Biomarkers for differentiation between Oral Lichen Planus and Early Oral Cancer Lesions

• DOI: https://doi.org/10.22533/at.ed.515752606035

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• Abstract:

  Introduction: Oral lichen planus (OLP) is a potentially malignant oral disorder whose distinction from early neoplastic transformation lesions is hampered by the overlap between chronic inflammation, mild dysplasia, and early epithelial changes. Objective: To synthesize evidence on tissue, salivary, and serum biomarkers capable of assisting in the differential diagnosis between OLP and potentially malignant lesions, based on a review conducted in October 2025. Results: Among the most studied biomarkers are p53, Ki-67, and PCNA, related to cell proliferation; Bcl-2, Bax, and caspase-3, associated with apoptosis regulation; and proinflammatory cytokines, immunological markers, and angiogenic mediators such as COX-2 and VEGF. Emerging approaches include salivary microRNAs, metabolomics, liquid biopsy, and evaluation of mutations in genes linked to oral carcinoma. Although these strategies broaden the understanding of the mechanisms involved in the progression of OPC, important limitations remain, such as methodological heterogeneity, small sample sizes, and lack of standardization between studies, which restricts clinical application. Conclusion: No single biomarker is accurate enough to replace clinical-histopathological evaluation. The integration of clinical, morphological, and molecular findings remains the most effective approach for monitoring and risk stratification in patients with OPL.