Oral proliferative verrucous leukoplakia (PVL); open trial of surgery compared with combined therapy using surgery and methisoprinol in papillomavirus-related PVL
Oral proliferative verrucous leukoplakia (PVL); open trial of surgery compared with combined therapy using surgery and methisoprinol in papillomavirus-related PVL
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DOI：
10.1054/ijom.2001.0066
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发表时间：
2001-08-01
影响因子：
2.4
通讯作者：
Scully, C
中科院分区：
文献类型：
--
作者：
Femiano, F;Gombos, F;Scully, C
摘要口腔黏膜疣状白斑是一种独特的口腔白色病变，人类乳头瘤病毒（HPV）可能在其中扮演重要角色。PVL比其他形式的白斑更具侵袭性，手术切除后复发率高，并不断进展为疣状增生和疣状或鳞状细胞癌。PVL的治疗通常是通过手术，但往往有早期复发，本研究是一个开放的试验，在25例口腔HPV阳性PVL患者的手术治疗，并比较了25例口腔PVL患者的母亲组使用手术和甲基异丙肾上腺素的联合治疗。术后6个月有显著差异，单独手术治疗的患者中有18例复发，而同时接受甲异丙烯醇（异丙肌苷或肌苷pranobex）治疗的患者中只有2例复发，甲异丙烯醇是一种具有免疫调节特性和抗HPV的抗病毒活性的合成药物。术后18个月，单纯手术治疗的患者没有进一步复发，但甲基异丙烯醇治疗的患者另有2例复发。总的来说，在18个月的随访中，单纯手术治疗组有18例复发，而同时接受甲异丙诺治疗组有4例复发。
Proliferative verrucous leukoplakia (PVL) is a unique oral white lesion in which human papillomavirus (HPV) may play a role. PVL behaves far more aggressively than other forms of leukoplakia with a high rate of recurrence after surgical excision, and relentless progression to verrucous hyperplasia and to verrucous or squamous cell carcinomas. The treatment of PVL is usually by surgery, but there is often early recurrence.This study was an open trial of surgery in 25 patients with oral HPV-positive PVL, compared with combined therapy using surgery and methisoprinol in mother group of 25 patients with oral PVL. Six months postoperatively there was a significant difference, with 18 recurrences in the patients treated by surgery alone compared to only two recurrences in the patients treated also with methisoprinol (isoprinosine or inosine pranobex), a synthetic agent with immunomodulatory properties and some antiviral activity against HPV. Eighteen months postoperatively there were no further recurrences in the patients treated by surgery alone but another two recurrences in the patients treated with methisoprinol. Overall, by 18 months follow-up, there were 18 recurrences in the group treated by surgery alone, compared with four in those also receiving methisoprinol.The use of this antiviral agent appeared to offer a significant enhancement to the surgical management of PVL.