Keratosis of unknown significance and leukoplakia: a preliminary study

Woo, Sook‐Bin; Grammer, Rebecca; Lerman, Mark A.

doi:10.1016/j.oooo.2014.09.016

Cited by 62 publications

(65 citation statements)

References 39 publications

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“…Leukoplakia is thought to progress from hyperkeratosis or hyperplasia (or the so called KUS) (Woo, Grammer, & Lerman, ), to various degrees of dysplasia (mild, moderate, and severe), and ultimately carcinoma in situ and/or OSCC (Lumerman et al., ; Warnakulasuriya et al., ). The presence of dysplastic areas in the epithelium of the oral cavity has been associated with an increased risk of malignant transformation.…”

Section: From Leukoplakia To Oral Squamous Cell Carcinomamentioning

confidence: 99%

Oral leukoplakia remains a challenging condition

Villa

Sonis

2018

Oral Diseases

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Crispian Scully had many interests in the realm of oral diseases. But oral leukoplakia was one that piqued his curiosity when he was still an academic neophyte and remained a topic which he studied throughout his enormously productive career. It is easy to understand why. While the clinical manifestations of oral leukoplakia are common, we still do not fully understand why one version of the condition is benign, while another, similar in appearance, progresses to a malignancy. The diagnosis of oral leukoplakia is based on expert clinical and histopathological examamination. Management and treatment of leukoplakia remain challenging especially for large lesions and the proliferative subtype. This review aims to provide a general overview on leukoplakia, explore current challenges in its diagnosis and management and discuss the opportunities to better understand the condition.

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Section: From Leukoplakia To Oral Squamous Cell Carcinomamentioning

confidence: 99%

Oral leukoplakia remains a challenging condition

Villa

Sonis

2018

Oral Diseases

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“…One explanation for this is that such keratotic but minimally atypical lesions already harbor alterations in the first step toward carcinogenesis, the first “strike” in the “three strikes” theory of carcinogenesis (Vogelstein & Kinzler, ). This histologic entity of hyperkeratosis with minimal to no atypia (i.e., hyperkeratosis without epithelial dysplasia) has been referred to as “keratosis of unknown significance (KUS)” and constituted 57% of all biopsies of leukoplakias in one study (Woo, Grammer, & Lerman, ).…”

Section: Introductionmentioning

confidence: 99%

Oral keratosis of unknown significance shares genomic overlap with oral dysplasia

et al. 2019

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Objectives To identify molecular characteristics of keratosis of unknown significance and to nominate pathways of molecular progression to oral cancer. Our work could provide a rationale for monitoring and treating these lesions definitively. Methods Patients with oral leukoplakia were eligible for our prospective observational study. We correlated alterations in cancer‐associated genes with clinical and histopathologic variables (keratosis of unknown significance vs. moderate‐to‐severe dysplasia) and compared these alterations to a previously molecularly characterized oral cancer population. Results Of 20 enrolled patients, 13 (65%) had evidence of keratosis of unknown significance, while seven (35%) had dysplasia. Nine patients (45%) developed oral cancer (4/13 with keratosis of unknown significance, 5/7 with dysplasia). At a median follow‐up of 67 (range 22–144) months, median overall survival was significantly shorter for patients with dysplasia (hazard ratio 0.11, p = .02). KMT2C and TP53 alterations were most frequent (75% and 35%, respectively). There were molecular similarities between keratosis of unknown significance and dysplasia patients, with no significant differences in mutational frequency among genes with ≥15% rate of alteration. Conclusions Among patients with leukoplakia, both patients with keratosis of unknown significance and patients with dysplasia developed oral cancer. Molecular alterations between these two groups were similar at this sample size.

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“…7,24 When the biomolecular changes begin in tissue, it is possible that the earliest mutations cause only increased keratin formation without visible dysplasia. 3 It is necessary to detect these biomolecular changes at the earliest time to prevent progression of the disease. However, early detection of these changes is impossible, due to the lack of adequate early predictive biomarkers.…”

Section: Resultsmentioning

confidence: 99%

The Evaluation of Ghrelin Expression In Oral Leukoplakia And Oral Squamous Cell Carcinoma: An Immunohistochemical Study

Fikirli¹,

Özeç²,

Eğılmez³

et al. 2017

EÜ Dişhek Fak Derg

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ÖZET AMAÇ: Biobelirteçler normal dokuda, prekanseröz lezyonlarda ve kanserli dokuda farklı miktarlarda bulunabilen proteinler veya genlerdir, biobelirteçlerin değerlendirilmesi daha etkin bir şekilde malign transformasyon öngörüsü yapılmasını sağlayabilir. Bu çalışmanın amacı normal oral epitel, oral lökoplaki ve oral skuamoz hücreli karsinomada (OSHK) ghrelin seviyelerinin araştırılarak karşılaştırılmasıdır. YÖNTEM: Patoloji bölümü arşivinden elde edilen toplam 55 adet daha önce tanısı konulmuş normal oral mukoza (n = 15), oral lökoplaki (n = 18) ve OSHK (n = 22) bloklarından deparafinize edilerek elde edilen preparatlar özel antikorlar kullanılarak immünhistokimyasal olarak boyanmış ve ghrelin seviyeleri değerlendirilmiştir. İmmünhistokimyasal boyamada ghrelin mevcudiyeti mikroskop altında 100 hücre değerlendirilerek sayısallaştırılmıştır. Ghrelin pozitif hücrelerde kahverengi sitoplazmik boyama görülmüştür. BULGULAR: Normal oral mukozada hücrelerinin % 64'ünde, oral lökoplaki hücrelerinin % 66'sında ghrelin pozitif boyama görülürken, OSHK'da bu boyama yalnızca hücrelerin % 8'inde olmuştur. Diğer gruplar ile karşılaştırıldığı zaman OSHK grubunda ghrelin pozitif boyalı hücre miktarının istatistiksel olarak anlamlı şekilde az olduğu görülmüştür (P < 0.05). SONUÇ: Normal oral mukoza ve oral lökoplaki ile karşılaştırıldığı zaman OSHK grubunda ghrelin seviyesinin daha az olduğu tespit edilmiştir. Oral lökoplaki ve normal oral mukoza gruplarının ghrelinin seviyelerinin benzer olduğu belirlenmiştir. Oral karsinogenezis ile birlikte oluşan ghrelin seviyesinde ki değişikliklerin artmış malign potansiyelin belirlenmesinde bir biobelirteç olabileceği düşünülmektedir.

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Keratosis of unknown significance and leukoplakia: a preliminary study

Cited by 62 publications

References 39 publications

Oral leukoplakia remains a challenging condition

Oral leukoplakia remains a challenging condition

Oral keratosis of unknown significance shares genomic overlap with oral dysplasia

The Evaluation of Ghrelin Expression In Oral Leukoplakia And Oral Squamous Cell Carcinoma: An Immunohistochemical Study

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