Second, in OSF patients, lower expression of the tumor and adhesive signaling repressor phosphatase and tensin homolog (PTEN) correlated with higher α-SMA expression, dysplasia, and OSCC [48], consistent with studies showing that fibroblast-specific PTEN loss promotes fibrosis and myofibroblast differentiation [49], suggesting PTEN loss contributes to OSF pathology. Here, PTEN is linked to neoplasm.