title: Malignant transformation of oral verrucous leukoplakia: a clinicopathologic study of 53 cases.
abstract: BACKGROUND
  Oral verrucous leukoplakia (VL) is one of the non-homogenous oral leukoplakias. The objective of this study was to investigate the clinicopathologic features of VL and identify the clinicopathologic risk factors that might be associated with VL malignant transformation from China.
  
  
  METHODS
  Among 1541 patients with oral leukoplakia, a total of 53 patients with clinical and histopathologic diagnosis of VL between 1996 and 2009 were reviewed retrospectively in our hospital.
  
  
  RESULTS
  Of the 53 patients, 11 (20.8%) with VL were observed to develop cancer in the study period. The average age at diagnosis was 59.8 years with a male/female ratio of 1.7:1. Tongue was the predominant site (41.5%). Multivariate regression analysis revealed that the elderly patients (>65 years old) were associated with 8.36-fold [95% confidence interval (95% CI), 1.45-48.09; P = 0.017] increased risk of malignant transformation compared with the non-elderly patients. The lesion located on gingiva was associated with 20.81-fold (95% CI, 1.94-222.80; P = 0.012) increased risk of malignant transformation compared with tongue. However, the gender, smoking, alcohol intake, and epithelial dysplasia were not risk factors.
  
  
  CONCLUSIONS
  Clinicopathologic features of VL in China were elucidated. The utilization of age and lesion site at diagnosis as significant factors for evaluating malignant transformation risk in patients with VL was suggested. Further studies are required to investigate the roles of the potential risk factors in the VL malignant transformation.
authors.affiliation: Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Xue-Min
authors.initials: XM
authors.lastname: Shen
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.forename: Zeng-Tong
authors.initials: ZT
authors.lastname: Zhou
authors.forename: Li-Zhen
authors.initials: LZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D018289:Carcinoma, Verrucous / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D005887:Gingival Neoplasms / Q000473:pathology; D006801:Humans; D007972:Leukoplakia, Oral / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D014062:Tongue Neoplasms / Q000473:pathology