Ishii J, Fujita K, Komori T
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. ishiijun@med,kobe-u.ac.jp
Oral Oncol. 2003 Dec;39(8):759-69. doi: 10.1016/s1368-8375(03)00043-5.
Various treatment procedures for oral leukoplakia have been reported. However, after some treatments, oral leukoplakia show recurrence and/or malignant transformation, even following complete resection. Furthermore, patients with oral leukoplakia may develop new lesions in other oral cavity locations. Laser surgery for oral mucosal lesions has been reported to have many advantages, and it is widely used in the treatment of oral leukoplakia. In previous studies, recurrence and malignant transformation from the lesion have occasionally been observed following laser surgery. We reviewed the records of oral leukoplakia patients treated with laser surgery to assess its clinical usefulness. It has been reported that the rate of recurrence was 7.7-38.1%, while malignant transformation was 2.6-9% for oral leukoplakia treated with laser surgery. In the present study, there was 29.3% recurrence and 1.2% malignant transformation after laser surgery. This was similar to previous findings. This suggests that non-homogeneous leukoplakia on nonkeratinized epithelia, i.e. the tongue mucosa has a high risk for malignant transformation, so lesions should be excised after detecting abnormal epithelia using vital tissue staining. The wound healing process after laser surgery was satisfactory and no significant complications were observed. Management of oral leukoplakia prevents not only recurrence and malignant transformation, but also postoperative dysfunction: laser surgery is an excellent procedure that is able to overcome these problems.
已有多种治疗口腔白斑的方法被报道。然而,经过一些治疗后,即使在完全切除后,口腔白斑仍会出现复发和/或恶变。此外,口腔白斑患者可能会在口腔的其他部位出现新的病变。据报道,激光手术治疗口腔黏膜病变具有许多优点,并且广泛应用于口腔白斑的治疗。在以往的研究中,激光手术后偶尔会观察到病变复发和恶变。我们回顾了接受激光手术治疗的口腔白斑患者的记录,以评估其临床实用性。据报道,激光手术治疗口腔白斑的复发率为7.7%-38.1%,恶变率为2.6%-9%。在本研究中,激光手术后的复发率为29.3%,恶变率为1.2%。这与先前的研究结果相似。这表明非角化上皮上的非均质型白斑,即舌黏膜,具有较高的恶变风险,因此在使用活体组织染色检测到异常上皮后应切除病变。激光手术后的伤口愈合过程令人满意,未观察到明显并发症。口腔白斑的治疗不仅能预防复发和恶变,还能预防术后功能障碍:激光手术是一种能够克服这些问题的优秀治疗方法。