Mashberg A, Meyers H
Cancer. 1976 May;37(5):2149-57. doi: 10.1002/1097-0142(197605)37:5<2149::aid-cncr2820370502>3.0.co;2-g.
The site and size of 222 asymptomatic, primarily erythroplastic, cancers of the oral mucosa in 161 patients have been prospectively documented. Of 207 intraoral lesions (excluding 15 of the lip), 201 (97.1%) were found in three locations; floor of the mouth (101), ventral or lateral tongue (36), and soft palate complex (64). Of the 101 in the floor of the mouth, 73 occurred in the anterior portion with 33 involving the papilla at exit of Wharton's Duct (submaxillary gland). Of the cancers 84.2% were 2 cm or less and 41.9% were 1 cm or less. Of the lesions 2 cm or less 70.6% were invasive carcinoma. Minimal size does not preclude invasiveness. In view of the apparent predilection of oral carcinoma for particular sites (where there is no obvious agent), rather than random occurrence, the three aforementioned sites are designated as high risk areas which deserve particular scrutiny in an examination of the oral cavity. It is incumbent upon the clinician to biopsy all asymptomatic, persisten (14 days or more) mucosal aberrations in the high risk areas, especially those with erythroplastic components, regardless of size.
对161例患者的222例无症状、主要为红斑样的口腔黏膜癌的部位和大小进行了前瞻性记录。在207例口腔内病变（不包括15例唇部病变）中，201例（97.1%）位于三个部位：口底（101例）、舌腹或舌侧（36例）以及软腭复合体（64例）。在口底的101例病变中，73例发生在前部，其中33例累及颌下腺导管开口处的乳头。这些癌症中，84.2%直径小于或等于2 cm，41.9%直径小于或等于1 cm。直径小于或等于2 cm的病变中，70.6%为浸润性癌。最小尺寸并不排除浸润性。鉴于口腔癌明显倾向于特定部位（无明显致病因素）而非随机发生，上述三个部位被指定为高危区域，在口腔检查中值得特别仔细检查。临床医生有责任对高危区域所有无症状、持续（14天或更长时间）的黏膜异常进行活检，尤其是那些有红斑样成分的病变，无论其大小。
