Hsue Shue-Sang, Wang Wen-Chen, Chen Chung-Ho, Lin Cheng-Chung, Chen Yuk-Kwan, Lin Li-Min
Department of Oral Pathology, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
J Oral Pathol Med. 2007 Jan;36(1):25-9. doi: 10.1111/j.1600-0714.2006.00491.x.
It is generally accepted that the development of cancer in the oral mucosa is preceded by an identifiable non-invasive precursor lesion. The aim of this follow-up study was to estimate the rate and the time to transformation in a group of patients from southern Taiwan with potentially malignant oral epithelial lesions.
The follow-up time is defined as the duration between the onset of the initial diagnosis and the occurrence of confirmed oral cancer. A total of 1458 patients with histological diagnoses of various pre-malignant oral lesions were followed up between 1991 and 2001. The average age at initial diagnosis was 47.5 years. The histological diagnoses were divided into six categories: epithelial dysplasia with hyperkeratosis/epithelial hyperplasia (8.85%); epithelial dysplasia with submucous fibrosis (2.54%); submucous fibrosis (27.57%); hyperkeratosis/epithelial hyperplasia (29.01%); lichen planus (9.80%) and verrucous hyperplasia (22.22%).
Within the cohort of 1458 patients, 44 patients progressed to oral cancer in the same site as the initial lesions with an overall transformation rate of 3.02% and a mean follow-up time of 42.64 months. Eight of the 166 patients with dysplastic lesions and 15 of 423 patients with hyperkeratosis/epithelial hyperplasia progressed to malignancy. The other patients with malignant transformation originated from various pre-cancerous oral lesions and conditions (submucous fibrosis, eight of 402; lichen planus, three of 143; verrucous hyperplasia, 10 of 324).
These results indicate that patients with pre-malignant oral lesions need long-term follow up.
人们普遍认为，口腔黏膜癌的发生之前会出现可识别的非侵袭性前驱病变。这项随访研究的目的是评估台湾南部一组患有潜在恶性口腔上皮病变患者的病变转变率和转变时间。
随访时间定义为初次诊断开始至确诊口腔癌发生之间的持续时间。1991年至2001年期间，对总共1458例经组织学诊断为各种癌前口腔病变的患者进行了随访。初次诊断时的平均年龄为47.5岁。组织学诊断分为六类：伴有角化过度/上皮增生的上皮发育异常（8.85%）；伴有黏膜下纤维化的上皮发育异常（2.54%）；黏膜下纤维化（27.57%）；角化过度/上皮增生（29.01%）；扁平苔藓（9.80%）和疣状增生（22.22%）。
在1458例患者队列中，44例患者在与初始病变相同的部位进展为口腔癌，总体转变率为3.02%，平均随访时间为42.64个月。166例发育异常病变患者中有8例以及423例角化过度/上皮增生患者中有15例进展为恶性肿瘤。其他发生恶性转变的患者源自各种癌前口腔病变和状况（黏膜下纤维化，402例中有8例；扁平苔藓，143例中有3例；疣状增生，324例中有10例）。
这些结果表明，患有癌前口腔病变的患者需要长期随访。
