Tissue Biomarkers for Predicting the Risk of Oral Cancer in Patients Diagnosed With Oral Leukoplakia: A Systematic Review of the Past 4 Years

Abstract

Background: Oral potentially malignant disorders may precede the development of oral cancer, and biomarkers are being investigated for their risk assessment. We aim to provide updated information on tissue biomarkers related to the risk of malignant transformation (MT) in patients with oral leukoplakia (OL) published during the last four years. Methods: A search strategy was developed using the electronic databases PubMed, EBSCO, and Cochrane Library to search for articles related to this topic (published from 2020 to 2024) (CRD42024527395). Results: Of the 1385 articles identified, 14 were included, with a combined sample of 1479 patients of whom 216 suffered MT. There were 30 different biomarkers evaluated of which Bmi-1, CD3/CD8, Ki-67, p16, and DNA ploidy were evaluated in more than one study. Of the 9 studies with multivariate analysis, Bmi-1, Tipe-2, copy number alteration, DcR2, and Ki-67, PTHrP, podoplanin (PDPN), and BubR1/Mad2 biomarkers presented independent significant value on MT. In one study, adding DNA ploidy status to the grade of dysplasia increased the model's predictive power. Conclusion: Although heterogeneity continues to exist, this systematic review reconfirms the role of biomarkers previously described such as PDPN and DNA ploidy and some new additional biomarkers.