Considering SOD and miRNA analysis as potential prognostic markers in white lesion malignant transformation: A report of two cases.

RATIONALE: Predictive biomarkers can be effective in the identification of the oral leukoplakia with an increased probability of malignant transformation. PATIENTS CONCERNS: A 63-year-old patient presents with persistent burning sensations throughout the oral cavity, accompanied by a white lesion on the tongue. Additionally, a 57-year-old patient with multiple white lesions in the oral cavity. DIAGNOSIS: Histopathological analysis of the excised tissue. INTERVENTIONS: Changes in the expression miRNAs (miR17, miR206, and miR23), the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase, glutathione reductase, and glutathione-S-transferase), and concentration of reduced glutathione were detected, followed by meta-analysis of previous studies. OUTCOMES: In both patients (verrucous leukoplakia, oral squamous cell carcinoma) upregulated expression of miR-23a, miR-17, and downregulated expression of miR206 were detected when compared to healthy individuals. In the plasma of a patient diagnosed with carcinoma, higher activity of antioxidant enzymes connected to glutathione was measured in comparison to healthy individuals. LESSONS: The connection between miRNA expression changes, the increase in glutathione-S-transferase and especially the decrease in superoxide dismutase activities in patients with white lesion potential malignant transformation using the provided statistical analysis was confirmed.