Proliferative verrucous leukoplakia and its tumor markers: Systematic review and meta-analysis

Background The aim was to update information on oral proliferative verrucous leukoplakia (PVL), a disease of verrucous-like lesions with high risk of malignancy, and its biomarkers. Methods A systematic search of literature on PVL and its biomarkers showed 22 biomarkers that were investigated in 19 papers. A meta-analysis was possible for human papillomavirus (HPV), aneuploidy, Ki-67, and p53. Results Aneuploidy was found consistently (I-2 = 0%, P = 0.61) in 92% (95% CI 80%-99%) of the PVL cases. P53 positivity prevalence was 27% (95% CI 15%-40%) in two available studies (I-2 = 0%, P = 0.64). With HPV and Ki-67, the most outlying studies needed to be removed and after that the pooled HPV positivity prevalence (I-2 = 24%, P = 0.27) was 5% (95% CI 0%-14%) and for Ki-67 (I-2 = 9%, P = 0.33) 14% (95% CI 6%-26%). Conclusions With the evidence of the current literature, aneuploidy could value as a biomarker of PVL but should be further validated.