Abstract:
Oral epithelial dysplasia (OED) is a premalignant condition that carries an appreciable risk of malignant progression. The current grading system for severity, as defined by the World Health Organization, is a valuable clinical tool, but further work is required to improve the accuracy of predicting OED malignant progression. This systematic review aimed to assess progress in prognostic biomarker discovery in OED over the past 16 years. The primary objective was to update the latest evidence on prognostic biomarkers that may predict malignant progression of OED, with strict inclusion criteria of studies with a longitudinal design and long-term follow-up data to enhance the robustness and translational clinical potential of the findings. Of 2829 studies identified through the searching of five databases, 20 met our inclusion criteria. These studies investigated a total of 32 biomarkers, 20 of which demonstrated significant potential to predict malignant progression of OED. Meta-analysis demonstrated the significant prognostic value of four biomarkers: podoplanin, EGFR expression, p16 methylation, and DNA aneuploidy. Our review has identified 20 reported biomarkers with prognostic potential to predict malignant progression in OED, but their translation into clinical practice remains elusive. Further research is required, and this should focus on validating the promising biomarkers identified in large cohort studies, with adherence to standardised reporting guidelines.
摘要:
口腔上皮发育不良(OED)是一种癌前疾病,具有明显的恶性进展风险。当前的严重程度分级系统,根据世界卫生组织的定义,是一种有价值的临床工具,但需要进一步的研究来提高预测OED恶性进展的准确性.本系统综述旨在评估过去16年OED预后生物标志物发现的进展。主要目的是更新有关预后生物标志物的最新证据,这些生物标志物可以预测OED的恶性进展。采用严格的纳入标准,采用纵向设计和长期随访数据,以增强研究结果的稳健性和转化临床潜力。在通过搜索五个数据库确定的2829项研究中,20符合我们的纳入标准。这些研究共调查了32种生物标志物,其中20例显示出预测OED恶性进展的显著潜力。荟萃分析表明四种生物标志物的显着预后价值:Podoplanin,EGFR表达,p16甲基化,和DNA非整倍性。我们的综述已经确定了20个报道的生物标志物,这些生物标志物具有预测OED恶性进展的潜力。但将其转化为临床实践仍然难以捉摸。需要进一步的研究,这应该集中在验证大型队列研究中确定的有前途的生物标志物,遵守标准化报告准则。