IADR Abstract Archives
Are Lichenoid Lesions at Risk of Malignancy? a Clinical Study
Objectives: Oral lichen planus (OLP) is frequently encountered in the dental practice, and although it is recognized as potentially malignant by the World Health Organization, this designation continues to incite debate. Our previous research has found that lesions presenting with both dysplasia and features of lichenoid mucositis (LM) do have malignant risk, though not all lesions progress to malignancy. Thus, we aimed to determine clinical features indicative of cancer risk in LM with dysplasia.
Methods: Using a case control study design, patients enrolled in the Oral Cancer Prediction Longitudinal study with biopsy confirmed LM with dysplasia, no previous history of head and neck cancer, at least 5 years of follow-up, and accessible charts were selected. A chart review and an analysis of clinical photographs was conducted by two blinded clinicians. Association with malignant progression (defined as progression to severe dysplasia, carcinoma in situ, or squamous cell carcinoma) was tested using Chi-squared or Fisher’s Exact test.
Results: All progressing cases presented with a non-homogenous clinical appearance (P=0.005) and a significantly higher proportion exhibited high risk clinical features such as an erosive appearance or verrucous texture, compared to non-progressing cases (P<0.001). Non progressing lesions were more apt to present as reticular and smooth (P=0.007, P=0.016, respectively), and were less likely to change in appearance or size over time (P=0.002).
Conclusions: LM with dysplasia exhibiting a non-homogenous and non-reticular clinical presentation are at greater risk of progression to malignancy, compared to reticular and smooth lesions that do not tend to change over time. This research indicates that close clinical follow-up of lichenoid lesions is essential and highlights the key role that oral health professionals can play in disease prevention and early detection.
Methods: Using a case control study design, patients enrolled in the Oral Cancer Prediction Longitudinal study with biopsy confirmed LM with dysplasia, no previous history of head and neck cancer, at least 5 years of follow-up, and accessible charts were selected. A chart review and an analysis of clinical photographs was conducted by two blinded clinicians. Association with malignant progression (defined as progression to severe dysplasia, carcinoma in situ, or squamous cell carcinoma) was tested using Chi-squared or Fisher’s Exact test.
Results: All progressing cases presented with a non-homogenous clinical appearance (P=0.005) and a significantly higher proportion exhibited high risk clinical features such as an erosive appearance or verrucous texture, compared to non-progressing cases (P<0.001). Non progressing lesions were more apt to present as reticular and smooth (P=0.007, P=0.016, respectively), and were less likely to change in appearance or size over time (P=0.002).
Conclusions: LM with dysplasia exhibiting a non-homogenous and non-reticular clinical presentation are at greater risk of progression to malignancy, compared to reticular and smooth lesions that do not tend to change over time. This research indicates that close clinical follow-up of lichenoid lesions is essential and highlights the key role that oral health professionals can play in disease prevention and early detection.