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. 2019 Jun;25 Suppl 1(Suppl 1):64-78.
doi: 10.1111/odi.13087.

World Workshop on Oral Medicine VII: Prognostic biomarkers in oral leukoplakia: A systematic review of longitudinal studies

Alessandro Villa  1   2 , Antonio Celentano  3 , Ingrid Glurich  4 , Wenche S Borgnakke  5 , Siri Beier Jensen  6 , Douglas E Peterson  7 , Konstantina Delli  8 , David Ojeda  9 , Arjan Vissink  8 , Camile S Farah  10
Affiliations

World Workshop on Oral Medicine VII: Prognostic biomarkers in oral leukoplakia: A systematic review of longitudinal studies

Alessandro Villa et al. Oral Dis. 2019 Jun.

Abstract

Objective: To identify the prognostic biomarker candidates for stratification and long-term surveillance of oral leukoplakia progressing to cancer via a systematic literature review.

Materials and methods: Systematic searches with no date restrictions were conducted on March 29, 2018, targeting the databases PubMed (Ovid), EMBASE (Ovid), EBM (Ovid), and Web of Science (ISI). Bias was assessed using the Quality in Prognosis Studies tool. Biomarkers were stratified based on hallmarks of cancer.

Results: Inclusion criteria were met by 25 of 3,415 studies. A range of biomarkers were evaluated experimentally for risk stratification, prognosis, and surveillance of oral leukoplakia in tissue, blood, and saliva. However, the studies were highly heterogeneous and require further validation. Biomarkers reported in these studies included inflammatory or oxidative markers, growth factors, ion channels, genetic and cellular regulatory factors, and epigenetic biomarkers. Studies tended to include small sample sizes, under-reported or variably reported histopathological data, did not address potential confounding, reported limited/variable follow-up data, or lacked a control group. Inclusion of subsets from chemoprevention trials may have introduced bias regarding reported malignant transformation rates and accuracy of prognostic biomarkers.

Conclusions: This review identified insufficient longitudinal evidence to support validated prognostic biomarkers for oral leukoplakia. Further studies are needed to identify molecular targets with the potential to mitigate risk of malignant transformation.

Keywords: biomarkers; cancer progression; leukoplakia; neoplastic cell transformation; prognosis; tumor.

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Figures

Figure 1.
Figure 1.
Selection of studies for systematic review of prognostic biomarkers for oral leukoplakia.
Figure 2.
Figure 2.
Risk of bias in the 25 included studies according to the Quality in Prognosis Studies (QUIPS) criteria (Hayden et al., 2013).
See this image and copyright information in PMC

Comment in

  • Prognostic biomarkers in oral leukoplakia.
    Warnakulasuriya S. Warnakulasuriya S. Oral Dis. 2019 Nov;25(8):2047. doi: 10.1111/odi.13184. Epub 2019 Sep 11. Oral Dis. 2019. PMID: 31461556 No abstract available.
  • Response to "prognostic biomarkers in oral leukoplakia".
    Villa A, Celentano A, Glurich I, Borgnakke WS, Jensen SB, Peterson DE, Delli K, Ojeda D, Vissink A, Farah CS. Villa A, et al. Oral Dis. 2019 Nov;25(8):2048-2049. doi: 10.1111/odi.13185. Epub 2019 Sep 11. Oral Dis. 2019. PMID: 31469945 No abstract available.

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