Multimodal diagnostic segregation of oral leukoplakia and cancer

Oral leukoplakia (OL) is a premalignant lesion described as “a predominant white lesion of the oral mucosa which cannot be defined as any other known lesion”. OL located on the floor of the mouth, soft palate and tongue are considered as high-risk lesions, while, in other areas, they may be considered as of low malignancy risk. A Forty five years old male patient had complaints of white lesion on left lat. Surface of tongue, along with burning sensation since 4-5 months. He was diagnosed with Leukoplakia and he had taken allopathic medicine for 4 to 5 times, but it was inversely relapsed, so he was treated with Pratisarana of Bibhitaka Churna and Rasayana Churna, Yastimadhu Ghanavati as lozenges along with Rasayana tablets orally for a period of 6 months. After 6 month therapy, white lesion became disappear and no burning sensation. Thus this patient was successfully treated with above therapy with no recurrence or any complications till date.

Download Full-text

Oral Leukoplakia Revisited: Retrospective Analysis of 176 Cases

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2014.07.337 ◽

2015 ◽

Vol 119 (3) ◽

pp. e178

Author(s):

Alper Sinanoglu ◽

Merva Soluk Tekkeşin ◽

Nihan Aksakalli ◽

Vakur Olgac

Keyword(s):

Retrospective Analysis ◽

Oral Leukoplakia

Download Full-text

Recombinant Human Adenovirus-p53 Therapy for the Treatment of Oral Leukoplakia and Oral Squamous Cell Carcinoma: A Systematic Review

Medicina ◽

10.3390/medicina57050438 ◽

2021 ◽

Vol 57 (5) ◽

pp. 438

Author(s):

Jagadish Hosmani ◽

Shazia Mushtaq ◽

Shahabe Saquib Abullais ◽

Hussain Mohammed Almubarak ◽

Khalil Assiri ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Oral Cancer ◽

Adverse Events ◽

Randomized Clinical Trials ◽

Oral Leukoplakia ◽

Research Articles ◽

Original Research ◽

Therapeutic Effects ◽

The World

Background and Objectives: Oral cancer is the 6th most common cancer in the world and oral leukoplakia is an oral potentially malignant disorder that could develop into oral cancer. This systematic review focusses on randomized clinical trials for recombinant adenovirus p-53 (rAD-p53) therapy for the treatment of oral leukoplakia and cancer. Materials and Methods: We searched for research articles on various databases such as Pubmed/Medline, Embase, CNKI (China National Knowledge Infra-structure), Springerlink, cochrane and Web of sciences from 2003 to 2020. MeSH (Medical Subject Headings) terms were used for the search. Inclusion criteria included original research, randomized clinical trials and articles only in English language. Exclusion criteria were any articles that were not research articles, not randomized trials, non-human studies, etc. The articles were further graded on the Jadad scale. Results: 578 articles were assessed from various databases; only 3 articles were found to be appropriate for this review. Thus, meta-analysis was not performed because of heterogeneity and lack of data. In the three studies, whether rAD-p53 was used as a standalone therapy or with other therapies, there was a beneficial effect of the therapy. Furthermore, there were no serious adverse events and the only adverse events reported were fever, pain at the local injection site, flu-like symptoms and lowered WBC count. Conclusions: Thus, we can conclude that this therapy has a potential for beneficial therapeutic effects and further clinical trials with more patients need to be performed to get better understanding of the effect of rAD-p53 therapy, which probably will pave the way to its approval in other parts of the world.

Download Full-text

Importance of the PD-1/PD-L1 Axis for Malignant Transformation and Risk Assessment of Oral Leukoplakia

Biomedicines ◽

10.3390/biomedicines9020194 ◽

2021 ◽

Vol 9 (2) ◽

pp. 194

Author(s):

Jutta Ries ◽

Abbas Agaimy ◽

Falk Wehrhan ◽

Christoph Baran ◽

Stella Bolze ◽

...

Keyword(s):

Immune Response ◽

Cell Death ◽

Programmed Cell Death ◽

Malignant Transformation ◽

Immune Escape ◽

Checkpoint Inhibitors ◽

Precancerous Lesions ◽

Death Receptor ◽

Oral Leukoplakia ◽

Significant Difference

Background: The programmed cell death ligand 1/programmed cell death receptor 1 (PD-L1/PD-1) Immune Checkpoint is an important modulator of the immune response. Overexpression of the receptor and its ligands is involved in immunosuppression and the failure of an immune response against tumor cells. PD-1/PD-L1 overexpression in oral squamous cell carcinoma (OSCC) compared to healthy oral mucosa (NOM) has already been demonstrated. However, little is known about its expression in oral precancerous lesions like oral leukoplakia (OLP). The aim of the study was to investigate whether an increased expression of PD-1/PD-L1 already exists in OLP and whether it is associated with malignant transformation. Material and Methods: PD-1 and PD-L1 expression was immunohistologically analyzed separately in the epithelium (E) and the subepithelium (S) of OLP that had undergone malignant transformation within 5 years (T-OLP), in OLP without malignant transformation (N-OLP), in corresponding OSCC and in NOM. Additionally, RT-qPCR analysis for PD-L1 expression was done in the entire tissues. Additionally, the association between overexpression and malignant transformation, dysplasia and inflammation were examined. Results: Compared to N-OLP, there were increased levels of PD-1 protein in the epithelial and subepithelial layers of T-OLP (pE = 0.001; pS = 0.005). There was no significant difference in PD-L1 mRNA expression between T-OLP and N-OLP (p = 0.128), but the fold-change increase between these groups was significant (Relative Quantification (RQ) = 3.1). In contrast to N-OLP, the PD-L1 protein levels were significantly increased in the epithelial layers of T-OLP (p = 0.007), but not in its subepithelial layers (p = 0.25). Importantly, increased PD-L1 levels were significantly associated to malignant transformation within 5 years. Conclusion: Increased levels of PD-1 and PD-L1 are related to malignant transformation in OLP and may represent a promising prognostic indicator to determine the risk of malignant progression of OLP. Increased PD-L1 levels might establish an immunosuppressive microenvironment, which could favor immune escape and thereby contribute to malignant transformation. Hence, checkpoint inhibitors could counteract tumor development in OLP and may serve as efficient therapeutic strategy in patients with high-risk precancerous lesions.

Download Full-text