Leukoplakia: molecular understanding of pre-malignant lesions and implications for clinical management

Oral leukoplakia is a white patch or plaque of the oral mucosa that cannot be characterized clinically or pathologically as any other diagnosable disease. Although oral leukoplakia is a well-known oral premalignant lesion with a high risk for development of oral cancer, little is known about its genetic basis. The development of oral cancer is a multistep process and it is believed that multiple genetic alterations are involved. Understanding this underlying genetic basis of oral cancer development will help us design better diagnosis and treatment plans in the cancer clinic. This review discusses recent progress in the identification of genetic and cytogenetic alterations in oral pre-malignant lesions and their potential clinical applications.