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Prognosis of oral pre-malignant lesions: significance of clinical, histopathological, and molecular biological characteristics.
- Source :
-
Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists [Crit Rev Oral Biol Med] 2003; Vol. 14 (1), pp. 47-62. - Publication Year :
- 2003
-
Abstract
- The concept of a two-step process of cancer development in the oral mucosa, i.e., the initial presence of a precursor subsequently developing into cancer, is well-established. Oral leukoplakia is the best-known precursor lesion. The evidence that oral leukoplakias are pre-malignant is mainly derived from follow-up studies showing that between < 1 and 18% of oral pre-malignant lesions will develop into oral cancer; it has been shown that certain clinical sub-types of leukoplakia are at a higher risk for malignant transformation than others. The presence of epithelial dysplasia may be even more important in predicting malignant development than the clinical characteristics. Three major problems, however, are attached to the importance of epithelial dysplasia in predicting malignant development: (1) The diagnosis is essentially subjective, (2) it seems that not all lesions exhibiting dysplasia will eventually become malignant and some may even regress, and (3) carcinoma can develop from lesions in which epithelial dysplasia was not diagnosed in previous biopsies. There is, therefore, a substantial need to improve the histologic assessment of epithelial dysplasia or, since epithelial dysplasia does not seem to be invariably associated with or even a necessary prerequisite for malignant development, it may be necessary to develop other methods for predicting the malignant potential of pre-malignant lesions. As a consequence of these problems, numerous attempts have been made to relate biological characteristics to the malignant potential of leukoplakias. Molecular biological markers have been suggested to be of value in the diagnosis and prognostic evaluation of leukoplakias. Markers of epithelial differentiation and, more recently, genomic markers could potentially be good candidates for improving the prognostic evaluation of precursors of oral cancer. As yet, one or a panel of molecular markers has not been determined that allows for a prognostic prediction of oral pre-cancer which is any more reliable than dysplasia recording. However, these new markers could be considered complementary to conventional prognostic evaluation.
- Subjects :
- Biomarkers, Tumor
Candidiasis, Oral complications
Cell Transformation, Neoplastic
Diagnosis, Differential
Epithelium pathology
Genetic Markers
Humans
Leukoplakia etiology
Leukoplakia genetics
Mouth Neoplasms etiology
Mouth Neoplasms genetics
Precancerous Conditions etiology
Precancerous Conditions genetics
Prognosis
Smoking adverse effects
Terminology as Topic
Leukoplakia pathology
Mouth Neoplasms pathology
Precancerous Conditions pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1544-1113
- Volume :
- 14
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists
- Publication Type :
- Academic Journal
- Accession number :
- 12764019
- Full Text :
- https://doi.org/10.1177/154411130301400105