González-Ruiz Isabel, Samayoa-Descamps Valerie, Guagua-Cortez Karen Andrea, González-Moles Miguel Ángel, Ramos-García Pablo
Pius de Valls Hospital, 43800 Valls, Spain.
School of Dentistry, University of Granada, 18071 Granada, Spain.
Cancers (Basel). 2025 Jul 22;17(15):2427. doi: 10.3390/cancers17152427.
BACKGROUND/OBJECTIVES: Oral leukoplakia (OL) is a prevalent oral potentially malignant disorder. Despite its clinical relevance, the molecular basis of its progression to malignancy is not yet fully elucidated. This scoping review of systematic reviews and meta-analyses aimed to synthesize current knowledge and evidence gaps regarding the implications of hallmarks of cancer expression in OL malignant transformation. METHODS: A systematic search was conducted in MEDLINE, Embase, DARE, and the Cochrane Library to identify systematic reviews (with or without meta-analysis) published up to April-2025. RESULTS: Twenty-two systematic reviews were included. The most frequently explored hallmark was activation of invasion and metastasis (n = 12; 32.40%), followed by tumor-promoting inflammation (n = 10; 27.03%), evasion of growth suppressors (n = 8; 21.60%), sustained proliferative signaling (n = 3; 8.10%), energy metabolism reprogramming (n = 2; 5.40%), replicative immortality (n = 1; 2.70%), and resistance to cell death (n = 1; 2.70%). No evidence was found for angiogenesis or immune evasion in OL. CONCLUSIONS: Available evidence indicates that OL may develop oncogenic mechanisms in early stages of oral oncogenesis, especially those related to sustained proliferation, evasion of growth suppressor signals, and cellular migration and invasion. Chronic inflammation also may facilitate the acquisition of other hallmarks throughout the multistep process of oral carcinogenesis. These findings also reveal evidence gaps in underexplored hallmarks of cancer, which highlights the need to expand future primary- and secondary-level investigations to better define the molecular mechanisms underlying OL malignant transformation.
背景/目的:口腔白斑(OL)是一种常见的口腔潜在恶性疾病。尽管其具有临床相关性,但其恶变的分子基础尚未完全阐明。本系统评价和荟萃分析的范围综述旨在综合当前关于癌症特征表达在OL恶变中的影响的知识和证据空白。 方法:在MEDLINE、Embase、DARE和Cochrane图书馆进行系统检索,以识别截至2025年4月发表的系统评价(有无荟萃分析)。 结果:纳入了22项系统评价。研究最频繁的特征是侵袭和转移激活(n = 12;32.40%),其次是促肿瘤炎症(n = 10;27.03%)、生长抑制因子逃逸(n = 8;21.60%)、持续增殖信号(n = 3;8.10%)、能量代谢重编程(n = 2;5.40%)、复制永生(n = 1;2.70%)和细胞死亡抵抗(n = 1;2.70%)。未发现OL中有血管生成或免疫逃逸的证据。 结论:现有证据表明,OL可能在口腔肿瘤发生的早期阶段发展致癌机制,尤其是那些与持续增殖、生长抑制信号逃逸以及细胞迁移和侵袭相关的机制。慢性炎症也可能在口腔癌发生的多步骤过程中促进其他特征的获得。这些发现还揭示了在癌症特征研究不足方面的证据空白,这突出了扩大未来一级和二级研究以更好地定义OL恶变潜在分子机制的必要性。
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