Oral leukoplakia is considered one of the most significant precancerous lesions of the oral cavity, with varying degrees of epithelial dysplasia and risk of progression to oral squamous cell carcinoma. Conventional clinical examination alone is often insufficient for accurately determining the severity and biological behavior of leukoplakic lesions. Morphological assessment of epithelial architecture and cellular atypia remains the gold standard for diagnosis; however, modern molecular biomarkers provide additional information regarding proliferative activity, apoptosis, genetic instability, and carcinogenic potential. Early identification of high-risk lesions through integrated molecular and histological evaluation may improve patient prognosis and reduce the incidence of oral cancer. Therefore, studying the diagnostic value of these markers is highly relevant in contemporary oral medicine and pathology.
The aim of the study was to evaluate the role of molecular and morphological markers in the diagnosis and prediction of oral mucosal changes in patients with leukoplakia and to determine their prognostic significance in assessing the risk of malignant transformation.
The study included 70 patients diagnosed with oral leukoplakia and 25 healthy individuals as a control group. Clinical examination and biopsy of oral mucosal lesions were performed in all patients. Histopathological analysis assessed epithelial hyperkeratosis, dysplasia severity, nuclear atypia, and inflammatory infiltration. Immunohistochemical analysis was conducted to evaluate molecular markers including Ki-67, p53, cyclin D1, and E-cadherin expression. Statistical analysis was used to identify correlations between molecular marker expression and the severity of morphological changes. Diagnostic sensitivity and prognostic significance of the markers were also analyzed.
Histopathological examination revealed varying degrees of epithelial dysplasia in patients with leukoplakia, ranging from mild to severe atypia. Increased expression of Ki-67 and p53 was observed in lesions with moderate and severe dysplasia, indicating elevated proliferative activity and genetic instability. Reduced E-cadherin expression was associated with loss of epithelial integrity and increased malignant potential. Cyclin D1 overexpression correlated with progression of dysplastic changes. Combined assessment of morphological and molecular markers demonstrated significantly higher diagnostic accuracy compared to routine histological examination alone. Patients with elevated Ki-67 and p53 expression showed a greater risk of lesion progression and malignant transformation during follow-up observation.
Molecular and morphological markers play an essential role in the diagnosis and prediction of oral mucosal alterations in leukoplakia. The combined use of histopathological evaluation and immunohistochemical biomarkers improves the accuracy of detecting high-risk lesions and allows earlier identification of patients susceptible to malignant transformation. Incorporation of molecular diagnostics into routine clinical practice may contribute to more effective prevention, individualized treatment strategies, and improved prognosis in patients with oral leukoplakia.
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