Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases

Q: What is the purpose of this study?

To assess whether elevated serum C-reactive protein (CRP) levels are associated with malignant transformation risk in patients with oral inflammatory diseases and lesions with malignant potential.

Q: How were patients grouped in the analysis?

Patients were classified based on CRP levels measured within 30 days of oral disease diagnosis, using a threshold of 0.269 mg/dL to define elevated CRP vs control groups.

Q: Which outcomes and statistical methods were used?

The primary outcome was progression to oral squamous cell carcinoma (OSCC). Cox proportional hazard models were used, with 1:1 and 1:2 propensity score matching and pooled meta-analyses to estimate risk.

Q: What do the study findings suggest about CRP?

Elevated CRP, as an indicator of systemic inflammation, was significantly associated with a higher OSCC risk, supporting its potential role in risk assessment and prevention.

Sep 22, 2026

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Chronic inflammation functions as a cancer hallmark, motivating investigation into whether elevated serum C-reactive protein (CRP) predicts malignant transformation in oral inflammatory diseases and potentially malignant lesions. This multicentre retrospective cohort study used Observational Medical Outcomes Partnership Common Data Model data, analyzing CRP within 30 days of diagnosis from 9 medical centres. Meta-regression estimated 0.269 mg/dL as an optimal malignancy threshold, followed by Cox models with propensity score matching and pooled meta-analyses. Results showed elevated CRP increased risk of oral squamous cell carcinoma progression.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Methods

Results

Conclusions

Scientiﬁc Research Report Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases Jeong-Hyun Kang Department of Dental Education, Yonsei University College of Dentistry, Seoul, Korea | A R T I C L E I N F O | A B S T R A C T | | --- | --- | | Article history:
Received 21 August 2025 Received in revised form 23 March 2026
Accepted 26 March 2026
Available online xxx | Introduction and aims: Chronic inﬂammation is recognised as a hallmark of cancers. This multicentre cohort study investigated the inﬂuence of elevated serum C-reactive protein (CRP) levels on the malignant transformation risk of oral inﬂammatory diseases and lesions with malignant potential utilising the Observational Medical Outcomes Partnership Common Data Model.
Methods: This retrospective, observational cohort study included the data from 9 medical centres. CRP levels recorded within 30 days of oral diseases diagnosis were analysed. A meta-regression identiﬁed 0.269 mg/dL as the optimal threshold for predicting malignancy. Patients were classiﬁed into elevated CRP (CRP ≥ 0.269 mg/dL) and control (CRP < 0.269 mg/dL) groups. Cox proportional hazard models were applied to estimate risk of developing oral squamous cell carcinoma (OSCC), followed by 1:1 and 1:2 propensity score matching and pooled meta-analyses.
Results: In total, 10029 individuals with oral diseases and available CRP data were included, comprising 4142 and 5887 in the elevated CRP and control groups, respectively. Overall, 204 individuals (2.03%) progressed to OSCC, with higher incidence in the elevated CRP group (2.32%) compared with controls (1.83%) . Elevated CRP was signiﬁcantly associated with increased OSCC risk in both 1:1 (HR = 1.79 [95% CI 1.08-2.95]), and 1:2 propensity score matching models (HR = 1.55 [95% CI 1.01-2.38]) .
Conclusions: Elevated CRP levels, indicative of systemic inﬂammation, were linked to an increased risk of malignant progression in patients with inﬂammatory oral conditions and lesions with malignant potential. Understanding the role ofinﬂammation may help assess OSCC risk and improve prevention.
􀀁 2026 The Authors. Published by Elsevier Inc. on behalf ofFDI World Dental Federation. This is an open access article under the CC BY-NC-ND license
([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) | | Keywords:
Oral potentially malignant disorder Malignant transformation
Oral squamous cell carcinoma
C-reactive protein
Common data model | | Introduction Oral cancer is the 18th most prevalent malignancy globally and is characterised by a relatively poor 5-year survival rate.1,2 This poor prognosis is primarily due to delayed diagnosis, which often results in advanced-stage presentation and limited therapeutic options. The majority of oral cancers are oral squamous cell carcinoma (OSCC), which frequently arises from precancerous lesions, known as oral potentially malignant disorders (OPMDs), including a range oforal mucosal abnormalities such as oral leukoplakia, erythroplakia, erythroleukoplakia, oral lichen planus (OLP), oral lichenoid E-mail address: [irene85@yuhs.ac](irene85@yuhs.ac) Jeong-Hyun Kang: [http://orcid.org/0000-0001-7124-8693](http://orcid.org/0000-0001-7124-8693) [https://doi.org/10.1016/j.identj.2026.109589](https://doi.org/10.1016/j.identj.2026.109589) lesions, and oral submucous ﬁbrosis (OSF), which each exhibit different degrees of malignant potential.3-5 Reported transformation rates vary by lesion type, with oral leukoplakia, OLP, and1 OSF carrying risks of approximately 9.8%, 1.14% to 1 .40%, and 1 .9 to 9 .0%, respectively.6-9 Timely detection of early stage OSCC and identiﬁcation of risk factors for malignant transformation of OPMDs are essential to prevent cancer development and to enable less invasive treatments. Even after malignant transformation, minimal resection may help preserve ora

FAQs

What is the purpose of this study?

To assess whether elevated serum C-reactive protein (CRP) levels are associated with malignant transformation risk in patients with oral inflammatory diseases and lesions with malignant potential.

How were patients grouped in the analysis?

Patients were classified based on CRP levels measured within 30 days of oral disease diagnosis, using a threshold of 0.269 mg/dL to define elevated CRP vs control groups.

Which outcomes and statistical methods were used?

The primary outcome was progression to oral squamous cell carcinoma (OSCC). Cox proportional hazard models were used, with 1:1 and 1:2 propensity score matching and pooled meta-analyses to estimate risk.

What do the study findings suggest about CRP?

Elevated CRP, as an indicator of systemic inflammation, was significantly associated with a higher OSCC risk, supporting its potential role in risk assessment and prevention.

Sep 22, 2026

Uploaded by นรินทร์