Recurrence in Oral Premalignancy: Clinicopathologic and Immunohistochemical Analysis

Area of Science:

• Oral pathology
• Oncology
• Immunohistochemistry

Background:

• Oral leukoplakia (OL) frequently recurs and has potential for malignant transformation (MT).
• Predictive factors for OL recurrence and MT require further investigation.
• Understanding recurrence patterns is crucial for effective patient management.

Purpose of the Study:

• To identify sociodemographic, clinical, microscopic, and immunohistochemical predictors of OL recurrence.
• To compare primary OL lesions (PLs) with recurrent lesions.
• To analyze molecules in the STAT3 oncogenic pathway (pSTAT3, Bcl-xL, survivin, cyclin D1, Ki-67) in relation to recurrence.

Main Methods:

• Analysis of 135 OL lesions (97 PLs, 38 recurrences) from 33 patients.
• Evaluation of clinical and microscopic features, including homogeneity and dysplasia.
• Immunohistochemical analysis of STAT3 pathway molecules (pSTAT3, Bcl-xL, survivin, cyclin D1, Ki-67).

Main Results:

• Lower Bcl-xL and survivin expression were significant risk factors for OL recurrence.
• Recurrent lesions were often smaller, more homogeneous, and less dysplastic than PLs.
• Recurrences showed increased expression of pSTAT3 and Bcl-xL compared to PLs.

Conclusions:

• Distinct parameters may predict OL recurrence versus malignant transformation risk.
• Lower Bcl-xL and survivin levels are associated with increased OL recurrence.
• Excision and close monitoring are recommended for OL management, considering recurrence potential.