Hence, EGFR amplification/overexpression, 18 differentially expressed FL transcripts, and enhanced immune rearrangements of IGKV4-1–IGKJ1, IGKV4-1–IGKJ2, IGKV4-1–IGKJ3, and IGKV4-1–IGKJ4 can be used as signature markers for characterizing keratinized OSCC with MD/PD/WD with lymphadenopathy and may play an important role in controlling the premalignant phenotype of keratinized OSCC and progression of the disease. The gene discussed is IGKV4-1; the disease is Wilson disease.