Malignant Transformation of Oral Lichen Planus to Oral Squamous Cell Carcinoma: Recent Evidence and Molecular Insights

Oral lichen planus (OLP) is a chronic immune-mediated disorder of the oral mucosa with a low but uncertain risk of malignant transformation (MT) to oral squamous cell carcinoma (OSCC). The molecular mechanisms behind this progression remain unclear. This review synthesizes current epidemiological data on MT rates, evaluates recent molecular and biomarker studies, and highlights clinical risk factors to improve understanding and guide future research. A systematic literature search was conducted in PubMed, Scopus, and Web of Science up to November ۲۰۲۵. Eligible studies included meta-analyses, cohort, case-control, and molecular studies evaluating MT rates and biomarkers such as p۵۳, p۱۶, Ki-۶۷, aneuploidy, and dysregulated microRNAs. Disease-specific and molecular search terms were combined. Non-English articles, reviews, and case reports were excluded. Data extraction included study design, patient characteristics, MT rates, molecular alterations, and clinical risk factors. Study quality and risk of bias were assessed using validated tools. Pooled MT rates ranged from ۰.۴% to ۱.۵%, with higher risk in erosive and atrophic OLP subtypes and in patients with tobacco use and hepatitis C infection. Molecular studies demonstrated shared alterations in tumor suppressor genes, proliferation markers, and microRNAs (e.g., miR-۲۷a, miR-۱۳۷, miR-۱۲۹۰), supporting a biological continuum between OLP and OSCC. Salivary microRNAs and aneuploidy emerged as promising biomarkers for early risk stratification. OLP carries a low but clinically significant risk of malignant transformation to OSCC driven by complex molecular changes. Integrating clinical and molecular markers may improve early detection, surveillance, and patient management.

کلیدواژه ها:

Oral Lichen Planus ، Oral Squamous Cell Carcinoma ، Malignant Transformation ، Biomarkers ، MicroRNA