Band-Like Chronic Inflammatory Infiltrate in Proliferative Verrucous Leukoplakia: A Meta-Analysis

Proliferative verrucous leukoplakia is an oral potentially malignant disorder with a difficult diagnosis. A band-like chronic inflammatory infiltrate is frequently described in early lesions, but its prevalence and prognostic relevance remain unclear. This study aimed to estimate the prevalence of this feature in proliferative verrucous leukoplakia and assess its prognostic value.

A systematic review and meta-analysis were conducted according to PRISMA guidelines, with protocol registration in PROSPERO (CRD420251249570). Electronic databases and gray literature were searched. Observational studies reporting a band-like chronic inflammatory infiltrate in lesions from patients with proliferative verrucous leukoplakia were included. Data extraction and risk of bias assessment were performed independently. Random effects models estimated pooled prevalence and odds ratios for malignant transformation.

Eleven studies including 307 patients were analyzed. The pooled prevalence of a band-like chronic inflammatory infiltrate was 57%. Malignant transformation occurred in 39.5% of cases with this feature and 53% of cases without it. Meta-analysis revealed no statistically significant association between a band-like chronic inflammatory infiltrate and malignant transformation.

Band-like chronic inflammatory infiltrates are common in proliferative verrucous leukoplakia, but current evidence is insufficient to determine whether this feature is associated with malignant transformation and clinically meaningful effects cannot be excluded.