Transcriptomic Analysis Reveals Molecular Signatures Distinguishing Vocal Fold Leukoplakia from Benign Lesions: Synergistic Dysregulation of Chronic Inflammation, Immune Dysfunction, and Epithelial Barrier Disruption

Objective: Vocal cord leukoplakia (VCL) represents a precancerous laryngeal lesion with a risk of malignant transformation. By employing transcriptomic analysis, this research sought to ascertain the key signatures and regulatory networks capable of distinguishing VCL from benign lesions. Methods: Surgically resected tissues from 8 individuals with VCL and 11 individuals with vocal cord polyps (VCP) were included for RNA sequencing and bioinformatics analysis. Core genes were identified through differential expression analysis, and functional enrichment analyses were utilized to characterize the associated biological processes. Results: The transcriptomic profile of VCL was characterized by abnormalities in three primary aspects: activation of inflammation-related pathways (e.g., NF-κB), downregulation of immune function-related genes (e.g., CD8A, CD19), and downregulation of epithelial barrier-related molecules (e.g., CLDN4). Conclusion: The transcriptomic signatures of VCL are linked to the coordinated dysregulation of pathways related to inflammation, immunity, and the epithelial barrier.