐2024, with no lower date limit. The risk of bias was analyzed using the Joanna Briggs Institute tool for meta‐analyses of proportions. We carried out meta‐analyses, explored heterogeneity across subgroups and identified risk factors with potential prognostic value.Fifty‐five studies (41,231 with OL) were included. The pooled malignant transformation proportion for OL was 6.64% (95% CI = 5.21–8.21). The malignant transformation did not significantly vary by time periods (p = 0.75), 5.35% prior to 1978, 7.06% from 1979 to 2007 and 6.97% during more recent times. The risk factors that significantly had a higher impact on malignant transformation were the non‐homogeneous leukoplakias (RR = 4.23, 95% CI = 3.31–5.39, p < 0.001), the larger size (RR = 2.08, 1.45–2.96, p < 0.001), leukoplakia located on the lateral border of tongue (malignant transformation = 12.71%; RR = 2.09, 95% CI = 1.48–2.95, p < 0.001), smoking (RR = 1.64, 95% CI = 1.25–2.15, p < 0.001), and the presence of epithelial dysplasia (RR = 2.75, 95% CI = 2.26–3.35, p < 0.001).OL presents a considerable malignant transformation probability that is especially increased in large non‐homogeneous lesions in smokers, located on the lateral border of the tongue, with epithelial dysplasia. [ABSTRACT FROM AUTHOR]

Background: Several existing studies have shown a correlation between some of the blood and urine biomarkers and oral leukoplakia (OLK). However, the causality of this relationship remains uncertain. Thus, this study aimed to examine the causal association between 35 blood and urine biomarkers and OLK. Methods: Single nucleotide polymorphisms (SNPs) associated with 35 blood and urine biomarkers were selected as instrumental variables (IVs) using a twosample Mendelian randomization(MR) study to assess the causal relationship between the biomarkers and the risk of oral leukoplakia. We used the inverse variance weighted (IVW) method as the main analysis. Furthermore, several sensitivity analyses were performed to assess heterogeneity, horizontal pleiotropy, and stability. Results: Based on the selection criteria of the Inverse Variance Weighted (IVW) method, the analysis found that 5 blood and urine biomarkers were significantly associated with the development of leukoplakia, of which the results of IVW showed that abnormalities of Apolipoprotein B (Apo B), Cholesterol, Low-density Lipoprotein (LDL), Triglycerides (TG) promoted the development of oral leukoplakia, and Non Albumin Protein (NAP) had a protective effect on the development of oral leukoplakia. We then performed a Bonferroni correction for these results, and after correction Apo B was still causally associated with the development of oral leukoplakia (IVW P<0.0007), whereas the other four biomarkers could only provide some evidence of predisposition. Conclusion: Our two-sample Mendelian randomization study supports the existence of a causal relationship between these five blood and urine biomarkers and the occurrence of oral leukoplakia, and provides evidence for a number of risk and protective factors for the development of oral leukoplakia; however, the definitive mechanisms for the occurrence and development of oral leukoplakia still remain to be elucidated, and further studies on these relevant mechanisms are still needed. [ABSTRACT FROM AUTHOR]

Introduction: The estimation of serum bioelements for the identification of oral premalignant and malignant lesions has been extensively studied. Higher amounts of copper have been found in all smoking and Smokeless Tobacco (SLT) products, which are responsible for the higher incidence of premalignant and malignant lesions in the oral cavity. Limited studies have shown the significance and role of salivary bioelements in premalignant lesions, such as Oral Submucous Fibrosis (OSMF) and oral leukoplakia, and malignant lesions like Squamous Cell Carcinoma (SCC) of the oral cavity. Aim: To estimate salivary copper levels in premalignant and malignant lesions of the oral cavity. Materials and Methods: The preent cross-sectional study was undertaken in Tagore Dental College and Hospital in Chennai, Tamil Nadu, India for a period of 6 months, from March 2022 to August 2022. A total of 50 patients were recruited and divided into five groups of 10 patients each: Group I- control group; Group II- SLT chewing habit without any oral lesion; Group III- 10 patients with Tobacco Pouch Keratosis (TPK); Group IV- 10 patients with OSMF; and Group V- 10 patients with oral SCC. About 5 mL of salivary samples were collected and centrifuged at 3000 rpm to obtain the supernatant saliva for analysis. The levels of copper were estimated using photo calorimetry. Statistical analysis was done using One-way Analysis of Variance (ANOVA) followed by a Post-hoc test. Results: A total of 50 patients with a mean age of 40±20 years were included in present study, comprising 46% females and 54% males. There was a statistically significant difference (p <0.05) between the mean salivary copper levels in the premalignant lesions of the oral cavity. Within the premalignant group, copper levels were found to be more in OSMF (Group IV: 296.64±56.08) compared to the other groups (Group II: 202.95±125.14; Group III: 229.25±73.35). In the oral cancer patients, no significant difference (p-value=0.174; not less than 0.001) obtained in salivary copper levels. Conclusion: Compared to the control group, salivary copper levels were significantly higher in cases of OSMF, followed by cases of TPK and non lesional cases. [ABSTRACT FROM AUTHOR]

Introduction: Leukoplakia is one of the most common lesions of potentially malignant lesions of the oral cavity. It is important to clarify the histopathological diagnosis underlying cases clinically diagnosed as leukoplakia, which is crucial in determining the prognosis and the required therapy. Material and Methods: 75 patients diagnosed with oral leukoplakia were histologically sampled between April 2021 and April 2024 at the Department of Oral Diagnostics, Department of Dento-alveolar Surgery, Semmelweis University. Histopathological analysis of the histopathological samples was performed on the basis of hematoxylin-eosin staining and in selected cases immunohistochemical analysis was performed at the Department of Pathology and Experimental Cancer Research. Results and discussion: The 75 patients were classified according to the location of leukoplakia in decreasing order of frequency: gingiva/ edentulous jaw ridge (n = 26), buccal (n = 16), floor of the mouth (n = 12), tongue (n = 11), palate (n = 6), lip (n = 2). Multifocal appearance was also seen (n = 2). Histological sampling was usually a partial and not total excision of the lesion. Histopathological findings were hyperkeratosis (without dysplasia) in 51 cases, 19 cases with mild dysplasia, 5 cases with moderate dysplasia. There were no cases with severe dysplasia. In 61 cases were homogeneous and in 14 cases non-homogeneous leukoplakia. Dysplasia was significantly more frequent in clinically non-homogeneous leukoplakia (p = 0.0088). 32 of the 75 patients were smokers and 43 were non-smokers. Our results showed that smoking had no significant effect on the presence and severity of dysplasia. Patients were followed up continuously (6 months follow-up). Average follow-up time: 17.4 months (range: 1–38 months). Conclusion: Patients diagnosed with oral leukoplakia require histopathological sampling for histopathological examination and long-term follow-up is recommended to prevent late malignant transformation.

Introduction: The estimation of serum bioelements for the identification of oral premalignant and malignant lesions has been extensively studied. Higher amounts of copper have been found in all smoking and Smokeless Tobacco (SLT) products, which are responsible for the higher incidence of premalignant and malignant lesions in the oral cavity. Limited studies have shown the significance and role of salivary bioelements in premalignant lesions, such as Oral Submucous Fibrosis (OSMF) and oral leukoplakia, and malignant lesions like Squamous Cell Carcinoma (SCC) of the oral cavity. Aim: To estimate salivary copper levels in premalignant and malignant lesions of the oral cavity. Materials and Methods: The preent cross-sectional study was undertaken in Tagore Dental College and Hospital in Chennai, Tamil Nadu, India for a period of 6 months, from March 2022 to August 2022. A total of 50 patients were recruited and divided into five groups of 10 patients each: Group I- control group; Group II- SLT chewing habit without any oral lesion; Group III- 10 patients with Tobacco Pouch Keratosis (TPK); Group IV- 10 patients with OSMF; and Group V- 10 patients with oral SCC. About 5 mL of salivary samples were collected and centrifuged at 3000 rpm to obtain the supernatant saliva for analysis. The levels of copper were estimated using photo calorimetry. Statistical analysis was done using One-way Analysis of Variance (ANOVA) followed by a Post-hoc test. Results: A total of 50 patients with a mean age of 40±20 years were included in present study, comprising 46% females and 54% males. There was a statistically significant difference (p

Background and Aim: Oxidative stress markers have been firmly established as elevated in oral squamous cell carcinomas (OSCCs). These markers play a crucial role in the pathogenic mechanism underlying the accumulation of advanced glycation end products (AGEs) and their respective receptors. The primary objective of this study is to discern and compare the levels of receptors of AGEs (RAGEs) within tissue samples from patients diagnosed with oral submucous fibrosis (OSMF) at varying stages, oral leukoplakia at various stages, and OSCC. Materials and Methods: A cross-sectional investigation was conducted, enrolling a total of 49 patients, distributed across three distinct groups. Tissue samples were meticulously collected from the aforementioned patient groups. Subsequently, these samples underwent a process of homogenization and centrifugation. The supernatant obtained was subjected to enzyme-linked immunosorbent assay analysis to precisely determine the concentration of RAGE. Results: The concentration of RAGEs was found to be significantly higher at various stages of OSMF when compared to the reference group of OSCC (P < 0.05). This difference was statistically significant, indicating a substantial association. In contrast, the levels of RAGE in patients with hyperkeratosis accompanied by epithelial dysplasia at various stages were observed to be lower than those in the OSCC group, with the difference in concentration being statistically insignificant (P > 0.05). Conclusion: This comprehensive study has provided compelling evidence demonstrating the heightened levels of RAGE in OSMF when compared to OSCC. These findings collectively suggest the potential utility of anti-RAGE interventions as a promising avenue for novel therapeutic strategies in potentially malignant disorders such as OSMF.

Aberrant PI3K/AKT/mTOR/ pathway have been considered one of the starting points of various types of human cancer, including the oral squamous cell carcinoma (OSCC). The important role played by this signaling pathway in oncogenesis and cancer evolution, oriented the researchers’ attention toward studies of AKT and the PI3K/AKT/mTOR axis in the context of malignant transformation of oral precancerous lesions. Consequently, this article’s aim is an update of the possible key role played by the PI3K /AKT/mTOR axis on the oral lesions’ malignant transformation stage. Oral potentially malignant disorders are defined as lesions that will most probably progress to malignant lesions of the oral cavity. These lesions are mainly represented by leukoplakia, erythroplakia, actinic cheilitis and lichen planus. PI3K/AKT/mTOR signaling cascade should be regarded as a crucial subject for additional research, focusing not only on the early identification of malignant transformations of oral lesions, but also on opening new therapeutic ways in order to prevent malignant transformation and OSCC evolution.

The study aimed to present the characteristics of the three most prevalent oral potentially malignant disorders, leukoplakia, oral lichen planus (OLP), and actinic cheilitis, using data from 62 patients collected at the “Sfântul Spiridon” Emergency Clinical Hospital in Iași, Romania, between January 2015 and January 2023. The results revealed a higher prevalence of these lesions among older adults, particularly those over 50 years old, and a significant gender disparity in the incidence of actinic cheilitis, which was more common in males (68%). Leukoplakia was frequently observed on the tongue and lower lip, whereas OLP commonly affected the buccal mucosa. Actinic cheilitis was primarily noted on the lower lip, attributed to chronic sun exposure. The study highlighted the importance of early detection and regular monitoring of these conditions to prevent malignant transformation.

Proliferative verrucous leukoplakia (PVL) is a non-homogenous type of oral leukoplakia, characterized by multifocal white plaques, propensity to recur after treatment, with strong tendency towards malignant transformation. Interestingly, some studies show that, at initial stages, PVL may resemble oral lichen planus (OLP), potentially leading to misdiagnosis. A 52-year-old woman, with a previous OLP diagnosis, was referred to our service for implant installation and follow-up of OLP lesions. After clinicopathological re-evaluation, a diagnosis of PVL (early stage) was made, and a maxillary full-arch implant-supported prosthesis supported by implants was installed. After 6 years of follow-up, the patient developed squamous cell carcinoma around the implants. The current case emphasizes that PVL patients with oral lesions suggesting peri-implantitis or peri-implant mucositis deserve a more meticulous investigation. [ABSTRACT FROM AUTHOR]

Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct oral disorder with a high potential for malignant transformation (MT). It presents as multifocal lesions that progress over time and frequently recur, often developing carcinomas. Accurately diagnosing PVL is crucial to distinguish it from other oral mucosa lesions that have a lower risk of cancer progression. However, due to the diverse histological features observed in PVL, identifying clinical criteria and histological patterns that can be applied by unfamiliar professionals is challenging. In this study, we present a case of PVL associated with dysplasia in a 53‐year‐old female patient. The patient exhibited macular and leukoplakic nonscrapable lesions disseminated throughout the oral cavity, with continuous growth. The diagnosis of PVL was established during an 18‐month follow‐up. This case highlights the difficulties faced by both clinicians and pathologists in diagnosing PVL, emphasizing the need for careful evaluation and accurate diagnosis, particularly in patients with unusual oral lesions, and highlighting the discrepancies observed in the application of available protocols to our particular case. Distinguishing PVL from similar conditions can be challenging due to overlapping clinical signs and indistinct histopathological features. [ABSTRACT FROM AUTHOR]

Aim: To estimate and compare the level of serum immunoglobulin A in patients of oral submucous fibrosis (OSMF), leukoplakia, and control group. Introduction: OSMF is a well‑recognized potentially malignant condition in the oral cavity, and a transformation rate as high as 7.6% over a period of 10 years has been reported from India. Leukoplakia has evolved as a clinico‑pathologic concept over many years, with the current clinical designation being accepted worldwide. Materials and Methods: Quantia IgA is a turbidometric immunoassay for the detection of IgA in human serum and is based on the principle of agglutination reaction. The test specimen is mixed with the activation buffer (R1) and then with antihuman IgA reagent (R2) and allowed to react. For the estimation of serum IgA, 500 μl of Quantia IgA activation buffer R1 is taken in a clean test tube. Serum sample is diluted in the ratio of 1:5 with normal saline. Ten microliters of diluted serum sample are added to R1. After incubation for 10 min, 50 μl of R2 is added, which is Quantia IgA antihuman IgA reagent to the sample, and the reading is recorded at wavelength 340 nm at 37°C. The level of IgA will be estimated by a semi‑automatic biochemical analyzer machine and then data analysis will be done. Results: The immunologic alterations observed by us in OSMF and leukoplakia are almost similar or nearer to the alterations observed in oral cancer, so it is reasonable to assume that OSMF and leukoplakia can be an intermediate stage in the transformation process of a normal cell to oral malignancy. Conclusion: Prevention and early detection is the best way to reduce the incidence and mortality of premalignant disorders and oral cancer. There are many ways and methods of early detection of premalignant disorders and oral cancer, and the immunological method is one of them. [ABSTRACT FROM AUTHOR]

Aims: Oral epithelial dysplasia (OED) often exhibits a lymphocytic/lichenoid immune response (LIR), imparting histological resemblance to lichenoid mucositis and rendering diagnosis challenging. The clinical appearances of OED and lichenoid inflammatory processes are generally divergent, presenting as well‐demarcated hyperkeratotic plaques and diffuse white and/or red mucosal change with variably prominent Wickham striae, respectively. To date, clinicopathological characterisation of OED with LIR, including clinical/gross appearance, has not been depicted. Methods and results: Cases of solitary OED with LIR for which a clinical photograph was available were identified in the authors' institutional files. Clinical and histological features were documented. In 44 identified cases, dysplasia was mild (19 of 44, 43.2%), moderate (19 of 44, 43.2%) and severe (six of 44, 13.6%). Clinically/grossly, all 44 cases (100.0%), presented as well‐demarcated hyperkeratotic plaques lacking diffuse white‐and‐red mucosal change or Wickham striae. Histologically, OED with LIR exhibited numerous 'lichenoid' features beyond the lymphocytic band in the superficial lamina propria, including: leucocyte transmigration (38 of 44, 86.4%), spongiosis (37 of 44, 84.1%), Civatte/colloid bodies (36 of 44, 81.8%), basal cell degeneration (29 of 45, 65.9%), sawtooth rete ridges (11 of 44, 25.0%) and subepithelial clefting (7 of 44, 15.9%). Conclusions: Virtually any lichenoid histological feature may be seen in OED with LIR, representing a significant diagnostic pitfall. The typical clinical appearance of OED with LIR is of a well‐demarcated hyperkeratotic plaque, characteristic of keratinising dysplasia and devoid of lichenoid features. This suggests that pathologist access to clinical photographs during diagnostic interpretation of biopsied white lesions, which represents opportunity to perform gross examination of the disease process, may reduce interobserver variability and improve diagnostic accuracy in this challenging differential diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether genes in the Wnt pathway, which have been previously associated with both oral clefts and oral squamous cell carcinoma, are also associated with oral potentially malignant disorders (leukoplakia, erythroplakia and lichen planus). Materials and Methods: Case–control study: Dataset consisted of clinical information linked to DNA samples from affected subjects diagnosed with oral potential malignant disorders and oral cancer and their matched controls. Individual samples, clinical history, and potential risk factors were obtained through the Dental Registry and DNA Repository project of the School of Dental Medicine, University of Pittsburgh. The rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 (AXIN2) were tested. After genomic DNA had been extracted, genotyping was performed blindly to clinical diagnosis status. Representation of genotypes and alleles in affected subjects in comparison to the unaffected individuals was determined using PLINK. Additional analysis was performed to investigate associations between environmental (socioeconomic/lifestyle) risk factors and the oral pathologies studied using STATA. Results: Two of the SNPs tested (rs9879992 in GSK3B and rs3923087 in AXIN2) were statistically, significantly associated with the pathologies studied (p = 0.039 and 0.038, respectively). Conclusion: Single‐nucleotide polymorphisms in genes in the Wnt pathway were associated with oral potentially malignant disorders. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. Methods: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential‐OSCC versus OSCC‐de novo (OSCC‐dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t‐test, and qualitative variables with chi‐square. Results: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC‐dn, while s‐OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. Conclusions: In Latin America, OSCC‐dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosing oral potentially malignant disorders (OPMD) is critical to prevent oral cancer. This study aims to automatically detect and classify the most common pre-malignant oral lesions, such as leukoplakia and oral lichen planus (OLP), and distinguish them from oral squamous cell carcinomas (OSCC) and healthy oral mucosa on clinical photographs using vision transformers. Methods: 4,161 photographs of healthy mucosa, leukoplakia, OLP, and OSCC were included. Findings were annotated pixel-wise and reviewed by three clinicians. The photographs were divided into 3,337 for training and validation and 824 for testing. The training and validation images were further divided into five folds with stratification. A Mask R-CNN with a Swin Transformer was trained five times with cross-validation, and the held-out test split was used to evaluate the model performance. The precision, F1-score, sensitivity, specificity, and accuracy were calculated. The area under the receiver operating characteristics curve (AUC) and the confusion matrix of the most effective model were presented. Results: The detection of OSCC with the employed model yielded an F1 of 0.852 and AUC of 0.974. The detection of OLP had an F1 of 0.825 and AUC of 0.948. For leukoplakia the F1 was 0.796 and the AUC was 0.938. Conclusions: OSCC were effectively detected with the employed model, whereas the detection of OLP and leukoplakia was moderately effective. Clinical relevance: Oral cancer is often detected in advanced stages. The demonstrated technology may support the detection and observation of OPMD to lower the disease burden and identify malignant oral cavity lesions earlier. [ABSTRACT FROM AUTHOR]

Background: Laryngeal leukoplakia (LL) is a white lesion with high potential of recurrence and malignant transformation. Currently, CO2 laser has become the primary surgical treatment for LL, and the recurrence and malignant transformation rates after treatment vary widely. Objective: We performed a systematic review and meta‐analysis dedicated to evaluating the rates of recurrence and malignant transformation of LL lesions treated with CO2 laser and exploring relevant risk factors for recurrence or malignant transformation. Methods: Literature searches were conducted on ProQuest, PubMed, Web of Science, Ovid Medline, Embase, and Cochrane databases. Some articles identified through hand searching were included. Results: A total of 14 articles and 1462 patients were included in this review. Pooled results showed that the overall recurrence rate was 15%, and the malignant transformation rate was 3%. Subgroup analysis showed that the dysplasia grade was not a significant risk factor for the recurrence and malignant transformation of LL (P >.05). Conclusions: The results of this systematic review and meta‐analysis suggest that the CO2 laser is a safe and effective surgical instrument for the excision of LL, which yields low rates of recurrence and malignant transformation. The risk factors relevant to recurrence or malignant transformation remain unclear and require further investigation. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare the efficacy between conventional exfoliative cytology (EC) and centrifuged liquid-based cytology (CLBC) in control, leukoplakia, and oral squamous cell carcinoma (OSCC) patients. Oral leukoplakia and oral cancer require an early definitive diagnosis for better prognostic outcome. Oral EC, a minimally invasive technique that involves the examination of desquamated cells from the tissue surfaces used as a method of early diagnosis. CLBC is a modified technique that is used to achieve improved quality of the cytology findings. Materials and Methods: A comparative study was done in 30 subjects, of which, 10 cases from control group, 10 oral leukoplakia, and 10 OSCC cases. These subjects were selected according to the appropriate inclusion and exclusion criteria. The cases in each group underwent conventional as well as CLBC. The comparison was carried out between these groups with respect to the cellular and background stromal factors. Appropriate qualitative evaluation of the samples was collected and statistical analysis was done using the Chi-squared test. The significance level of value was P < 0.05. Results: Significant results were obtained for certain parameters such as cellular overlap clear background, uniform distribution in control, leukoplakia, and OSCC with a P = 0.004**, P = 0.001**, P = 0.006** using CLBC. Conclusion: CLBC is better and give clearer vision as compared to conventional cytology and can be used in the early diagnosis. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to compare the reproducibility and consistency of the World Health Organization (WHO) and Binary oral epithelial dysplasia grading systems when applied to leukoplakic lesions, the most common oral potentially malignant disorders (OPMDs). Methods In this retrospective, cross-sectional study, clinical data and microscopic slides of 89 leukoplakia cases were reviewed. Two pathologists independently graded each sample using both WHO and Binary systems. Inter-observer agreement was evaluated using kappa statistics. The relationship between variables and the grade of dysplasia was analyzed using T-test and Chisquare test at p<0.05. Results The mean age of cases was 53.93 ± 13.84 years, with a slight female predominance. The lesions were most commonly located on the tongue (38.2%) and buccal mucosa (37.08%). The inter-observer agreement was higher for the Binary system (kappa index= 0.62) compared to the WHO system (kappa index= 0.46). The highest agreement was observed for cellular features such as the increased number of cell nucleoli (0.74) and cell pleomorphism (0.73), while keratin pearls showed the lowest agreement (0.21). Conclusion The Binary classification system demonstrated superior consistency and reproducibility compared to the WHO system due to fewer grading categories. However, its detailed numerical requirements and time-consuming nature may limit its widespread adoption, which is why the WHO system is more commonly used. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Oral leukoplakia (OL) is one of the most common and investigated oral potentially malignant disorders (OPMD). Preventing OSCC occurrence should be the primary outcome in the clinical management of OL. Surgical removal of OL is performed by most clinicians, although its effectiveness in reducing OSCC onset has still not been established by randomized controlled trials (RCT). Wait and see approach is characterized by frequent clinical examinations and periodical biopsies of OL, avoiding unnecessary surgical procedures.This is the first multicenter RCT in literature aiming at comparing the effectiveness of surgical removal and the “wait and see” approach in preventing OSCC onset in patients affected by dysplastic and non‐dysplastic OL.Two Italian referral care centres for oral diseases were involved in this multicenter two‐arm RCT comparing the surgical removal of OL (group A) and the “wait and see” approach (group B), with the aim of reducing oral cancer onset.This report shows preliminary data on the first 161 patients, with a mean follow‐up of 19.14 ± 11.25 months. Eight cases of OSCC occurred (6 out 8 involving the tongue): one case in group A and seven cases in group B. Moreover, OL recurred in 13 (20%) cases after surgical excision.Within the limitations of this preliminary report, these initial data underline the increased risk of OSCC onset in the case of OL of the tongue in the presence of epithelial dysplasia in group B (“wait and see”) compared to group A (surgery). This RCT is currently ongoing at the same clinical departments, with the aim of enrolling 310 patients and collecting data at 5‐year follow‐up, in order to achieve conclusive results, in an evidence‐based medicine approach. [ABSTRACT FROM AUTHOR]

Intermediate filaments are one of three polymeric structures that form the cytoskeleton of epithelial cells. In the epithelium, these filaments are made up of a variety of keratin proteins. Intermediate filaments complete a wide range of functions in keratinocytes, including maintaining cell structure, cell growth, cell proliferation, cell migration, and more. Given that these functions are intimately associated with the carcinogenic process, and that hyperkeratinization is a quintessential feature of oral leukoplakias, the utility of keratins in oral leukoplakia is yet to be fully explored. This scoping review aims to outline the current knowledge founded on original studies on human tissues regarding the expression and utility of keratins as diagnostic, prognostic, and predictive biomarkers in oral leukoplakias. After using a search strategy developed for several scientific databases, namely, PubMed, Scopus, Web of Science, and OVID, 42 papers met the inclusion and exclusion criteria. One more article was added when it was identified through manually searching the list of references. The included papers were published between 1989 and 2024. Keratins 1–20 were investigated in the 43 included studies, and their expression was assessed in oral leukoplakia and dysplasia cases. Only five studies investigated the prognostic role of keratins in relation to malignant transformation. No studies evaluated keratins as a diagnostic adjunct or predictive tool. Evidence supports the idea that dysplasia disrupts the terminal differentiation pathway of primary keratins. Gain of keratin 17 expression and loss of keratin 13 were significantly observed in differentiated epithelial dysplasia. Also, the keratin 19 extension into suprabasal cells has been associated with the evolving features of dysplasia. The loss of keratin1/keratin 10 has been significantly associated with high-grade dysplasia. The prognostic value of cytokeratins has shown conflicting results, and further studies are required to ascertain their role in predicting the malignant transformation of oral leukoplakia. [ABSTRACT FROM AUTHOR]

Background Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented malignancy of the ocular surface and is represents with a wide morphological types and clinical symptoms. Along with that it has wide range of histologic diagnoses, ranging from mild epithelial dysplasia to invasive squamous carcinoma. The diagnosis rely on histopathological examination of the excised mass and imaging to rule out infiltration. Aim The aim to study the demographics, presenting features, different morphological types, histopathological types and associated risk factors of ocular surface squamous neoplasia (OSSN). Methods This was a prospective case study of 27 cases with conjunctival masses suspicious of OSSN presenting to our centre between November 2022 and October 2023. Results Among 27 cases 17 (62.96%) males and 10 (37.03%) females, with a mean age of 54.3 years (range 22-68 years). The main presenting symptoms were a mass or growth on the eye, followed by eye irritation or pain, pigmentation and visual impairment. The associated risk factors included chronic sun exposure, smoking and tobacco usage, HIV serology positive, and Ocular trauma. The lesions were most common near the limbus, most commonly seen in the interpalpebral area, nasal quadrant. Among the lesions 59.25% had less than 3 clock hours of limbal involvement. The most common presenting clinical morphological feature of the tumor was a leukoplakic lesion, followed by papilliform, nodular, gelatinous, pigmented and mixed morphology accordingly. Vascularization, hyperpigmentation and pterygium was the most common association. Conjunctival or corneal intraepithelial neoplasm (17) was most common in comparison with squamous cell carcinoma (10) Conclusion OSSN in our study mainly presented with leukoplakic variant, most commonly involving limbus with a feeder vessel. Most common in males. HIV serology was positive in younger patients. Larger lesion, papilliform variant most commonly showed squamous cell neoplasia in histology. [ABSTRACT FROM AUTHOR]

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, which is usually caused by the most common premalignant lesion of oral leukoplakia (OL). For changes of dysplasia and malignancy, the level of antioxidants in the blood and tissue of patients changes significantly, which may be effective in early diagnosis of malignancies. Therefore, the purpose of this study is to evaluate antioxidants (enzymatic and non-enzymatic) in the blood of patients with OSCC and OL. Material & Methods: This study is a case-control study and was conducted on 75 blood samples of patients with OSCC and OL referred to the Cancer Institute of Imam Khomeini Hospital, Ilam. Enzymatic antioxidants [catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx)] and non-enzymatic antioxidants (ascorbic acid, beta-carotene, vitamin E) were evaluated in the blood of patients. The data obtained from this study were evaluated by ANOVA test and the significance level (P

Abstract It has been found that progression from leukoplakia to head and neck squamous cell carcinoma (HNSCC) is a long-term process that may involve changes in the multicellular ecosystem. We acquired scRNA-seq samples information from gene expression omnibus and UCSC Xena database. The BEAM function was used to construct the pseudotime trajectory and analyze the differentially expressed genes in different branches. We used the ssGSEA method to explore the correlation between each cell subgroup and survival time, and obtained the cell subgroup related to prognosis. During the progression from leukoplakia to HNSCC, we found several prognostic cell subgroups, such as AURKB + epithelial cells, SFRP1 + fibroblasts, SLC7A8 + macrophages, FCER1A + CD1C + dendritic cells, and TRGC2 + NK/T cells. All cell subgroups had two different fates, one tending to cell proliferation, migration, and enhancement of angiogenesis capacity, and the other tending to inflammatory immune response, leukocyte chemotaxis, and T cell activation. Tumor-promoting genes such as CD163 and CD209 were highly expressed in the myeloid cells, and depletion marker genes such as TIGIT, LAG3 were highly expressed in NK/T cells. Our study may provide a reference for the molecular mechanism of HNSCC and theoretical basis for the development of new therapeutic strategies.

Background Aims Materials and Methods Discussion Oral cancer and Oral Potentially Malignant Disorders (OPMD) are major health problems in South and Southeast Asia.To describe and discuss the clinical aspects of Oral Cancer and OPMD in South and Southeast Asia.Literature review of concepts and data over the last four decades.Asian countries account for about two‐thirds of new cases of oral cancer (OC) globally, with the highest burden in the South and Southeast Asian countries, including Pakistan and India. Habits, dietary patterns, socioeconomic status, and access to routine dental care play a crucial role in defining the demographics and clinical presentation of OC in these regions and significantly influence the morbidity and mortality of the disease. This region sees the use of different types of tobacco with or without areca nut (AN), such as pan masala, gutka, gul, snuff, mawa, and mishri. Tobacco use is high among men in Sri Lanka, Myanmar, Maldives, Bangladesh, Nepal, India and Bhutan. Areca nut is the fourth most common addictive substance globally and is frequently used in South and Southeast Asian countries, including Southeast China, Hainan Island, India, Taiwan, and the Pacific Islands, and immigrants from these regions in Africa, Europe, and North America. The use of these products results in mucosal alterations with varied clinical presentation of Oral Potentially Malignant Disorders (OPMDs) and OC. We discuss here the different types of OPMD and OC, the diagnostic aids and their relevance in clinical practice, and factors that influence their prognosis. [ABSTRACT FROM AUTHOR]

Dyskeratosis congenita (DKC) is a rare genetic disorder characterized by lacy reticular skin hyperpigmentation, bone marrow failure, nail dystrophy, and oral leukoplakia. To the best of our knowledge, only around 200 cases were reported in the medical literature, and in this report, we present another distinctive case from Syria. This case report describes a male patient with generalized reticular pigmentation and abnormal nails since childhood. The patient reported a history of recurrent urethral stenosis and corneal density. Dermoscopic examination revealed pigmented lines arranged in a netlike pattern. Histopathological findings were nonspecific. Hematological values were unremarkable. A contrast CT scan revealed changes in the bladder wall. The final diagnosis of Dyskeratosis Congenita was made based on the clinical criteria. This disorder can present with additional cutaneous manifestations and systemic complications. Treatment are generally prescribed to maintain bone marrow function, based on the fact that it is the major cause of death. Regular monitoring and screening for associated conditions are recommended. [ABSTRACT FROM AUTHOR]