Risk co-factors inducing malignant transformation of oral lichen planus: A literature review of clinical studies

Oral lichen planus (OLP) is an autoimmune chronic inflammatory disease. The potential risk of malignant transformation in OLP remains controversial. The aim of the present study was to review original clinical studies published in indexed databases, which assessed the potential risk cofactors which were implicated in the malignant transformation of oral lichen planus. We focused our search to include most of the studies that reported malignant transformation of oral lichen planus using different combinations of the following key indexing terms: oral lichen planus, malignant transformation, smoking, alcohol, chronic inflammation, candida, human papillomavirus (HPV), hepatitis C virus (HCV) and immunosuppression. The animal studies were excluded from our study. Despite a dearth of studies on this topic we have identified consumption of tobacco and/or alcohol, the presence of erosive and/or atrophic areas, infection with candida, HCV, HPV, and immunosuppression as significant cofactors. Patients with OLP with these risk co-factors are at risk of malignant transformation should, therefore be followed up for an extensive period or even for life.

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Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1914 ◽

2016 ◽

Vol 17 (8) ◽

pp. 692-701 ◽

Cited By ~ 16

Author(s):

Farzaneh Agha-Hosseini ◽

Nafiseh Sheykhbahaei ◽

Maryam-Sadat SadrZadeh-Afshar

Keyword(s):

Risk Factors ◽

Literature Review ◽

Malignant Transformation ◽

Lichen Planus ◽

Potential Risk ◽

Oral Lichen Planus ◽

World Health ◽

Extensive Literature ◽

Potential Risk Factors ◽

Oral Lichen

ABSTRACT Aim Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP. Introduction World Health Organization (WHO) classifies OLP as a “potentially malignant disorder” with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored. Numerous studies have attempted to confirm the malignant transformation potential of OLP. Review results The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015. The medical subject heading search terms were “lichen planus,” “oral lichen planus,” “erosive oral lichen planus,” “dysplasia,” “oral precancerous condition,” “oral premalignant condition,” oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus. A total of 120 English language abstracts were reviewed, and 50 relevant articles identified. Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and nongenetic factors for more accurate assessment. Conclusion In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 4.59%. The highest rate of malignancy was noted in erythematosus and erosive lesions. In this way, follow-up of OLP patients could be carried out more efficiently and appropriately. Clinical significance Oral lichen planus is a premalignant lesion. All types of OLP in any site of oral mucosa must be monitored regularly. How to cite this article Agha-Hosseini F, Sheykhbahaei N, SadrZadeh-Afshar M-S. Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review. J Contemp Dent Pract 2016;17(8):692-701.

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Markers of Oral Lichen Planus Malignant Transformation

Disease Markers ◽

10.1155/2018/1959506 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 13

Author(s):

Mircea Tampa ◽

Constantin Caruntu ◽

Madalina Mitran ◽

Cristina Mitran ◽

Isabela Sarbu ◽

...

Keyword(s):

Quality Of Life ◽

Squamous Cell Carcinoma ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Chronic Inflammatory Disease ◽

Unknown Etiology ◽

Molecular Alterations ◽

Oral Lichen

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with significant impact on patients’ quality of life. Malignant transformation into oral squamous cell carcinoma (OSCC) is considered as one of the most serious complications of the disease; nevertheless, controversy still persists. Various factors seem to be involved in the progression of malignant transformation; however, the mechanism of this process is not fully understood yet. Molecular alterations detected in OLP samples might represent useful biomarkers for predicting and monitoring the malignant progression. In this review, we discuss various studies which highlight different molecules as ominous predictors of OLP malignant transformation.

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The Characteristics of Patients with Oral Lichen Planus and Malignant Transformation—A Retrospective Study of 271 Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126525 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6525

Author(s):

Vladimíra Radochová ◽

Romana Koberová Ivančaková ◽

Ondřej Heneberk ◽

Radovan Slezák

Keyword(s):

Retrospective Study ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Chronic Inflammatory Disease ◽

University Hospital ◽

Unknown Etiology ◽

Transformation Rate ◽

Oral Lichen

Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. Patients and methods: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003–2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. Results: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2–85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. Conclusions: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.

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Detection of Human Papillomavirus 33 in Erosive Oral Lichen Planus

International Journal of Cancer Management ◽

10.5812/ijcm.101488 ◽

2020 ◽

Vol 13 (10) ◽

Author(s):

Sareh Farhadi ◽

Donia Sadri ◽

Mojgan Bandehpour ◽

Mana Akbari ◽

Elnaz Jafarzadeh ◽

...

Keyword(s):

Human Papillomavirus ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Normal Mucosa ◽

Pcr Analysis ◽

Hpv Dna ◽

Transformation Potential ◽

Oral Lichen ◽

Hpv 18

Background: A correlation is suggested between oral lichen planus (OLP) and the human papillomavirus (HPV) with possible malignant transformation potential in OLP. Objectives: The present study aimed at evaluating the prevalence of HPV-16 and HPV-18 as the most recognized oncogenic subtypes and relatively recently introduced subtype HPV33 in OLP samples. Methods: This retrospective study was carried out on 32 OLP samples (consisting of 12 reticular and 20 erosive forms) and 20 healthy oral mucosa samples. Polymerase chain reaction (PCR) was undertaken to identify HPV Deoxyribonucleic Acid (DNA). Subsequently, the samples positive for HPV DNA underwent PCR analysis again with the specific primers. The data were analyzed statistically by Fisher’s exact test regarding the significance level of lower than 0.05. Results: Eight out of 32 OLP samples (25%) and none of the 20 normal mucosa samples (0%) exhibited HPV DNA. The presence of HPV in the OLP group was significantly higher than that in the normal mucosa (P = 0.014). Also, all the samples that exhibited HPV DNA were registered as the erosive form. Besides, one sample (3.12%) exhibited the 873-bp band, which was attributed to HPV-18, and 7 samples (21.87%) exhibited the 300-bp band, which was attributed to HPV-33. Conclusions: Based on the recent findings in the current study of the Iranian population, the presence of high-risk HPV subtypes, whether primarily or as a secondary infection, can suggest the malignant transformation potential for the studied OLP samples. The exclusive presence of these subtypes in the erosive type of this lesion and the noticeable presence of HPV-33 might reflect this issue’s importance. However, further studies are necessary to evaluate the possibility of a higher proliferation rate of HPV in erosive lichen planus and identify its possible malignant transformation mechanism.

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