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Brazilian Journal of Otorhinolaryngology 2009Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation.
UNLABELLED
Erythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation.
AIM
A retrospective analysis was conducted to investigate the clinicopathologic features of 13 cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and Histopathological diagnosis of oral diseases.
MATERIALS AND METHODS
All cases diagnosed with erythroplakia and speckled leukoplakia between 1978 and 2006 were retrieved from the service archives.
RESULTS
The lesions exhibited a predilection for males with a female-to-male ratio of 1:3.3. Mean age was 57 years old and soft palate was the site affected in 77% of the cases. Pain symptoms were reported by 61.5% of the patients and association with risk factors such as smoking and excessive alcohol intake was seen in 100% and in 46% of the cases, respectively. The lesions showed epithelial dysplasia, where more than 50% were diagnosed as in situ or invasive carcinoma.
CONCLUSIONS
Despite low prevalence, oral homogeneous erythroplakia and speckled leukoplakia show Histopathological alterations vary from epithelial dysplasia to invasive carcinoma. These lesions must be included among those oral lesions with the highest potential for malignant tranformation.
Topics: Adult; Aged; Biopsy; Carcinoma in Situ; Cross-Sectional Studies; Epithelium; Erythroplasia; Female; Humans; Leukoplakia, Oral; Male; Middle Aged; Mouth Mucosa; Precancerous Conditions; Retrospective Studies; Risk Factors
PubMed: 19575119
DOI: 10.1016/s1808-8694(15)30793-x -
Scientific Reports Dec 2023The programmed cell death protein (PD-1)/programmed cell death protein ligand (PD-L1) pathway and cytotoxic T lymphocyte antigen are the most important co-stimulatory...
The programmed cell death protein (PD-1)/programmed cell death protein ligand (PD-L1) pathway and cytotoxic T lymphocyte antigen are the most important co-stimulatory molecules that play a key role in the negative regulation of T cells during carcinogenesis. We aimed to evaluate the immunohistochemical expression of PD-1 and PD-L1 in oral leukoplakia and squamous cell carcinoma compared with normal oral mucosa. Twenty-five cases of oral squamous cell carcinoma, oral leukoplakia and normal oral mucosa tissue specimens were immunohistochemically stained to assess PD-1 and PD-L1 expression. The PD-L1 positivity of subepithelial TAFs (p < 0.001) increased with increasing grades of oral leukoplakia. Pearson's correlation indicated a high positive correlation between the PD-L1 labelling index of epithelial tumour cells and the PD-1 labelling index of tumour infiltrating lymphocytes (p value: 0.005) in OSCC. A high positive correlation was noted between the H-score of PD-L1 positive tumour epithelial cells and the H-score of PD-1 positive tumour infiltrating lymphocytes in OSCC (p value: 0.001). PD-L1 positivity increased in dysplastic epithelial cells from premalignant lesions to malignancy. The sub-epithelial PD-L1 positive TAFs were higher in oral leukoplakia compared to OSCC inferring that PD-L1 positivity in TAFs decreased with malignant transformation. The PD-1 positivity in TILs was higher in oral leukoplakia than in OSCC.
Topics: Humans; Apoptosis Regulatory Proteins; B7-H1 Antigen; Carcinoma, Squamous Cell; Leukoplakia, Oral; Mouth Neoplasms; Programmed Cell Death 1 Receptor; Squamous Cell Carcinoma of Head and Neck
PubMed: 38066025
DOI: 10.1038/s41598-023-48572-w -
Head and Neck Pathology Sep 2021Oral hairy leukoplakia (OHL) is an Epstein-Barr virus (EBV) related lesion seen in severely immunocompromised patients especially, those with concomitant human... (Review)
Review
Oral hairy leukoplakia (OHL) is an Epstein-Barr virus (EBV) related lesion seen in severely immunocompromised patients especially, those with concomitant human immunodeficiency virus (HIV) infection. It has been rarely reported in immunocompetent patients. OHL most often presents on the lateral border of the tongue as an asymptomatic, white, and corrugated plaque that does not rub off. With Institutional Review Board (IRB) approval, the University of Florida Oral & Maxillofacial Pathology Biopsy Service archives spanning 1994-2020 were queried. All cases of OHL affecting immunocompetent patients were identified. Data related to age, gender, clinical presentation, results of Epstein-Barr virus in situ hybridization (EBER-ISH), and periodic acid-Schiff (PAS)-fungus stains were recorded. Medical history and histology of all cases were reviewed for confirmation of diagnosis. A total of 11 cases were identified, the majority of which were males (63.6%) with a mean age of 62 years. All patients were Caucasian. Lesions entirely were located on the lateral borders of the tongue. OHL should not be considered pathognomonic for HIV infection and should be included in the differential diagnoses of keratotic lesions affecting the lateral border of tongue even in immunocompetent elderly patients. The etiology of OHL in this group of patients is not clearly understood.
Topics: Adult; Aged; Epstein-Barr Virus Infections; Female; Humans; Leukoplakia, Hairy; Male; Middle Aged
PubMed: 33428065
DOI: 10.1007/s12105-021-01287-8 -
Brazilian Oral Research Mar 2017To assess the immunocytochemical and immunohistochemical correlation of adhesion (E-cadherin) and cell differentiation (involucrin) molecules in oral leukoplakia and...
To assess the immunocytochemical and immunohistochemical correlation of adhesion (E-cadherin) and cell differentiation (involucrin) molecules in oral leukoplakia and oral squamous cell carcinoma. Cytological samples and biopsies were obtained from male and female patients aged over 30 years with oral leukoplakia (n = 30) and oral squamous cell carcinoma (n = 22). Cell scrapings and the biopsy were performed at the site of the lesion and histological slides were prepared for the immunocytochemical analysis of exfoliated oral mucosal cells and for the immunohistochemical analysis of biopsy tissues using E-cadherin and involucrin. Spearman's correlation and kappa coefficients were used to assess the correlation and level of agreement between the techniques. Immunostaining for E-cadherin and involucrin by both techniques was similar in the superficial layers of the histological sections compared with cell scrapings. However, there was no statistical correlation and agreement regarding the immunocytochemical and immunohistochemical expression of E-cadherin and involucrin in oral leukoplakia (R = 0.01, p = 0.958) (Kappa = 0.017, p = 0.92) or in oral squamous cell carcinoma (R = 0.26, p = 0.206) (Kappa = 0.36, p = 0.07). The immunoexpression of E-cadherin and involucrin in tissues is consistent with the expression patterns observed in exfoliated oral mucosal cells, despite the lack of a statistically significant correlation. There is an association of the histopathological characteristics of leukoplakia with the expression E-cadherin and of the microscopic aspects of oral squamous cell carcinoma with immunohistochemical expression of involucrin.
Topics: Adult; Aged; Antigens, CD; Biomarkers, Tumor; Biopsy; Cadherins; Carcinoma, Squamous Cell; Female; Humans; Immunohistochemistry; Leukoplakia, Oral; Male; Middle Aged; Mouth Neoplasms; Protein Precursors; Reference Values; Statistics, Nonparametric
PubMed: 28273205
DOI: 10.1590/1807-3107BOR-2017.vol31.0019 -
Asian Pacific Journal of Cancer... Dec 2018Objectives: The present observational study was conducted with an aim to evaluate the efficacy of diode laser in management of homogenous oral leukoplakia (OL) and... (Observational Study)
Observational Study
Objectives: The present observational study was conducted with an aim to evaluate the efficacy of diode laser in management of homogenous oral leukoplakia (OL) and reticular oral lichen planus (OLP), so that these potentially malignant disorders can be limited and further malignant transformation can be prevented. Further the assessment of associated postoperative complications after laser therapy was also carried out. Study Design: Present study was carried out using diode laser 810nm on 60 subjects, of whom 30 subjects were of homogenous OL and 30 subjects were of reticular OLP aged between 20 – 60 years, the diagnosis of which was histopathologically confirmed. Results: Of the 60 subjects none complained of pain during and immediately after surgery with no bleeding at any stage of the procedure. By the end of 3rd day post operative most subjects reported no pain and swelling and very few subjects had negligible pain and swelling when evaluated. On subsequent follow-up of 1,2 and 4 week(s) none of the subject reported of pain, swelling or bleeding and it was noted that all the areas treated with laser had healed without scarring with no signs of recurrence. Fibrosis was seen in two male patients and one female patient treated for OL and OLP respectively. Conclusion: Patient compliance and contentment without any postoperative complications were observed to be of high degree in the present study. Thus diode laser can be considered as a best alternative to conventional surgical treatment modality in managing OL and OLP and preventing its further transformation.
Topics: Adult; Cell Transformation, Neoplastic; Female; Humans; Leukoplakia, Oral; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Neoplasm Recurrence, Local; Precancerous Conditions; Risk Factors; Young Adult
PubMed: 30583693
DOI: 10.31557/APJCP.2018.19.12.3635 -
Indian Journal of Dermatology,... 2021
Topics: Aged; Humans; Leukoplakia, Oral; Male
PubMed: 33943065
DOI: 10.25259/IJDVL_992_20 -
BMC Oral Health Apr 2024Oral leukoplakia (OLK) is a prevalent precancerous lesion with limited non-pharmacological treatment options. Surgery and various lasers are the mainstay of treatment;... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Oral leukoplakia (OLK) is a prevalent precancerous lesion with limited non-pharmacological treatment options. Surgery and various lasers are the mainstay of treatment; however, their relative efficacy and optimal choice remain unclear. This first network meta-analysis compared the effects of different lasers and surgical excision on post-treatment recurrence and comfort in OLK patients.
METHODS
We searched four databases for relevant randomized controlled trials (RCTs) up to April 2023. The primary outcome was post-treatment recurrence, and secondary outcomes included intraoperative hemorrhage and postoperative pain scores. The Cochrane Risk of Bias tool was used to assess the study quality. Meta-analysis and network meta-analysis were employed to determine efficacy and identify the optimal intervention.
RESULTS
A total of 11 RCTs including 917 patients and 1138 lesions were included. Er,Cr:YSGG laser treatment showed significantly lower recurrence rates compared to CO laser (OR: 0.04; 95% CI: 0.01-0.18), CO laser with margin extension (OR: 0.06; 95% CI: 0.01-0.60), Er:YAG laser (OR: 0.10; 95% CI: 0.03-0.37), electrocautery (OR: 0.03; 95% CI: 0.00-0.18), and standard care (OR: 0.08; 95% CI: 0.02-0.33). Er,Cr:YSGG laser also ranked the best for reducing recurrence, followed by standard care and CO laser combined with photodynamic therapy (PDT). Er:YAG and Er:Cr:YSGG lasers minimized bleeding and pain, respectively. None of the interventions caused severe adverse effects.
CONCLUSION
For non-homogeneous OLK, Er:YAG, Er:Cr:YSGG, and CO laser combined with PDT offer promising alternatives to surgical excision, potentially reducing recurrence and improving patient comfort. Further high-quality RCTs are necessary to confirm these findings and determine the optimal laser-PDT combination for OLK treatment.
Topics: Humans; Network Meta-Analysis; Carbon Dioxide; Patient Comfort; Laser Therapy; Leukoplakia, Oral; Lasers, Solid-State
PubMed: 38632580
DOI: 10.1186/s12903-024-04179-9 -
American Family Physician Mar 2010Although easily examined, abnormalities of the tongue can present a diagnostic and therapeutic dilemma for physicians. Recognition and diagnosis require a thorough... (Review)
Review
Although easily examined, abnormalities of the tongue can present a diagnostic and therapeutic dilemma for physicians. Recognition and diagnosis require a thorough history, including onset and duration, antecedent symptoms, and tobacco and alcohol use. Examination of tongue morphology and a careful assessment for lymphadenopathy are also important. Geographic tongue, fissured tongue, and hairy tongue are the most common tongue problems and do not require treatment. Median rhomboid glossitis is usually associated with a candidal infection and responds to topical antifungals. Atrophic glossitis is often linked to an underlying nutritional deficiency of iron, folic acid, vitamin B12, riboflavin, or niacin and resolves with correction of the underlying condition. Oral hairy leukoplakia, which can be a marker for underlying immunodeficiency, is caused by the Epstein-Barr virus and is treated with oral antivirals. Tongue growths usually require biopsy to differentiate benign lesions (e.g., granular cell tumors, fibromas, lymphoepithelial cysts) from premalignant leukoplakia or squamous cell carcinoma. Burning mouth syndrome often involves the tongue and has responded to treatment with alpha-lipoic acid, clonazepam, and cognitive behavior therapy in controlled trials. Several trials have also confirmed the effectiveness of surgical division of tongue-tie (ankyloglossia), in the context of optimizing the success of breastfeeding compared with education alone. Tongue lesions of unclear etiology may require biopsy or referral to an oral and maxillofacial surgeon, head and neck surgeon, or a dentist experienced in oral pathology.
Topics: Atrophy; Carcinoma, Squamous Cell; Glossitis; Humans; Leukoplakia, Hairy; Lichen Planus, Oral; Nutrition Disorders; Primary Health Care; Tongue Diseases; Tongue Neoplasms
PubMed: 20187599
DOI: No ID Found -
Head and Neck Pathology Sep 2021Prior studies have established the carcinogenic role of HPV16 and also demonstrated its unique biological behavior in cervical and oropharyngeal squamous cell carcinoma...
Prior studies have established the carcinogenic role of HPV16 and also demonstrated its unique biological behavior in cervical and oropharyngeal squamous cell carcinoma (OPSCC) but its role in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) is not well explored. Therefore, in the present study, we assessed HPV16 prevalence using PCR and Anti-HPV16 antibodies for the first time and correlated its biological behavior using p16 and Ki67 proliferation index (PI) in OL, OSCC, and OPSCC. This study included 63 subjects comprising of 25 OL, 26 OSCC, and 12 OPSCC cases. Exfoliated cells were collected and processed for PCR followed by immunohistochemistry with primary antibodies p16, Anti-HPV16, and Ki67. The expressions were evaluated and statistical analysis included Chi-square and Spearman's test. Cumulatively 37% (OL-7%, OSCC-14% & OPSCC-16%) of cases showed positive PCR expression. PCR positivity was observed to be significantly higher (p 0.00) in OPSCC (9/12) than OSCC (9/26) and OL (5/25) cases. Overall immunohistochemical expression of p16, Anti-HPV16, and Ki67 were significantly (p 0.02) higher in HPV16 (PCR) positive cases. HPV16 + OSCC cases showed higher grades of p16 and Ki67 expression. We have demonstrated a prevalence of HPV16 in OL, OSCC, and OPSCC through PCR, which may be concluded as a gold standard for the detection of HPV16 DNA.
Topics: Adult; Aged; Female; Head and Neck Neoplasms; Human papillomavirus 16; Humans; Immunohistochemistry; India; Leukoplakia, Oral; Male; Middle Aged; Papillomavirus Infections; Polymerase Chain Reaction; Prevalence; Squamous Cell Carcinoma of Head and Neck
PubMed: 33646558
DOI: 10.1007/s12105-021-01309-5 -
Asian Pacific Journal of Cancer... Feb 2020Oral cancer usually has an early precancerous stage before its actual malignant transformation. Although there are various approaches to diagnose early stages of cancer,...
OBJECTIVE
Oral cancer usually has an early precancerous stage before its actual malignant transformation. Although there are various approaches to diagnose early stages of cancer, yet there is one less explored, cost effective and simple technique known as crystallization test. The aim of the study was to reaffirm the effectiveness of Pfeiffer's crystallization test in screening oral leukoplakia and squamous cell carcinoma.
METHODS
Fifty oral leukoplakia, sixty five oral squamous cell carcinoma and sixty healthy individuals participated in crystallization test. Single blood drop was used to perform the test and obtained crystal patterns were analysed. Cross tabulation and Chi-Square test was performed to find the frequency and association between the groups. Kruskal-Wallis H test and Mann Whitney U test was applied comparing mean transverse form.
RESULTS
Sensitivity of crystallization test was 80% and 93.84% in oral leukoplakia and squamous cell carcinoma. Chi-Square analysis revealed highly significant transverse form between the study groups (p < 0.000).
CONCLUSION
Crystallization test proves to be simple, reliable and minimal invasive diagnostic approach under strictly maintained physical conditions.
Topics: Adult; Aged; Case-Control Studies; Copper; Crystallization; Female; Humans; Indicators and Reagents; Leukoplakia, Oral; Male; Middle Aged; Mouth Neoplasms; Sensitivity and Specificity; Squamous Cell Carcinoma of Head and Neck; Young Adult
PubMed: 32102533
DOI: 10.31557/APJCP.2020.21.2.517