Oral Leukoplakia Microbiome Predicts the Degree of Dysplasia and is Shaped by Smoking and Tooth Loss

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Abstract
Objective: This study aimed to determine if the oral potentially malignant disorder, oral leukoplakia (OLK), exhibited microbiome changes that predict the degree of dysplasia and the risk of malignant progression. Results: We examined the microbiome in 216 swabs of OLK from 177 patients. Compared to healthy controls ( n = 120 swabs from 61 patients), who were less likely to smoke and had better oral health, OLK patients exhibited an increased abundance of Rothia mucilaginosa , Streptococcus parasanguinis and S. salivarius , resembling acetaldehyde generating communities described previously. Compared to the patients' healthy contralateral normal (CLN) mucosa ( n = 202), which acts as a matched control for oral health parameters, OLK exhibited increased S. infantis , Leptotrichia spp., Bergeyella spp., Porphyromonas spp. and F. nucleatum . Machine learning with clinical and microbiome data could discriminate high‐risk dysplasia (moderate to severe) from low‐risk dysplasia (none or mild) (sensitivity 87.4%; specificity 76.5%). Follow‐up swabs were recovered from 58 patients, eight of whom progressed to a higher grade of dysplasia or OSCC and these eight patients exhibited a higher abundance of Fusobacterium species at their initial presentation. Conclusions: Our study suggests that the OLK microbiome has potential to be an aid to the prediction of dysplasia grade and the risk of malignant transformation.
Funding Information
  • Health Research Board

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