Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
Med Oral Patol Oral Cir Bucal. 2012 Jan 1;17(1):e35-40. doi: 10.4317/medoral.17399.
To identify factors related to advanced-stage diagnosis of oral cancer to disclose high-risk groups and facilitate early detection strategies.
An ambispective cohort study on 88 consecutive patients treated from January 1998 to December 2003.
pathological diagnosis of OSCC (primary tumour) at any oral site and suffering from a tumour at any TNM stage. Variables considered: age, gender, smoking history, alcohol usage, tumour site, macroscopic pattern of the lesion, co-existing precancerous lesion, degree of differentiation, diagnostic delay and TNM stage.
A total of 88 patients (mean age 60±11.3; 65.9% males) entered the study. Most patients (54.5%) suffered no delayed diagnosis and 45.5% of the carcinomas were diagnosed at early stages (I-II). The most frequent clinical lesions were ulcers (70.5%). Most cases were well- and moderately-differentiated (91%). Univariate analyses revealed strong associations between advanced stages and moderate-poor differentiation (OR=4.2; 95%CI=1.6-10.9) or tumour site (floor of the mouth (OR=3.6; 95%CI=1.2-11.1); gingivae (OR=8.8; 95%CI=2.0-38.2); and retromolar trigone (OR=8.8; 95%CI=1.5-49.1)). Regression analysis recognised the site of the tumour and the degree of differentiation as significantly associated to high risk of late-stage diagnosis.
Screening programmes designed to detect asymptomatic oral cancers should be prioritized. Educational interventions on the population and on the professionals should include a sound knowledge of the disease presentation, specifically on sites like floor of the mouth, gingivae and retromolar trigone. More studies are needed in order to analyse the part of tumour biology on the extension of the disease at the time of diagnosis.
确定与口腔癌晚期诊断相关的因素，以揭示高危人群并促进早期检测策略。
对 1998 年 1 月至 2003 年 12 月期间治疗的 88 例连续患者进行前瞻性队列研究。
任何口腔部位的口腔鳞状细胞癌（原发性肿瘤）的病理诊断，并患有任何 TNM 分期的肿瘤。考虑的变量：年龄、性别、吸烟史、饮酒史、肿瘤部位、病变的大体模式、共存癌前病变、分化程度、诊断延迟和 TNM 分期。
共有 88 例患者（平均年龄 60±11.3；男性占 65.9%）进入研究。大多数患者（54.5%）没有延迟诊断，45.5%的癌处于早期阶段（I-II 期）。最常见的临床病变是溃疡（70.5%）。大多数病例为高分化和中分化（91%）。单因素分析显示，晚期阶段与中低分化（OR=4.2；95%CI=1.6-10.9）或肿瘤部位（口底（OR=3.6；95%CI=1.2-11.1）；牙龈（OR=8.8；95%CI=2.0-38.2）；磨牙后三角（OR=8.8；95%CI=1.5-49.1））之间存在很强的关联。回归分析确认肿瘤部位和分化程度与晚期诊断的高风险显著相关。
应优先制定筛查无症状口腔癌的计划。针对人群和专业人员的教育干预应包括对疾病表现的深入了解，特别是在口底、牙龈和磨牙后三角等部位。为了分析肿瘤生物学在诊断时对疾病扩散的影响，还需要更多的研究。
