Lim Jimie Siew Mei, Tang Sum Pei, Siar Chong Huat
Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2009;10(6):1071-4.
Conventional methods for writing case notes detailing the progress of oral lichen planus (OLP), a precancerous condition that requires long-term surveillance, is both time-consuming and tedious for the busy clinician.
To design and perform a simple surveillance on OLP patients based on colour-coded topography mouth maps (TMM).
Three colour-coded TMM were employed: red for OLP in high risk oral mucosal sites, yellow for cases showing improvement and green for asymptomatic lesions at each recall visit. In this preliminary study, these were applied on 30 histologically confirmed OLP individuals attending the Oral Medicine Clinic at the Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya. The sites and extent of OLP lesions were charted on either red, yellow or green TMM based on defined criteria. This surveillance evaluated OLP in relation to patientandapos;s age, race, gender, underlying systemic conditions, oral habits, initial onset of OLP, oral manifestations and presence/absence of clinically suspicious areas.
Study sample comprised 4 (13.3%) Malays, 9 (30.0%) Chinese and 17 (56.7%) Indians. Most OLP patients belong to the green TMM (n= 14, 46.6%) group followed by red (n= 11, 36.7%) and yellow (n= 5, 16.7%) groups. Of the 11 cases with red TMM, rebiopsy was performed on 4 cases but no dysplasia was detected. Any local confounding factors namely periodontal disease or faulty dental restorations were managed accordingly.
TMM is simple to use and aided the clinicians in terms of time saving and patient management. Hence, follow-up of OLP patients can be carried out more efficiently and appropriately. TMM can be used for surveillance of other oral precancerous lesions and conditions.
口腔扁平苔藓(OLP)是一种需要长期监测的癌前病变,对于忙碌的临床医生而言,采用传统方法撰写详细记录OLP病情进展的病例报告既耗时又繁琐。
基于颜色编码的口腔地形图(TMM)对OLP患者进行简单监测。
采用三种颜色编码的TMM:红色代表口腔黏膜高危部位的OLP,黄色代表病情好转的病例,绿色代表每次复诊时无症状的病变。在这项初步研究中,将这些TMM应用于30名经组织学确诊的OLP患者,这些患者均就诊于马来亚大学牙科学院口腔病理学、口腔医学与牙周病学系的口腔医学门诊。根据既定标准,将OLP病变的部位和范围标注在红色、黄色或绿色的TMM上。该监测评估了OLP与患者的年龄、种族、性别、潜在全身状况、口腔习惯、OLP的初始发病情况、口腔表现以及临床可疑区域的有无。
研究样本包括4名(13.3%)马来人、9名(30.0%)华人以及17名(56.7%)印度人。大多数OLP患者属于绿色TMM组(n = 14,46.6%),其次是红色组(n = 11,36.7%)和黄色组(n = 5,16.7%)。在11例红色TMM病例中,对4例进行了再次活检,但未检测到发育异常。对任何局部混杂因素,如牙周病或有问题的牙齿修复体,都进行了相应处理。
TMM使用简便,在节省时间和患者管理方面有助于临床医生。因此,可以更高效、适当地对OLP患者进行随访。TMM可用于监测其他口腔癌前病变和病症。