School of Dentistry, University of Granada, 18071 Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.
Int J Mol Sci. 2022 Oct 28;23(21):13099. doi: 10.3390/ijms232113099.
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 ( = 17, 85%), sustaining proliferative signaling ( = 2, 10%), and evading growth suppressors ( = 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.
口腔扁平苔藓（OLP）是一种常见的慢性炎症性疾病，病因不明，可能具有自身免疫性质，目前被认为是一种口腔潜在恶性疾病，这意味着患有这种疾病的患者在其一生中都有发展为口腔癌的风险。OLP 中发生的使受影响的口腔上皮易发生恶性转化的分子改变尚不清楚，尽管与其他自身免疫性疾病（溃疡性结肠炎、原发性胆汁性肝硬化等）一样，它们可能与炎症浸润介导的促进癌变作用有关。到目前为止，对于 OLP 受影响的口腔上皮细胞中这些癌症特征是如何建立的，我们还没有深入的了解。在这项对系统评价和荟萃分析的范围审查中，提出了该领域基于证据的知识现状，以指出证据差距并指出未来的研究方向。检索了 MEDLINE、Embase、Cochrane Library 和 Dare 中截至 2022 年 10 月之前发表的二级研究。结果确定了 20 项批判性评估肿瘤促进炎症特征的系统评价和荟萃分析（=17，85%）、维持增殖信号（=2，10%）和逃避生长抑制物（=1，5%）。OLP 中没有发现其他癌症特征的证据。总之，OLP 的恶性转化假设源于炎症浸润的侵袭和基于上皮细胞过度增殖、逃避生长抑制信号和缺乏细胞凋亡的特定类型的上皮反应。需要进行基于证据的未来研究来支持这一假设。
