Misra Vatsala, Singh Premala A, Lal Nirupama, Agarwal Pooja, Singh Mamta
Department of Pathology, Moti Lal Nehru Medical College, University of Allahabad, India.
Indian J Community Med. 2009 Oct;34(4):321-5. doi: 10.4103/0970-0218.58391.
To do a prospective clinicohistological study of premalignant and malignant lesions of the oral cavity, and compare it with a 10-year retrospective data, especially in terms of incidence, age distribution, personal habits, and site and type of lesion.
Sections from 776 lesions of the oral cavity, which included 647 lesions of a 10-year (1993 - 2003) retrospective study and 129 lesions of a one-year (2003 - 2004) prospective study, were observed clinically, and a histological correlation was carried out.
Premalignant lesions included 78 cases of leukoplakia, 68 cases of oral submucous fibrosis, and 76 cases of squamous papilloma. Their incidence has increased in the last decade from 0.15 to 0.53. These lesions commonly presented in the fourth decade of life, as white patches in leukoplakia and oral submucous fibrosis, and as a growth in squamous cell papilloma. Squamous cell carcinoma was the commonest lesion (57%). Its incidence has increased significantly in the last decade. The mean age of presentation was the sixth decade. A personal history of tobacco chewing was given by most of the patients in the retrospective group, while the use of pan masala was found to be maximum in the prospective group. The overall agreement between the clinical and histological diagnosis was 95.36% (740 / 776) and the kappa coefficient of agreement was 0.9256.
Histology along with a detailed clinical workup was found to be a useful, reliable, and accurate diagnostic technique for lesions of the oral cavity. An increase in premalignant lesions in the prospective study, associated with increased pan masala intake is alarming and needs to be taken care of.
对口腔癌前病变和恶性病变进行前瞻性临床组织学研究,并与10年回顾性数据进行比较,特别是在发病率、年龄分布、个人习惯以及病变部位和类型方面。
对776例口腔病变切片进行临床观察,并进行组织学相关性分析。这些病变包括1993年至2003年10年回顾性研究中的647例病变以及2003年至2004年1年前瞻性研究中的129例病变。
癌前病变包括78例白斑、68例口腔黏膜下纤维化和76例鳞状乳头瘤。在过去十年中,它们的发病率从0.15增至0.53。这些病变常见于生命的第四个十年,白斑和口腔黏膜下纤维化表现为白色斑块,鳞状细胞乳头瘤则表现为肿物。鳞状细胞癌是最常见的病变(57%)。其发病率在过去十年中显著增加。发病的平均年龄为第六个十年。回顾性组中的大多数患者有咀嚼烟草的个人史,而前瞻性组中发现使用槟榔最多。临床诊断与组织学诊断的总体一致性为95.36%(740 / 776),一致性的kappa系数为0.9256。
组织学检查以及详细的临床检查被发现是诊断口腔病变的一种有用、可靠且准确的诊断技术。前瞻性研究中癌前病变的增加与槟榔摄入量增加相关,这令人担忧,需要加以关注。