Potencial de transformación maligna de las lesiones blanquecinas bucales / Potential for malignant transformation of whitish oral lesions

Introducción: Las lesiones blanquecinas bucales con potencial maligno, son un grupo reconocible de enfermedades de las mucosas, que preceden a la aparición de cánceres invasivos de la cavidad bucal. Objetivo: Determinar el potencial de transformación maligna de las lesiones blanquecinas de la cavidad bucal. Métodos: Se realizó un estudio observacional, descriptivo y transversal, de enero del año 2016 hasta enero de 2020, de todos los pacientes que acudieron al servicio de Cirugía Maxilofacial, con lesiones blanquecinas bucales. Las variables utilizadas fueron: edad, sexo, factores de riesgo, tiempo de evolución, sitio de la lesión, diagnóstico histológico y potencial de transformación maligna. Se exploró asociación mediante ji cuadrado. Resultados: Se encontraron lesiones con potencial de transformación maligna en el 24 por ciento de los mayores de 50 años, en el 24,3 por ciento de los hombres y en el 40 por ciento de pacientes con queilitis actínicas. El 83,3 por ciento fueron leucoplasias y entre ellas, el 20 por ciento con potencial de transformación maligna. Conclusiones: La leucoplasia es el diagnóstico histológico más común. Las lesiones con potencial de transformación maligna aumentan con la edad, son mayores en los hombres y en pacientes con queilitis actínicas. Los sitios anatómicos en que más aparecen son: paladar blando y labio superior; entre los factores de riesgo de mayor asociación está la exposición al sol(AU)

Introduction: Potentially malignant whitish oral lesions are a recognizable group of mucosal diseases that precede the appearance of invasive cancers of the oral cavity. Objective: To determine the potential malignant transformation of whitish lesions in the oral cavity. Methods: An observational, descriptive and cross-sectional study was carried, from January 2016 to January 2020, of all patients who attended the Maxillofacial Surgery service with whitish oral lesions. The variables used were: age, sex, risk factors, time of evolution, and site of the lesion, histological diagnosis and potential for malignant transformation. To explore the association between categorical variables, the Chi square distribution was used. Results: Lesions with the potential for malignant transformation were found in 24 percent of those over 50 years of age, in 24,3 percent of men and in 40 percent of patients with actinic cheilitis. 83,3 percent were leukoplakia, and among them 20 percent with the potential for malignant transformation. Conclusions: Leukoplakia was the most common histological diagnosis. Lesions with the potential for malignant transformation increased with age, were greater in men and in actinic cheilitis patients. The anatomical sites in which they appeared most were on the soft palate and upper lip and among the risk factors with the greatest association was sun exposure(AU)

Role of podoplanin in potentially malignant disorders and oral squamous cell carcinoma and its correlation with lymphangiogenesis.

BACKGROUND: Oral squamous cell carcinoma (OSCC) ranks as one of the most common types of cancer and oral potentially malignant lesions (OPMLs) provides with an overall increased risk for development of carcinoma. As podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis, this study assesses the role of podoplanin expression in such lesions. MATERIALS AND METHODS: Podoplanin expression and lymphatic vessel density (LVD) was determined using D2‑40, a marker for podoplanin, in 70 diagnosed cases of potentially malignant lesions and OSCC. RESULTS: Normal epithelium showed negligible podoplanin expression, whereas the expression extended predominantly at the basal layer and the suprabasal layer or above at one or multiple areas in potentially malignant lesions. Podoplanin expression in OSCC showed two different patterns‑diffuse and focal. A statistically significant increase in mean LVD was seen from normal epithelium to potentially malignant lesions (P < 0.001) and to OSCC (P < 0.022) while a non‑significant increase was seen (P < 0.594) between OPMLs and OSCC. Overall no significant correlation was found between D2‑40 epithelial positivity and LVD (P = 0.122). CONCLUSION: This study suggests the utility of podoplanin as a biomarker for cancer risk assessment as it detects the early changes and thus provides an additional value beyond current clinical and histopathological evaluations. Hence, podoplanin is suggested to be a marker of tumor initiation and to a lesser extent of tumor progression.

An update on precancerous lesions of oral cavity.

Oral cancer is the most common head and neck cancer, found in 270,000 patients annually worldwide. Some cancers develop from precancerous lesions; however, there is no definitive clinico pathological factor or biomarker that reliably enables malignant transformation to be predicted in an individual patient. Early detection and early treatment of oral cancer are important for improving the survival rate of patients; prevention of oral cancer will clearly contribute most to decreasing its death rate. So correct diagnosis and timely treatment of premalignant lesions with high risk of malignant transformation may help to prevent malignant transformation.