Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria.
malignant transformation
oral lichen planus
squamous cell carcinoma
systematic review and meta-analysis
Journal
Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology
ISSN: 1600-0714
Titre abrégé: J Oral Pathol Med
Pays: Denmark
ID NLM: 8911934
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
17
01
2020
accepted:
20
01
2020
pubmed:
26
1
2020
medline:
20
3
2021
entrez:
26
1
2020
Statut:
ppublish
Résumé
The malignant transformation (MT) potential of oral lichen planus (OLP) has sparked heated debates for almost a century, despite the fact that global figures of OLP prevalence and oral cancer incidence do not support an association mathematically. In this study, we performed a systematic review and meta-analysis, using strict inclusion criteria, to more precisely assess the malignant potential rate of OLP and the influence of associated risk factors. All reports that documented MT of OLP and published in the English language until January 2020 were included if they met the following strict criteria: (a) the presence of a properly verified OLP diagnosis, (b) a clear description of the cancerous lesion developing at the same site as the verified OLP lesion; and (c) a follow-up period of a minimum of 6 months prior to carcinoma development. Thirty-three studies were included in this analysis with a total of 12 838 OLP patients. Of these, 151 cases were initially considered to have progressed to carcinoma (1.2%). However, after applying strict criteria, only 56 cases were considered to have undergone MT from OLP (0.44%). The risk of MT was significantly higher among OLP patients who smoked (OR = 4.62), consumed alcohol (OR = 3.22), were seropositive for HCV (OR = 3.77) and/or displayed a red OLP subtype (OR = 0.37). Our results suggest that the reported OLP malignant transformation rates are exaggerated, and these do not reflect the actual clinical course of the disease according to strict clinical and histopathological criteria.
Sections du résumé
BACKGROUND
BACKGROUND
The malignant transformation (MT) potential of oral lichen planus (OLP) has sparked heated debates for almost a century, despite the fact that global figures of OLP prevalence and oral cancer incidence do not support an association mathematically. In this study, we performed a systematic review and meta-analysis, using strict inclusion criteria, to more precisely assess the malignant potential rate of OLP and the influence of associated risk factors.
METHODS
METHODS
All reports that documented MT of OLP and published in the English language until January 2020 were included if they met the following strict criteria: (a) the presence of a properly verified OLP diagnosis, (b) a clear description of the cancerous lesion developing at the same site as the verified OLP lesion; and (c) a follow-up period of a minimum of 6 months prior to carcinoma development.
RESULTS
RESULTS
Thirty-three studies were included in this analysis with a total of 12 838 OLP patients. Of these, 151 cases were initially considered to have progressed to carcinoma (1.2%). However, after applying strict criteria, only 56 cases were considered to have undergone MT from OLP (0.44%). The risk of MT was significantly higher among OLP patients who smoked (OR = 4.62), consumed alcohol (OR = 3.22), were seropositive for HCV (OR = 3.77) and/or displayed a red OLP subtype (OR = 0.37).
CONCLUSIONS
CONCLUSIONS
Our results suggest that the reported OLP malignant transformation rates are exaggerated, and these do not reflect the actual clinical course of the disease according to strict clinical and histopathological criteria.
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
287-298Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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