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[口腔癌前病变——概述]

[Oral precancerous conditions--an overview].

作者信息

Reichart P A

机构信息

Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Charité, Medizinische Fakultät, Humboldt-Universität Berlin, Augustenburger Platz 1, 13353, Berlin.

出版信息

Mund Kiefer Gesichtschir. 2003 Jul;7(4):201-7. doi: 10.1007/s10006-003-0483-y. Epub 2003 Jun 28.

Abstract

Precancerous conditions are defined as a generalized state associated with a significantly increased risk of cancer. For the oral and perioral region, sideropenic dysphagia, oral lichen planus (OLP), oral submucous fibrosis (OSF), syphilis, discoid lupus erythematosus, xeroderma pigmentosum as well as epidermolysis bullosa play a role as precancerous conditions. The number of published cases of oral or perioral malignant transformation for some of these diseases is small. In addition, carcinomas of the tongue and the oral cavity associated with syphilis are of historical interest, although publications in the 1990s still reported positive serology of syphilis and carcinomas of the tongue. OLP is still controversially discussed as to its premalignant nature. Transformation rates have been reported between 0% and 5.6%. Recent prospective studies have revealed that possibly oral lichenoid reactions (OLR) are more likely to form the basis of malignant transformation as compared to the classic OLP. The differentiation between OLP and OLR is difficult both from clinical and histopathological aspects. The second most important precancerous condition is oral submucous fibrosis, which is caused by betel quid chewing. OSF is most prevalent in South and Southeast Asia. The transformation rate is as high as 7.6% making OSF one of the most important precancerous conditions of the oral region.

摘要

癌前病变被定义为一种与癌症风险显著增加相关的全身性状态。对于口腔及口周区域,缺铁性吞咽困难、口腔扁平苔藓(OLP)、口腔黏膜下纤维化(OSF)、梅毒、盘状红斑狼疮、着色性干皮病以及大疱性表皮松解症均作为癌前病变发挥作用。其中一些疾病的口腔或口周恶性转化的已发表病例数量较少。此外,与梅毒相关的舌癌和口腔癌具有历史研究价值,尽管20世纪90年代的出版物仍报道了梅毒血清学阳性与舌癌的情况。OLP的癌前性质仍存在争议。其转化率报道在0%至5.6%之间。最近的前瞻性研究表明,与经典的OLP相比,口腔苔藓样反应(OLR)可能更易成为恶性转化的基础。从临床和组织病理学方面来看,区分OLP和OLR都很困难。第二重要的癌前病变是口腔黏膜下纤维化,它由咀嚼槟榔引起。OSF在南亚和东南亚最为普遍。其转化率高达7.6%,使OSF成为口腔区域最重要的癌前病变之一。

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