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Farah CS, Shearston K, Turner EC, Vacher M, Fox SA. Global gene expression profile of proliferative verrucous leukoplakia and its underlying biological disease mechanisms. Oral Oncol 2024; 151:106737. [PMID: 38408418 DOI: 10.1016/j.oraloncology.2024.106737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Proliferative verrucous leukoplakia (PVL) is a rare and enigmatic oral potentially malignant disorder which almost invariably results in oral squamous cell carcinoma (OSCC). The aims of this project were to use transcriptome profiling to characterise PVL gene expression patterns for biomarker identification and gain insight into the molecular aetiopathogenesis of PVL. METHODS Forty-three oral cavity mucosal biopsies from 32 patients with oral lesions clinically compatible with either PVL or non-PVL conventional oral leukoplakia (OLK) underwent transcriptome profiling by RNA sequencing. Data was analysed by hierarchical clustering, differential gene expression, functional enrichment and network analysis, sparse partial least squares discriminant analysis sPLS-DA, and immune cell phenotypic estimation. RESULTS We found 464 genes significantly differentially expressed at least 2-fold between PVL and non-PVL OLK (193 up and 271 down). HOX genes, including HOXA1 and HOXB7, keratin-associated proteins (KRTAPs) and olfactory receptor G proteins (OR) were significantly upregulated in PVL. Other upregulated genes in PVL included FOS, WNT16 and IFNA1. Pathway analysis showed that there was a significant downregulation of connective tissue signalling in PVL. Classifying multivariate models based upon 22 genes discriminated PVL from non-PVL OLK. Bioinformatic profiling showed that immune cell profiles in PVL and OLK were similar except that fibroblast markers were reduced in PVL. CONCLUSION These results demonstrate that PVL and conventional OLK are molecularly distinct with upregulation of many cancer-associated genes. They provide insight into the pathogenesis of PVL and show that biomarker based molecular diagnostics is feasible to discriminate and inform diagnosis and management.
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Affiliation(s)
- Camile S Farah
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia; Central Queensland University, Rockhampton, Queensland, Australia; Genomics for Life, Milton, QLD, Australia.
| | - Kate Shearston
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia; UWA Dental School, University of Western Australia, Nedlands, WA, Australia.
| | - Emma C Turner
- UWA Dental School, University of Western Australia, Nedlands, WA, Australia; Special Needs Dental Unit, Royal Darwin Hospital, Tiwi, NT, Australia
| | - Michael Vacher
- The Australian eHealth Research Centre, CSIRO Health and Biosecurity, Kensington, WA, Australia.
| | - Simon A Fox
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia; UWA Dental School, University of Western Australia, Nedlands, WA, Australia.
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Gilligan G, Panico R, Lazos J, Morelatto R, Belardinelli P, Criscuolo MI, Bolesina N, Molina Ávila I, Pimentel Solá JM, Rivarola E, Morgante MJ, Ingrassia Tonelli ME, Gimenez J, Doratti P, Werner LC, Prado-Ribeiro AC, Brandão TB, Vechiato-Filho AJ, Cuzzullin MC, Saldivia-Siracusa C, Lopes MA, Agostini M, Romañach MJ, Abrahão AC, Fonsêca TC, Kaminagakura E, Anbinder AL, Santos Alves K, de Almeida Lança ML, Sacsaquispe-Contreras S, Rodriguez Ibazetta K, Gerber-Mora R, Aranda Romo S, Tejeda Nava FJ, Cordero-Torres K, Moreno Silva R, Gonzalez-Arriagada W, Toro R, Silveira FM, Gonzalez N, Vargas PA, Santos-Silva AR, Bologna-Molina R, Villarroel-Dorrego M, Martinez B, Piemonte E. Oral squamous cell carcinomas and oral potentially malignant disorders: A Latin American study. Oral Dis 2023. [PMID: 37877476 DOI: 10.1111/odi.14778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/09/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
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.
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Affiliation(s)
- Gerardo Gilligan
- Oral Medicine Department "A", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - René Panico
- Oral Medicine Department "A", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Jerónimo Lazos
- Oral Medicine Department "A", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Rosana Morelatto
- Oral Medicine Department "B", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Paola Belardinelli
- Oral Medicine Department "B", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Maria Ines Criscuolo
- Oral Medicine Department "B", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nicolas Bolesina
- Oral Medicine Department "B", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | | | | | | | | | | | | | | | - Ana Carolina Prado-Ribeiro
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Thais Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Aljomar Jose Vechiato-Filho
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Maria Claudia Cuzzullin
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mario José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thamyres Campos Fonsêca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Estela Kaminagakura
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Ana Lia Anbinder
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Kamilla Santos Alves
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Maria Leticia de Almeida Lança
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | | | | | | | - Saray Aranda Romo
- Facultad de Estomatología, Universidad Autónoma de San Luis de Potosí, San Luis Potosi, Mexico
| | | | | | | | | | - Raiza Toro
- Instituto de Investigaciones Odontológicas, Facultad de Odontología, Universidad Central de Venezuela, Caracas, Venezuela
| | - Felipe Martins Silveira
- Oral Medicine and Oral Pathology Diagnosis Department, Facultad de Odontología, Universidad de la República UDELAR, Montevideo, Uruguay
| | - Natalia Gonzalez
- Oral Medicine and Oral Pathology Diagnosis Department, Facultad de Odontología, Universidad de la República UDELAR, Montevideo, Uruguay
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ronell Bologna-Molina
- Oral Medicine and Oral Pathology Diagnosis Department, Facultad de Odontología, Universidad de la República UDELAR, Montevideo, Uruguay
| | - Mariana Villarroel-Dorrego
- Instituto de Investigaciones Odontológicas, Facultad de Odontología, Universidad Central de Venezuela, Caracas, Venezuela
| | - Benjamin Martinez
- Oral Pathology Department, Facultad de Odontología, Universidad Mayor de Chile, Santiago de Chile, Chile
| | - Eduardo Piemonte
- Oral Medicine Department "A", Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
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Alsoghier A, AlBagieh H, AlSahman L, Alshagroud R, AlSahman R. Proliferative verrucous/multifocal leukoplakia: Updates and literature review "case report". Medicine (Baltimore) 2023; 102:e33783. [PMID: 37233434 PMCID: PMC10219708 DOI: 10.1097/md.0000000000033783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
RATIONALE Proliferative verrucous leukoplakia (PVL) is a multifocal, slowly evolving lesion that resists all types of treatment and has a high propensity for malignant transformation into oral squamous cell carcinoma. Lack of awareness and acquaintance with white lesions of the oral cavity makes it difficult to diagnose. Besides being rare, PVL significantly aggressive, so clinicians need to be aware of it carefully. Therefore, it is recommended to have the earliest possible diagnosis and total excision of this lesion. We report this case to present typical clinical and histologic features of PVL so a For the purpose of sensitizing clinician. PATIENT CONCERN A 61-year-old female came to the clinic concerning of recurring painless, white patch on the tongue 2 months ago, associated with oropharyngeal dryness. DIAGNOSES This case satisfies these major and minor criteria to diagnosed PVL. INTERVENTION An excisional biopsy of the lesion was done to check for the presence of dysplasia, as lesions were persisting. Hemostasis was achieved with single interrupted sutures. OUTCOME no recurrence has been observed since excisional 1 year follow-up. LESSON The key feature is early detection, precisely in cases of PVL it is critical for better treatment outcomes, lifesaving, quality-of-life enhancement. To detect and treat any potential pathologies, clinicians should meticulously examine the oral cavity and patients have to be aware and informed of the importance of regular screenings. This lesion is resistant to the presently available treatment modalities; therefore, total excision with free surgical margins is critical combined with a lifelong follow-up.
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Affiliation(s)
- Abdullah Alsoghier
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Hamad AlBagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Lujain AlSahman
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Rana Alshagroud
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Roba AlSahman
- Faculty of Dentistry, Royal College of Surgeons, Ireland, Dublin
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Zhang S, Deng Y, Ji T, Wang Y, Liu W. Overestimated risk of transformation in oral lichen planus: In reply with emphasis on natural history of proliferative verrucous leukoplakia. Oral Oncol 2023; 136:106263. [PMID: 36444802 DOI: 10.1016/j.oraloncology.2022.106263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shijian Zhang
- Department of Oral and Maxillofacial Surgery, Zhang Zhiyuan Academician Workstation, Hainan Western Central Hospital, Shanghai Ninth People's Hospital, Danzhou, Hainan, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yiwen Deng
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yufeng Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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Barba-Montero C, Lorenzo-Pouso AI, Gándara-Vila P, Blanco-Carrión A, Marichalar-Mendía X, García-García A, Pérez-Sayáns M. Lichenoid areas may arise in early stages of proliferative verrucous leukoplakia: A long-term study of 34 patients. J Oral Pathol Med 2022; 51:573-581. [PMID: 35596256 PMCID: PMC9541998 DOI: 10.1111/jop.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/07/2022] [Accepted: 05/09/2022] [Indexed: 11/06/2022]
Abstract
Background Proliferative verrucous leukoplakia is considered an uncommon oral potentially malignant disorder with a high malignant transformation rate. The objective of this paper was to define its cancer incidence and related risk factors. Methods A retrospective audit of 34 patients diagnosed with proliferative verrucous leukoplakia from a university‐based unit, during the period from 1995 to 2019 was performed. The mean number of visits was 23 ± 18.6. The follow‐up was divided into four‐time intervals to evaluate the clinical presentation, number of lesions, dysplasia grade, and malignant transformation rate. Results The majority of patients were females 29 (85.3%), with verrucous component (77.8%), with a gingival presentation (31.8%), and with a preceding lichenoid area (44.1%). Eleven patients (32.4%) were affected by oral cancer during the follow‐up, developing a total of 15 carcinomas. The mean age of malignant transformation was 67.2 ± 12.9 years, particularly 8 ± 8.5 from the onset of the lesions. Warty forms presented a higher mean estimate for malignant transformation (15.2 years, 95% confidence interval 4.4–26 years) than nodular forms (1.9 years, 95% confidence interval 1.9–1.9) (p = 0.019). Patients with an initial proliferative verrucous leukoplakia diagnosis suffered a higher risk of malignancy, particularly 15.55 times (95% confidence interval 1.69–143.17; p = 0.015) than those who did present a preceding area with lichenoid morphology. Conclusion Proliferative verrucous leukoplakia presented a high malignant transformation rate and sometimes displayed preceding oral lichenoid areas in early stages. Further studies are needed to understand the impact of these lichenoid areas in proliferative verrucous leukoplakia progression.
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Affiliation(s)
- Catalina Barba-Montero
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain
| | - Alejandro Ismael Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago, Spain
| | - Xabier Marichalar-Mendía
- Department of Nursing, Faculty of Medicine and Nursing, University of Basque Country, Leioa, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, University of Santiago de Compostela, Santiago, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago, Spain
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