Oral leukoplakia and malignant transformation. A follow-up study of 257 patients.
Oral leukoplakia and malignant transformation. A follow-up study of 257 patients.
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口腔白斑和恶变。
DOI：
10.1002/1097-0142(19840201)53:3
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发表时间：
1984
期刊：
影响因子：
6.2
通讯作者：
Lozada,F
中科院分区：
文献类型：
--
作者：
SilvermanJr,S;Gorsky,M;Lozada,F
研究了257例口腔白斑患者，平均随访时间为7.2年。所有病变的大小均超过1 cm，并且已经存在并观察了至少6个月。在最初的活检中，235例显示为良性角化过度，22例含有一定程度的上皮发育不良。73%的患者使用烟草，其中香烟使用是主要形式。45例患者（17.5%）随后在平均8.1年的时间内在过度角化上皮部位发生鳞状细胞癌。这些恶性转化中的8个来自最初患有上皮发育不良的患者。恶性转化的高风险还包括非吸烟患者、临床存在增生性红斑（红斑性白斑）和临床疣状乳头状角化过度模式。白斑的持续时间逐渐增加恶性转化的总数，最大的发生率在第二年。本研究证实，口腔白斑是一种癌前病变，某些特征表明更大的风险，值得考虑更积极的管理。
Two hundred fifty‐seven patients with oral leukoplakia were studied and followed for an average period of 7.2 years. All lesions were more than one cm in size and had been present and observed for a minimum of 6 months. Of the initial biopsies, 235 revealed a benign hyperkeratosis and 22 others contained some degree of epithelial dysplasia. Seventy‐three percent of the patients used tobacco, with cigarette usage being the predominant form. Forty‐five patients (17.5%) subsequently developed squamous carcinomas in the hyperkeratotic epithelial site in an average time of 8.1 years. Eight of these malignant transformations came from patients who originally had epithelial dysplasia. High risks for malignant transformation also included non‐smoking patients, the clinical presence of erythroplasia (erythroleukoplakia), and a clinical verrucous‐papillary hyperkeratotic pattern. Duration of the leukoplakia progressively increased the total number of malignant transformations, with the largest rate occurring in the second year. This study confirms that oral leukoplakia is a precancerous lesion and that certain characteristics indicate greater risks and warrant consideration of more aggressive management.