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Potentially malignant disorders of the oral cavity: Current practice and future directions in the clinic and laboratory.
[oral submucous fibrosis]
Despite
commendable
progress
in
the
prevention
,
detection
,
and
treatment
of
a
wide
variety
of
solid
tumor
types
,
oral
squamous
cell
carcinoma
(
OSCC
)
remains
a
significant
health
burden
across
the
globe
.
OSCC
carcinogenesis
involves
accumulation
of
genetic
alterations
that
coincide
with
the
multistep
malignant
transformation
of
normal
oral
epithelium
.
OSCC
is
often
first
diagnosed
at
late
stages
of
the
disease
(
advanced
regional
disease
and
/
or
metastasis
)
.
Delayed
diagnosis
precludes
successful
treatment
and
favorable
outcomes
.
In
clinical
practice
,
opportunities
exist
to
identify
patients
with
oral
potentially
malignant
disorders
(
OPMDs
)
,
which
precede
the
development
of
cancer
.
This
review
addresses
the
current
status
of
laboratory
and
clinical
research
on
OPMDs
,
with
emphasis
on
leukoplakia
and
erythroplakia
.
OSF
is
also
presented
,
though
there
is
a
paucity
of
published
studies
on
this
disorder
.
We
focus
on
findings
that
could
translate
into
earlier
diagnosis
and
more
efficacious
treatment
of
those
lesions
with
significant
malignant
potential
.
We
explore
how
markers
of
OPMD
malignant
transformation
might
be
implemented
into
current
diagnostic
practice
to
help
clinicians
objectively
stratify
patients
into
treatment
/
follow-up
groups
according
to
relative
risk
.
We
provide
an
overview
of
recently
concluded
and
ongoing
OPMD
chemoprevention
trials
.
We
describe
laboratory
OPMD
models
that
can
be
used
to
not
only
to
reveal
the
genetic
and
molecular
intricacies
of
oral
cancer
but
also
to
develop
novel
screening
methods
and
therapeutic
approaches
.
Finally
,
we
call
for
targeted
screening
programs
of
at
-risk
populations
in
order
to
facilitate
diagnosis
and
treatment
of
OPMD
and
early
OSCC
.
