Tissue biomarkers for predicting the risk of oral cancer in patients diagnosed with oral leukoplakia: A systematic review. (2nd February 2021)

• Record Type: Journal Article
• Authors: Monteiro, Luis; Mello, Fernanda Weber; Warnakulasuriya, Saman
• Other Names: Warnakulasuriya Saman guestEditor.
• Is Part Of: Oral diseases. Volume 27:Number 8(2021)
• Page Start: 1977
• Page End: 1992
• Publication Date: 2021-02-02
• Subjects: malignant transformation -- oral dysplasia -- oral leukoplakia -- systematic review -- tissue biomarkers; Mouth -- Diseases -- Research -- Periodicals; 617.522
• DOI: 10.1111/odi.13747
• Languages: English
• ISSNs: 1354-523X

Abstract

Abstract: Objectives: We performed a systematic review to evaluate the published biomarkers related to oral leukoplakia (OL), aiming to identify the biomarkers that indicate any future risk of cancer in patients with oral leukoplakia. Methods: A search strategy was developed for three main electronic databases: PubMed, Cochrane Library, and EBSCO, and also for Google Scholar, until February 28, 2020. The study selection was performed in a two‐phase process aiming at studies assessing tissue biomarkers for "malignant transformation of OL." Risk of bias analysis of included studies was performed using the Quality in Prognosis Studies Tool. Results: From 3, 130 articles initially identified by searching databases, a total of 46 studies were included in this systematic review, with a combined sample of 3, 783 patients, of whom 1, 047 presented with malignant transformation of a previously diagnosed OL as reported by the authors. The cancer incidence in the whole group was 27.6% (range: 5.4% to 54.1%). The studies were derived from different geographic areas, including Asia ( n = 21), Europe ( n = 15), North America ( n = 9), and Oceania ( n = 1). There were 49 different molecular biomarkers evaluated in the 46 included studies: p53 and podoplanin proteins were the most frequently reported, followed by abnormalities at particular chromosomal loci (e.g., LOH). Risk of bias analysis revealed concerns associated with "measurement of prognostic factor, " "study confounding" and "statistical analysis and reporting." Conclusions: Substantial heterogeneity and lack of standardized reporting of data among the studies were identified. The most promising biomarkers reported to have a significant association with the malignant transformation in OL included podoplanin and chromosomal loci abnormalities. A critical examination of the follow‐up studies on OL published so far indicated that tissue biomarkers that could predict the risk of oral cancer in patients with OL are still in a discovery phase.