Comparative Molecular Profiling of Lichenoid Dysplasia and Oral Lichen Planus.

Objectives: Oral squamous cell carcinoma (OSCC) is a common and deadly disease generally preceded by oral potentially malignant lesions (OPMLs). Although Oral Lichen Planus (OLP) is widely regarded as having malignant potential, some believe this not to be the case. It is controversially argued that the pre-malignant nature of OLP can be explained through Lichenoid Dysplasia (LD) – a clinically similar, yet histopathologically distinct lesion. The aim of this study is to determine and compare the molecular transcriptome profiles of LD, OLP and oral epithelial dysplasia (OED) via RNA-sequencing. This will allow determination of whether LD is a molecularly distinct entity or a progressive stage of OLP in the stepwise transformation to OSCC. This study is also designed to examine the functional biology of differentially expressed genes and their potential as specific biomarkers to objectively distinguish LD from OLP.
Methods: Eight samples each of LD, primary control OLP and secondary control OED were profiled in a retrospective case-control design. RNA sequencing was performed on Next-Generation Sequencing Ion S5 (Thermo Fisher Scientific) platform. Bioinformatics and statistics were undertaken using various genomic software packages.
Results: Distinct molecular profiles were determined for LD, OLP and OED. Ontological enrichment analysis of significantly differentially expressed genes elucidated differences in pathway impacts for each condition.
Conclusions: This study addresses the limitations of traditional clinical-histopathological diagnosis and establishes comparative molecular profiles for LD and OLP. Differentially expressed genes were identified, which are involved in functional pathways related to malignant transformation. Such potential molecular biomarkers may be used prospectively in development of prognostic indicators for risk of progression to OSCC. This will improve screening for earlier diagnosis of OPMLs and thus patient diagnosis, prognosis, morbidity, and healthcare efficacy.