更新关于口腔白斑 (OL) 恶性转化的当前证据，包括世界范围内发表的有关该主题的所有研究，并根据资格进行最严格的选择。ME​​DLINE、Embase、Web of Science 和 Scopus 搜索了 6 月之前发表的研究 - 2024 年，没有下限日期。使用乔安娜布里格斯研究所工具进行比例荟萃分析，分析偏倚风险。我们进行了荟萃分析，探讨了亚组之间的异质性，并确定了具有潜在预后价值的危险因素。纳入了 55 项研究（41,231 项 OL）。 OL 的合并恶变比例为 6.64%（95% CI = 5.21-8.21）。恶性转化随时间段变化不显着（p = 0.75），1978 年之前为 5.35%，1979 年至 2007 年为 7.06%，最近时期为 6.97%。对恶变影响显着的危险因素为非均质性白斑（RR = 4.23，95% CI = 3.31-5.39，p < 0.001）、较大尺寸（RR = 2.08、1.45-2.96，p < 0.001)、舌侧缘白斑(恶变 = 12.71%; RR = 2.09, 95% CI = 1.48-2.95, p < 0.001)、吸烟(RR = 1.64, 95% CI = 1.25- 2.15，第< 0.001），并且存在上皮发育不良（RR = 2.75，95％CI = 2.26-3.35，p < 0.001）。OL呈现出相当大的恶变概率，尤其是在吸烟者的大的非均质病变中增加，位于舌头外侧缘，上皮发育不良。© 2024 作者。约翰·威利出版的《口腔疾病》

To update the current evidence on the malignant transformation of oral leukoplakia (OL), including all studies published worldwide on the subject, selected with the maximum rigor regarding eligibility.MEDLINE, Embase, Web of Science and Scopus were searched for studies published before June-2024, with no lower date limit. The risk of bias was analyzed using the Joanna Briggs Institute tool for meta-analyses of proportions. We carried out meta-analyses, explored heterogeneity across subgroups and identified risk factors with potential prognostic value.Fifty-five studies (41,231 with OL) were included. The pooled malignant transformation proportion for OL was 6.64% (95% CI = 5.21-8.21). The malignant transformation did not significantly vary by time periods (p = 0.75), 5.35% prior to 1978, 7.06% from 1979 to 2007 and 6.97% during more recent times. The risk factors that significantly had a higher impact on malignant transformation were the non-homogeneous leukoplakias (RR = 4.23, 95% CI = 3.31-5.39, p < 0.001), the larger size (RR = 2.08, 1.45-2.96, p < 0.001), leukoplakia located on the lateral border of tongue (malignant transformation = 12.71%; RR = 2.09, 95% CI = 1.48-2.95, p < 0.001), smoking (RR = 1.64, 95% CI = 1.25-2.15, p < 0.001), and the presence of epithelial dysplasia (RR = 2.75, 95% CI = 2.26-3.35, p < 0.001).OL presents a considerable malignant transformation probability that is especially increased in large non-homogeneous lesions in smokers, located on the lateral border of the tongue, with epithelial dysplasia.© 2024 The Author(s). Oral Diseases published by John Wiley & Sons Ltd.