口腔扁平苔藓与恶性转化：一项纵向队列研究。
Oral lichen planus and malignant transformation: a longitudinal cohort study.
作者信息
Bombeccari Gian Paolo, Guzzi Gianpaolo, Tettamanti Mauro, Giannì Aldo Bruno, Baj Alessandro, Pallotti Francesco, Spadari Francesco
机构信息
Unit of Oral Pathology and Medicine, Department of Reconstructive and Diagnostic Surgical Sciences, University of Milan, Milan, Italy.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):328-34. doi: 10.1016/j.tripleo.2011.04.009. Epub 2011 Jul 22.
OBJECTIVE
Oral lichen planus (OLP) is associated with risk for developing oral squamous cell carcinoma (OSCC). We performed a 7-year prospective study to assess the incidence of malignant transformation of OLP among adults.
STUDY DESIGN
Three hundred twenty-seven OLP patients, 229 women (70.0%) and 98 men (30.0%), were observed during the follow-up period.
RESULTS
During a mean follow-up of 81.7 months, 8 of 327 patients developed an OSCC in OLP areas (0.36%/y), yielding the high overall standardized incidence ratio of 17.7 (95% confidence interval [CI] 8.8-35.3). The standardized incidence ratio for OSCC was significantly higher in women [27.0 (95% CI 11.2-64.8)] than in men [11.2 (95% CI 3.6-34.9)]. Six OSCCs were well differentiated (75%) and 2 moderately differentiated (25%). Three subjects (37.5%) developed recurrences within 2 years (mean 16.1 ± 3.5 months). Disease-free survival rate after 69.8 months was 97.3%.
CONCLUSIONS
OLP was associated with a significant increase in the risk for OSCC. Close surveillance may help to reduce the morbidity of OSCC arising from OLP at 24 months.
目的
口腔扁平苔藓（OLP）与发生口腔鳞状细胞癌（OSCC）的风险相关。我们进行了一项为期7年的前瞻性研究，以评估成年人中OLP恶变的发生率。
研究设计
在随访期间观察了327例OLP患者，其中229例女性（70.0%）和98例男性（30.0%）。
结果
在平均81.7个月的随访期间，327例患者中有8例在OLP区域发生了OSCC（0.36%/年），总体标准化发病率高达17.7（95%置信区间[CI]8.8 - 35.3）。女性OSCC的标准化发病率[27.0（95%CI 11.2 - 64.8）]显著高于男性[11.2（95%CI 3.6 - 34.9）]。6例OSCC为高分化（75%），2例为中分化（25%）。3例患者（37.5%）在2年内复发（平均16.1±3.5个月）。69.8个月后的无病生存率为97.3%。
结论
OLP与OSCC风险的显著增加相关。密切监测可能有助于降低24个月时OLP引发的OSCC的发病率。
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