Research progress on the mechanism and clinical significance of immunoediting in the malignant transformation of oral leukoplakia.

The insidious malignant transformation of oral leukoplakia (OLK) into oral squamous cell carcinoma (OSCC) represents a critical clinical bottleneck in head and neck oncology. Grounded in the cancer immunoediting theory of "elimination-equilibrium-escape," this review systematically reconstructs the spatiotemporal continuum of OLK transitioning toward malignant conversion. We comprehensively dissect the localized immunosuppressive network centered on T cell exhaustion, Natural killer cell inactivation, M2 macrophage polarization, antigen-presenting cell defects, and the dual roles of fibroblasts, elucidating the interactive mechanisms that drive mucosal barrier collapse and immune escape. Accordingly, this paper focuses on the translational pathways of leveraging multimodal deep learning algorithms and big data oncology to integrate heterogeneous omics data, thereby constructing chairside precision decision-making systems. This review ultimately aims to offer a new perspective on the clinical management of oral premalignant lesions, rendering the transition from traditional "reactive surveillance" to algorithm-driven "precision cancer interception" clinically feasible.