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Identifying Malignant Transformation Risk of Dysplastic Oral Lesions Using the S100A7 Biomarker Signature-Based

Audra Boehm¹, Jayson Workman², Krishna Kumar Kookal³

¹Resident, Katz Department of Oral and Maxillofacial Surgery, The University of Texas Health and Science Center at Houston School of Dentistry, Houston, TX.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons

|March 3, 2026

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A new biomarker signature-based risk score (BRS) shows high sensitivity and negative predictive value for predicting oral epithelial dysplasia transformation to oral squamous cell carcinoma (OSCC). This digital tool aids in risk stratification for oral cancer.

Area of Science:

Oral pathology
Biomarker discovery
Digital health

Background:

No clinically adopted molecular tests exist for oral epithelial dysplasia management.
A digital prognostic platform shows promise for estimating malignant transformation risk.

Purpose of the Study:

To evaluate a biomarker signature-based risk score (BRS) for identifying oral epithelial dysplasia transformation risk to oral squamous cell carcinoma (OSCC).

Main Methods:

Retrospective cohort study of 165 patients with oral epithelial dysplasia.
Assessed diagnostic parameters (sensitivity, specificity, PPV, NPV) of BRS.
Utilized Kaplan-Meier curves and Cox regression for time-to-cancer analysis.

Main Results:

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BRS demonstrated a sensitivity of 1.00 and a negative predictive value of 1.00.

Elevated BRS correlated with shorter time to cancer transformation (P = .0018).

Receiver operator curves showed similar performance to traditional dysplasia grading.

Conclusions:

BRS is a promising tool for assessing oral epithelial dysplasia transformation risk.
The digital platform aids in identifying high-risk lesions for closer monitoring.
Further validation is warranted for clinical adoption.