{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:35:12Z","timestamp":1791855312199,"version":"4.3.4"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The aim of this study was to evaluate the usefulness of close clinical surveillance intervals combined with oral brush biopsies to enable the early detection of malignant transformations in patients with oral lichen planus (OLP) performed in our oral medicine clinic. Methods: This retrospective study was carried out on 414 patients suffering from OLP, based on pre-established clinical and histopathological criteria, who received long-term follow-up between 1993\u20132022 (ranging from 6 months to 22.2 years). Results: A total of 297 patients were included in this study. Four people developed an oral squamous cell carcinoma (OSCC) during the observation period. Patients with close follow-up intervals were detected at early stages (two cases showed histologically SIN III and one patient was classified as having a pT1N0M0 tumour). One case was dropped in the consultation hour during the COVID19 pandemic and appeared again two years later, staged as a pT3N1M0 tumour based on an OLP. Three of the cases were clinically doubtful, which led to brush biopsies. Afterwards, additional DNA-image cytometry was performed, in which all the specimens of brush biopsies showed aneuploidy as a marker for malignancy, regarding both stem line and single cell aneuploidy. Conclusions: A careful surveillance programme consisting of check-ups every 3\u20134 months, oral brush biopsies, and static DNA image cytometry in cytologically diagnosed doubtful or suspicious cases assures the early detection of malignant transformation in the cancer\u2019s early intraepithelial and microinvasive stages.<\/jats:p>","DOI":"10.3390\/cancers17091489","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T11:48:33Z","timestamp":1745840913000},"page":"1489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Early Detection of Malignant Transformation of Potentially Malignant Disorders: Oral Lichen Planus"],"prefix":"10.3390","volume":"17","author":[{"given":"Camilla","family":"L\u00fcdecke","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial and Facial Plastic Surgery, Section of Clinical and Experimental Oral Medicine, University Hospital Leipzig, Liebigstra\u00dfe 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Neumann","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Cytopathology and Molecular Diagnostics, Merzenicher Stra\u00dfe 37, 52351 D\u00fcren, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten W.","family":"Remmerbach","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial and Facial Plastic Surgery, Section of Clinical and Experimental Oral Medicine, University Hospital Leipzig, Liebigstra\u00dfe 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/odi.13323","article-title":"Worldwide prevalence of oral lichen planus: A systematic review and meta-analysis","volume":"27","author":"Warnakulasuriya","year":"2021","journal-title":"Oral Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1601-0825.2009.01516.x","article-title":"Course of oral lichen planus: A retrospective study of 808 northern Italian patients","volume":"15","author":"Carbone","year":"2009","journal-title":"Oral Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.oraloncology.2005.11.022","article-title":"Dysplasia\/neoplasia surveillance in oral lichen planus patients: A description of clinical criteria adopted at a single centre and their impact on prognosis","volume":"42","author":"Mignogna","year":"2006","journal-title":"Oral Oncol."},{"key":"ref_4","first-page":"310","article-title":"Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects","volume":"14","year":"2009","journal-title":"Med. Oral Patol. Oral Y Cir. Bucal"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.clindermatol.2009.03.004","article-title":"Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: Facts and controversies","volume":"28","author":"Farhi","year":"2010","journal-title":"Clin. Dermatol."},{"key":"ref_6","first-page":"CD008092","article-title":"Interventions for erosive lichen planus affecting mucosal sites","volume":"2015","author":"Cheng","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Thongprasom, K., Carrozzo, M., Furness, S., and Lodi, G. (2011). Interventions for treating oral lichen planus. Cochrane Database Syst. Rev., CD001168.","DOI":"10.1002\/14651858.CD001168.pub2"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.coms.2012.11.007","article-title":"Oral lichen planus","volume":"25","author":"Au","year":"2013","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1111\/odi.13704","article-title":"Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer","volume":"27","author":"Warnakulasuriya","year":"2021","journal-title":"Oral Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/idoj.idoj_652_22","article-title":"Oral Lichen Planus: An Updated Review of Etiopathogenesis, Clinical Presentation, and Management","volume":"15","author":"Manchanda","year":"2024","journal-title":"Indian Dermatol. Online J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"5937540","DOI":"10.1155\/2022\/5937540","article-title":"A Survey of Brazilian Patients with Oral Lichen Planus Showing No Evidence of Malignancy","volume":"2022","author":"Migliari","year":"2022","journal-title":"Dermatol. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"834","DOI":"10.3109\/00016357.2012.734407","article-title":"Clinicopathological features and malignant transformation of oral lichen planus: A 12-years retrospective study","volume":"71","author":"Bardellini","year":"2013","journal-title":"Acta Odontol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4103\/jispcd.JISPCD_103_17","article-title":"Clinicopathological Profile and Malignant Transformation in Oral Lichen Planus: A Retrospective Study","volume":"7","author":"Bandyopadhyay","year":"2017","journal-title":"J. Int. Soc. Prev. Community Dent."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Moles, M.\u00c1., and Ramos-Garc\u00eda, P. (2024). An Evidence-Based Update on the Potential for Malignancy of Oral Lichen Planus and Related Conditions: A Systematic Review and Meta-Analysis. Cancers, 16.","DOI":"10.3390\/cancers16030608"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1111\/odi.13812","article-title":"Oral cancer development in lichen planus and related conditions-3.0 evidence level: A systematic review of systematic reviews","volume":"27","author":"Warnakulasuriya","year":"2021","journal-title":"Oral Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1111\/odi.13741","article-title":"An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review","volume":"27","author":"Warnakulasuriya","year":"2021","journal-title":"Oral Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.oraloncology.2019.07.012","article-title":"Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis","volume":"96","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"692","DOI":"10.5005\/jp-journals-10024-1914","article-title":"Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review","volume":"17","author":"Sheykhbahaei","year":"2016","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"364","DOI":"10.4103\/ams.ams_253_18","article-title":"Prognostic Indicators of Oral Squamous Cell Carcinoma","volume":"9","author":"Suresh","year":"2019","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1177\/154411130201300503","article-title":"Oral Lichen Planus and Malignant Transformation: Is a Recall of Patients Justified?","volume":"13","author":"Mattsson","year":"2002","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1016\/j.jcpo.2013.04.002","article-title":"Early detection and diagnosis of oral cancer: Strategies for improvement","volume":"1","author":"Ford","year":"2013","journal-title":"J. Cancer Policy"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.4103\/jpbs.jpbs_635_21","article-title":"Adjunctive Techniques and Diagnostic Aids in the Early Detection of Oral Premalignant Disorders and Cancer: An Update for the General Dental Practitioners","volume":"14","author":"Pandarathodiyil","year":"2022","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.14219\/jada.2013.10","article-title":"The malignant transformation of oral lichen planus and oral lichenoid lesions: A systematic review","volume":"145","author":"Fitzpatrick","year":"2014","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/odi.12803","article-title":"Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid","volume":"24","author":"Bravo","year":"2018","journal-title":"Oral Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s00403-016-1667-2","article-title":"Oral lichen planus: A literature review and update","volume":"308","author":"Alrashdan","year":"2016","journal-title":"Arch. Dermatol. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1034\/j.1600-0714.2003.00125.x","article-title":"Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications","volume":"32","year":"2003","journal-title":"J. Oral Pathol. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.oooo.2016.05.004","article-title":"Diagnosis of oral lichen planus: A position paper of the American Academy of Oral and Maxillofacial Pathology","volume":"122","author":"Cheng","year":"2016","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bechstedt, N., Pomjanski, N., Schramm, M., and Remmerbach, T.W. (2022). Evaluation of Static DNA Ploidy Analysis Using Conventional Brush Biopsy-Based Cytology Samples as an Adjuvant Diagnostic Tool for the Detection of a Malignant Transformation in Potentially Oral Malignant Diseases: A Prospective Study. Cancers, 14.","DOI":"10.3390\/cancers14235828"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.oooo.2016.02.008","article-title":"Image-based DNA ploidy analysis aids prediction of malignant transformation in oral lichen planus","volume":"121","author":"Sperandio","year":"2016","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.4317\/medoral.18940","article-title":"Oral lichen planus\u2014Retrospective study of 563 Croatian patients","volume":"19","author":"Budimir","year":"2014","journal-title":"Med. Oral Patol. Oral Cir. Buccal"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3146","DOI":"10.1002\/lary.31307","article-title":"The Clinical Behavior and Recurrence Patterns of Oral Cavity Cancer in Oral Lichen Planus Patients","volume":"134","author":"Yosefof","year":"2024","journal-title":"Laryngoscope"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/jop.12996","article-title":"Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria","volume":"50","author":"Idrees","year":"2020","journal-title":"J. Oral Pathol. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.tripleo.2011.04.009","article-title":"Oral lichen planus and malignant transformation: A longitudinal cohort study","volume":"112","author":"Bombeccari","year":"2011","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/j.joms.2020.01.032","article-title":"Oral Lichen Planus-Associated Oral Cavity Squamous Cell Carcinoma Is Associated with Improved Survival and Increased Risk of Recurrence","volume":"78","author":"Best","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104688","DOI":"10.1016\/j.oraloncology.2020.104688","article-title":"Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: A systematic review and a comprehensive meta-analysis","volume":"106","author":"Warnakulasuriya","year":"2020","journal-title":"Oral Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1034\/j.1600-0528.2002.00059.x","article-title":"Cost-effectiveness of screening for the possible development of cancer in patients with oral lichen planus","volume":"30","author":"Bezemer","year":"2002","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"6653","DOI":"10.1007\/s00784-022-04620-9","article-title":"Retrospective evaluation of the oral brush biopsy in daily dental routine\u2014An effective way of early cancer detection","volume":"26","author":"Neumann","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_39","first-page":"CD010276","article-title":"Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions","volume":"7","author":"Walsh","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_40","unstructured":"King, N. (2025, April 09). Eaom Handbook Oral Lichen Planus. Available online: https:\/\/eaom.eu\/education\/eaom-handbook\/oral-lichen-planus\/?v=5f02f0889301."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.oooo.2016.05.015","article-title":"AAOM Clinical Practice Statement: Subject: Oral lichen planus and oral cancer","volume":"122","author":"Greenberg","year":"2016","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_42","unstructured":"Hertrampf, K., and Kunkel, M. (2025, April 09). 007-092l_S2k_Orale_Vorlaeuferlaesion_Plattenepithelkarzinom_2020-04_1. Available online: https:\/\/register.awmf.org\/de\/leitlinien\/detail\/007-092."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/9\/1489\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:23:40Z","timestamp":1760030620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/9\/1489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["cancers17091489"],"URL":"https:\/\/doi.org\/10.3390\/cancers17091489","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}