Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2022 Oct;61(10):1227-1236. doi: 10.1111/ijd.16273. Epub 2022 May 16.
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.
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.
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.
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.
口腔扁平苔藓(OLP)是世界卫生组织(WHO)分类的一种口腔潜在恶性疾病,其转化为口腔鳞状细胞癌(OSCC)的风险为 1%。似乎没有对潜在的分子事件达成共识理解。本范围综述旨在确定关键的分子途径,并突出 OLP 恶性转化中现有知识的差距。
根据系统评价和荟萃分析报告的首选报告项目(PRISMA-P)指南,进行全面的文献检索和系统筛选,确定了 61 项详细描述 OLP 和 OSCC 之间分子差异的相关研究。
OLP 和 OSCC 之间共享的分子变化包括影响细胞增殖(p53 表达改变、p16/CDKN2A 高甲基化、MYC 增益、ki-67 增加)、凋亡(bcl-2 和 survivin 表达增加)、细胞外基质(ECM)重塑(基质金属蛋白酶 [MMP] 表达增加)和转录控制(bmi1 和 microRNA [miRNA] 表达改变)的改变。此外,一些分子改变从对照到 OLP 再到 OSCC 逐渐积累,或者存在于 OLP 的高风险糜烂变异体或转化的 OLP 中。很少有研究包括严格的诊断纳入标准或无偏发现方法。
本综述的结果支持 OLP 的潜在恶性性质,并暗示与恶性转化相关的分子事件可能是异质的。此外,本综述中的发现强调需要使用严格的诊断纳入标准和无偏发现方法进行更多研究,以进一步了解这一过程。