[口腔白斑癌变危险因素分析]

[Analysis of risk factors for carcinogenesis of oral leukoplakia].

作者信息

Lan Ai-xian, Guan Xiao-bing, Sun Zheng

机构信息

Department of Oral Medicine, Capital Medical University School of Stomatology, Beijing 100050, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2009 Jun;44(6):327-31.

PMID:19953947

Abstract

OBJECTIVE

To investigate the risk factors for malignant transformation of oral leukoplakia.

METHODS

A total of 409 cases with oral leukoplakia was retrospectively analyzed. Single factor test was first performed to examine the associations between oral leukoplakia's histopathological classification and each of risk factors including sex, age, systemic diseases, course of disease, clinical classification, site, size, numbers of lesion, alcohol and tobacco consumption, and symptom. Then the association of these selected factors with oral leukoplakia's histopathological classification was evaluated using multiple logistic regression analysis.

RESULTS

Fifty-two cases of all 409 patients with oral leukoplakia (including 9 severe dysplasia) developed oral cancer. The ratio of malignant transformation was 12.7%. Sex, age, clinical type, site and symptom were chosen as risk factors incorporated into the multiple logistic regression models. The risk of mild-moderate dysplasia in female was 2.40 times as high as that in male. The risk of mild-moderate dysplasia of speckled leukoplakia was 2.81 times as high as that of homogeneous leukoplakia. The risk of mild-moderate dysplasia of dangerous site was 1. 98 times as high as that non-dangerous site. The risk of mild-moderate dysplasia with symptom was 1.84 times as high as that without symptom. The risk of severe dysplasia and oral cancer in female was 3.11 times as high as that in male. The risk of severe dysplasia and oral cancer of speckled (4.50 times), ulcerative (5.63 times), verrucous leukoplakia (4.09 times) were much higher than that of homogeneous leukoplakia. The risk of severe dysplasia and oral cancer in dangerous site was 2.79 times as high as in non-dangerous site. The risk of severe dysplasia and oral cancer in leukoplakia with symptom was 4.38 times as high as without symptom.

CONCLUSIONS

The malignant transformation of oral leukoplakia is correlated to sex, clinical type, site and symptom.

摘要

目的

探讨口腔白斑恶变的危险因素。

方法

回顾性分析409例口腔白斑患者的临床资料。首先进行单因素检验，分析口腔白斑的组织病理学分类与性别、年龄、全身疾病、病程、临床分类、部位、大小、病损数目、烟酒嗜好及症状等危险因素之间的关系。然后采用多因素logistic回归分析评估这些因素与口腔白斑组织病理学分类的关联。

结果

409例口腔白斑患者中52例发生恶变（其中重度不典型增生9例），恶变率为12.7%。将性别、年龄、临床类型、部位及症状等因素纳入多因素logistic回归模型。女性轻中度不典型增生的风险是男性的2.40倍。斑点状白斑轻中度不典型增生的风险是均质型白斑的2.81倍。危险部位轻中度不典型增生的风险是非危险部位的1.98倍。有症状的轻中度不典型增生的风险是无症状者的1.84倍。女性重度不典型增生及口腔癌的风险是男性的3.11倍。斑点状（4.50倍）、溃疡型（5.63倍）、疣状白斑（4.09倍）重度不典型增生及口腔癌的风险均显著高于均质型白斑。危险部位重度不典型增生及口腔癌的风险是非危险部位的2.79倍。有症状的白斑重度不典型增生及口腔癌的风险是无症状者的4.38倍。