TREATMENT AND FOLLOW-UP OF ORAL DYSPLASIA - A SYSTEMATIC REVIEW AND META-ANALYSIS
TREATMENT AND FOLLOW-UP OF ORAL DYSPLASIA - A SYSTEMATIC REVIEW AND META-ANALYSIS
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DOI：
10.1002/hed.21131
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发表时间：
2009-12-01
影响因子：
2.9
通讯作者：
McConkey, Christopher C.
中科院分区：
文献类型：
--
作者：
Mehanna, Hisham M.;Rattay, Tim;McConkey, Christopher C.
背景本研究的目的是为口腔异型增生病变提供循证管理政策。采用荟萃分析进行系统评价。纳入了报告随访组织学证实的口腔发育不良患者的研究。结果指标包括恶变率（MTR）和恶变时间（TMT）。根据组织学分级、临床危险因素和治疗方式进行亚组分析。结果：纳入了14项非随机研究，报告了992例患者。研究之间存在相当大的异质性：平均总体MTR = 12.1%（置信区间：8.1%，17.9%），平均TMT = 4.3年。组织学分级显著影响平均MTR（p < .008）。未切除的病变显示MTR显著高于切除的病变（p = .003）。口腔异型增生转化为癌症的比率很高，与分级有关，并且显著降低，但不能通过切除消除。这表明有必要进行切割和继续监测。(C)2009 Wiley Periodicals，Inc.头颈部31：1600-1609，2009
Background. The aim of this study was to inform an evidence-based management policy for oral dysplastic lesions.Methods. Systematic review was performed with meta-analysis. Studies reporting follow-up of patients with histologically confirmed oral dysplasia were included. Outcome measures included malignant transformation rate (MTR) and time to malignant transformation (TMT). Subgroup analysis was performed by histologic grade, clinical risk factors, and treatment modality. Heterogeneity was assessed.Results. Fourteen nonrandomized studies, reporting on 992 patients, were included. There was considerable heterogeneity between studies: mean overall MTR = 12.1% (confidence interval: 8.1%, 17.9%) and mean TMT = 4.3 years. Histologic grade significantly affected mean MTR (p < .008). Lesions that were not excised demonstrated considerably higher MTR than those that were excised (p = .003).Conclusions. Oral dysplasia showed a significant rate of transformation to cancer, which was related to grade and was decreased significantly but not eliminated by excision. This suggested the need for excision and continued surveillance. (C) 2009 Wiley Periodicals, Inc. Head Neck 31: 1600-1609, 2009