INFLUENCE OF THE HIPPO PATHWAY IN PROLIFERATIVE VERRUCOUS LEUKOPLAKIAS
Keywords: Oral Leukoplakia; Hippo Signaling Pathway; YAP Signaling Proteins; TEA Domain Transcription Factors.
Proliferative verrucous leukoplakia (PVL) is a rare oral potentially malignant disorder of uncertain etiology, characterized by slowly progressing keratotic lesions. Diagnosis is challenging and relies on clinical and histopathological criteria. The variability in clinical course, high recurrence rate, resistance to therapeutic interventions, and the elevated malignant transformation rate into squamous cell carcinoma highlight the need to identify prognostic biomarkers to improve the understanding and management of this condition. In this context, the Hippo pathway (HP) plays a pivotal role in the initiation and progression of various cancer types by promoting cell growth and apoptosis evasion, thereby influencing carcinogenesis. Therefore, this study aims to evaluate the immunoexpression of YAP, LATS, and TEAD proteins, which are key components of the HP, in PVL samples, correlating them with histopathological severity grades according to the classifications proposed by the World Health Organization (El-Naggar et al., 2022) and Thompson et al. (2021).This is a retrospective, observational, cross-sectional study characterized by the observation, analysis, and documentation of the clinical features of lesions with a confirmed diagnosis of PVL, followed by histopathological examination and, subsequently, quantification of the aforementioned proteins through immunohistochemical analysis. The results will be expressed quantitatively, semi-quantitatively, and qualitatively according to the marker used, with a significance level set at 5% (p ≤ 0.05). The findings from this study are expected to contribute to establishing correlations between protein expression patterns and histopathological severity grades, assisting in predicting malignant transformation and clarifying the etiopathogenesis of PVL, thereby providing theoretical insights to enhance therapeutic strategies.