Table 5.
Research questions considered in this scoping review, grouped in a matrix format, according to the essential thematic areas, and results related to the aforementioned questions raised in the evidence derived from the research on malignant transformation of PVL.
| Research Questions | PVL Diagnostic Criteria Proposed Including Each Research Question * | Primary-Level Studies Included in This Scoping Review | |||
|---|---|---|---|---|---|
| Studies (n, %) Considering the Research Question among Their PVL Diagnostic Criteria | Patients (n) with Available Data ** | Positive Cases (%) ** | |||
| Q1 | - Is the clinical course of the disease (persistent or recurrent, periodicity of recurrences) determining in the PVL diagnosis? | Hansen et al. (1985) [10] | 6/24 (25%) (all persistent) |
NR | NR |
| Q2 | - To what extent is the age of the lesion decisive for the PVL diagnosis? | Cerero-Lapiedra et al. (2010) [11] Carrard et al. (2013) [12] |
5/24 (20.83%) | NR | NR |
| Q3 | - What should be the clinical appearance of the lesions to make a diagnosis of PVL? | All | NA | NA | NA |
|
Clinical descriptions of the PVL lesions made by the authors: White plaque |
All | 6/24 (25%) | 141 | 141 (100%) | |
| Multifocality | All | 6/24 (25%) | 81 | 74 (91.36%) | |
| Progressive/expansive nature | All | 3/24 (12.5%) | 51 | 36 (70.59%) | |
| Verrucous-like | Carrard et al. (2013) [12] | 5/24 (20.83%) | 61 | 22 (36.07%) | |
| Erythematous areas | Hansen et al. (1985) [10] Villa et al. (2018) [13] |
6/24 (25%) | 141 | 16 (11.35%) | |
| Ulcerated areas | Villa et al. (2018) [13] | 2/24 (8.33%) | 11 | 1 (9.09%) | |
| Fissured appearance | Villa et al. (2018) [13] | 0/24 (0%) | 0 | 0 (0%) | |
| Smooth appearance | Cerero-Lapiedra et al. (2010) [11] | 0/24 (0%) | 0 | 0 (0%) | |
| Q4 | - Is it necessary the affectation of gingiva and/or palate to make the diagnosis of PVL? | Cerero-Lapiedra et al. (2010) [11] Carrard et al. (2013) [12] | 1/24 (4.17%) | NA | NA |
|
Intraoral sites affected by PVL lesions: Buccal Mucosa |
None | 10/24 (41.67%) | 145 | 63 (43.45%) | |
| Gingiva | Cerero-Lapiedra et al. (2010) [11] Carrard et al. (2013) [12] | 10/24 (41.67%) | 145 | 58 (40%) | |
| Tongue | None | 10/24 (41.67%) | 145 | 47 (32.41%) | |
| Palate | Cerero-Lapiedra et al. (2010) [11] Carrard et al. (2013) [12] | 10/24 (41.67%) | 145 | 29 (13.79%) | |
| Q5 | - Is it necessary to demonstrate malignant transformation to make the diagnosis of PVL? | All | 0/24 (0%) *** | NA | NA |
| - Malignant transformation reported | All | 24/24 (100%) | 631 | 266 (43.74%) | |
| Q6 | - Is resistance to treatment necessary to make the diagnosis of PVL? | Hansen et al. (1985) [10] Carrard et al. (2013) [12] |
2/24 (8.33%) | 54 | 24 (44.44%) |
| Q7 | - To what extent is sex required to make the diagnosis of PVL? | Cerero-Lapiedra et al. (2010) [11] | 2/24 (8.33%) | NA | NA |
|
Description per sex: Females |
Cerero-Lapiedra et al. (2010) [11] | 23/24 (95.83%) | 556 | 363 (62.23%) | |
| Q8 | - To what extent is age required to make the diagnosis of PVL? | None | 0/24 (0%) | NA | NA |
| Description of age reported | None | 23/24 (95.83%) | 556 **** | Mean of means = 63.06y | |
| Q9 | - To what extent is tobacco use or its absence necessary to make the diagnosis of PVL? | Cerero-Lapiedra et al. (2010) [11] | 2/24 (8.33%) | NA | NA |
| Description for smoking habit:Non-smokers | Cerero-Lapiedra et al. (2010) [11] | 20/24 (83.33%) | 463 | 285 (61.56%) | |
| Q10 | - Is the histological study necessary for the diagnosis of PVL? | All | 16/24 (66.67%) | NA | NA |
|
Description of alterations in histology of PVL: Hyperkeratosis |
Hansen et al. (1985) [10] Cerero-Lapiedra et al. (2010) [11] Villa et al. (2018) [13] |
10/24 (41.67%) | 143 | 101 (70.63%) | |
| Atrophy | Villa et al. (2018) [13] | 1/24 (4.17%) | 15 | 1 (6.67%) | |
| Acanthosis | Villa et al. (2018) [13] | 2/24 (8.33%) | 18 | 6 (33.33%) | |
| Lymphocytic infiltrate in the chorion | Villa et al. (2018) [13] | 2/24 (8.33%) | 10 | 3 (30%) | |
| Verrucous hyperplasia | Hansen et al. (1985) [10] Cerero-Lapiedra et al. (2010) [11] Villa et al. (2018) [13] |
7/24 (29.17%) | 87 | 38 (43.68%) | |
| Epithelial dysplasia | Hansen et al. (1985) [10] Villa et al. (2018) [13] |
10/24 (41.67%) | 274 | 159 (58.03%) | |
| Verrucous carcinoma | Hansen et al. (1985) [10] Cerero-Lapiedra et al. (2010) [11] |
16/24 (66.67%) | 384 | 81 (21.09%) | |
| Papillary carcinoma | Hansen et al. (1985) [10] | 3/24 (12.5%) | 98 | 21 (21.43%) | |
| Squamous cell carcinoma | Hansen et al. (1985) [10] Cerero-Lapiedra et al. (2010) [11] Villa et al. (2018) [13] |
18/24 (75%) | 472 | 139 (29.45%) | |
NA, not applicable; NR, not reported., * This column reflects which diagnostic criteria for PVL proposed in the literature (Hansen et al. 1985 [10], Cerero-Lapiedra et al. 2010 [11], Carrard et al. 2013 [12] and Villa et al. 2018 [13]; described in Table 1) include the research question posed. ** Although a specific study may consider the research question posed as one of its diagnostic criteria, in some cases it does not offer individual data on the patients in its series. *** Although the 24 studies included in the scoping review offer the number of malignant cases in their series, none consider malignant transformation as a diagnostic criterion for the disease. **** Most of the studies that report data on age offer the mean of the series, with very few individual patient data on age.