Oral epithelial dysplasia and oral cancer prevalence in routine white lesion biopsies – a 6-year retrospective study
Oral epithelial dysplasia and oral cancer prevalence in routine white lesion biopsies – a 6-year retrospective study
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常规白色病变活检中口腔上皮发育不良和口腔癌的患病率——一项为期 6 年的回顾性研究
DOI：
10.26444/jpccr/125393
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
N. Lewkowicz
中科院分区：
文献类型：
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作者：
Maciej Kuzio;Karolina Wapniarska;M. Danilewicz;N. Lewkowicz
导论.白斑病和口腔扁平苔藓（OLP）是常见的疾病，表现为白色病变，被认为是潜在的恶性疾病（PMD）。上皮异型增生可能是未来转化为口腔鳞状细胞癌（OSCC）的早期迹象。建议对持续性白色口腔病变进行常规活检和密切观察。由于摩擦性角化病可能与口腔白斑相似，问题就来了：是否需要对创伤性持久性白色病变进行活检？材料和方法。回顾性分析了643例口腔组织活检的数据。共选择176例（27.37%）结果，其中暂定白斑（36例），OLP（77例）和摩擦角化病（63例）。收集的回顾性数据包括年龄、性别、吸烟状况、临时和组织病理学诊断。分析这些数据，以评估上皮异型增生和口腔鳞状细胞癌在年龄、性别和吸烟状况方面的患病率。结果报告了5例（2.84%）OSSC病例，均分级为G1; 4例OSCC病例在临床定义的白斑病变中发现; 1例OSCC病例（1.3%）在OLP活检中发现; 5例（2.84%）病变中报告上皮异常增生，暂定诊断为OLP（3例），2例白斑。在诊断为摩擦角化病的病变中未发现异常增生或OSCC。结论.上皮异型增生和口腔鳞状细胞癌可能会发现在白斑或OLP病变最初没有怀疑任何恶性肿瘤。在某些情况下，临床特征不足以在没有组织病理学的情况下诊断病变。炎症性角化病很容易被临床医生识别，并且可能不需要在每个病例中都进行活检。白色病变的临床和组织病理学评价仍需改进。
Introduction. Leukoplakia and oral lichen planus (OLP) are common diseases manifesting as white lesions that are considered potentially malignant disorders (PMD). Epithelial dysplasia may be an early sign of potency for the future transformation into oral squamous cell carcinoma (OSCC). A routine biopsy and close observation are recommended for persistent white oral lesions. As frictional keratosis may mimic oral leukoplakia, the question arises:Is there a need for a biopsy of persistent white lesion of traumatic origin? Materials and methods. Data from 643 oral tissue biopsies were retrospectively analyzed. A total of 176 (27.37%) results with provisional diagnosis of leukoplakia (36 cases), OLP (77 cases) and frictional keratosis (63 cases) were selected. Retrospective data collected included age, gender, smoking status, provisional and histopathological diagnosis. The data was analyzed to assess the prevalence of epithelial dysplasia and OSCC in terms of age, gender and smoking status. Results. Five (2.84%) cases of OSSC were reported, all of them were graded as G1; four cases of OSCC were found in clinically defined leukoplakia lesions; one case of OSCC (1.3%) was found in OLP biopsy; epithelial dysplasia was reported in 5 lesions (2.84%) provisionally diagnosed as OLP (3 cases), and leukoplakia in 2 cases. No dysplasia or OSCC were found in the lesions diagnosed as frictional keratosis. Conclusions. Epithelial dysplasia and OSCC may be found in leukoplakia or OLP lesions not initially suspected of any malignancy. In some cases, clinical features are not sufficient to diagnose a lesion without histopathology. Frictional keratosis is easily identified by clinicians, and may not require a biopsy in every case. Clinical and histopathological evaluation of the white lesions still needs improvement.