Mohammed Taib Fatih, Mohammed Khalid Mahmood, Balkees Taha Garib, Yad Mariwan Mohammed Amin, Ranjdar Mahmood Talabani, Tara Ali Rasheed, Handren Ameer Kurda, Balen Hamid Qadir, Zana Fuad Noori, Mohammed Aso Abdulghafor, Ariwan Othman Saeed, Herve Tassery, Delphine Tardivo, Romain Lan
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Twenty-seven systematic reviews encompassing more than 125,000 patients were included. Meta-analyses were conducted using random-effects models, with quality assessed using AMSTAR 2 and GRADE approaches.</p><p><strong>Results: </strong>Transformation rates were considerably higher in proliferative verrucous leukoplakia (48%) than in OL (6%). Females exhibited almost twice the MT rate of males (64% vs. 35%), while tongue lesions showed the highest site-specific risk (39%). The most promising predictive biomarker with a moderate level of evidence quality was DNA aneuploidy.</p><p><strong>Conclusions: </strong>Because of its high malignant potential, OL necessitates risk-based surveillance protocols. 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引用次数: 0
摘要
背景：口腔白斑（OL）是全球最常见的口腔潜在恶性疾病，报告的恶性转化（MT）率变化很大，为循证临床管理带来了挑战。目的：通过系统综述和荟萃分析，系统地综合OL中MT患病率的证据，并评估潜在的预测性生物标志物。方法：按照PRISMA指南，我们检索PubMed， MEDLINE， Scopus和Embase数据库至2025年7月。纳入了27项系统综述，涉及125,000多名患者。meta分析采用随机效应模型进行，质量评估采用AMSTAR 2和GRADE方法。结果：增殖性疣状白斑的转化率（48%）明显高于OL（6%）。女性的MT率几乎是男性的两倍（64% vs. 35%），而舌头病变显示最高的部位特异性风险（39%）。最有希望的具有中等证据质量的预测性生物标志物是DNA非整倍体。结论：由于其高恶性潜能，OL需要基于风险的监测方案。虽然大部分其他预测因素需要进一步研究，但DNA非整倍体显示出临床应用的潜力。
Malignant Transformation of Oral Leukoplakia and Proliferative Verrucous Leukoplakia and Its Biomarker Predictors: A Systematic Umbrella Review.
Background: Oral leukoplakia (OL) represents the most common oral potentially malignant disorder globally, with highly variable reported malignant transformation (MT) rates creating challenges for evidence-based clinical management.
Objective: To systematically synthesize evidence on MT prevalence in OL and evaluate potential predictive biomarkers through an umbrella review of systematic reviews and meta-analyses.
Methods: Following PRISMA guidelines, we searched PubMed, MEDLINE, Scopus, and Embase databases through July 2025. Twenty-seven systematic reviews encompassing more than 125,000 patients were included. Meta-analyses were conducted using random-effects models, with quality assessed using AMSTAR 2 and GRADE approaches.
Results: Transformation rates were considerably higher in proliferative verrucous leukoplakia (48%) than in OL (6%). Females exhibited almost twice the MT rate of males (64% vs. 35%), while tongue lesions showed the highest site-specific risk (39%). The most promising predictive biomarker with a moderate level of evidence quality was DNA aneuploidy.
Conclusions: Because of its high malignant potential, OL necessitates risk-based surveillance protocols. While the bulk of other predictors requires further investigation, DNA aneuploidy shows potential for clinical application.
期刊介绍：
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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