患有多个潜在恶性口腔病变的患者在发育异常、细胞更新和诊断方面的病损间差异。
Between-lesion discrepancies in terms of dysplasia, cell turnover and diagnosis in patients with multiple potentially malignant oral lesions.
作者信息
Lucio Montebugnoli, Andrea Gabusi, Bartolomeo Gissi Davide, Fabio Cervellati, Dora Servidio
机构信息
Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
出版信息
Open Dent J. 2013 Nov 29;7:169-74. doi: 10.2174/1874210601307010169. eCollection 2013.
OBJECTIVE
The present study assessed patients with multiple oral lesions to evaluate the mis-estimation rate in terms of diagnosis and risk of malignant transformation when only one biopsy is performed.
STUDY DESIGN
Thirty-five patients presenting at least two white and/or red lesions in different oral mucosa sites with a final diagnosis of leuko/erythroplakias or lichenoid lesions were included, for a total of 70 biopsies.
RESULTS
Nineteen patients (54%) had at least one between-lesion discrepancy considering the presence/absence of dysplasia (10 patients), normal/high cell turnover (13 patients) or diagnosis (5 patients). Discrepancies were not related to clinical aspect or within-patient similarity of lesions.
CONCLUSIONS
Multiple oral lesions in the same patient can significantly differ in terms of dysplasia, high cell turnover and, even diagnosis. Multiple biopsies are imperative and diagnosis as well as risk of malignant transformation should be formulated for each single lesion rather than for each individual patient.
目的
本研究评估了患有多处口腔病变的患者，以评估仅进行一次活检时在诊断和恶性转化风险方面的错误估计率。
研究设计
纳入了35例在不同口腔黏膜部位出现至少两个白色和/或红色病变且最终诊断为白斑/红斑或苔藓样病变的患者，共进行了70次活检。
结果
19例患者（54%）在发育异常的存在与否（10例患者）、正常/高细胞周转率（13例患者）或诊断（5例患者）方面存在至少一处病变间差异。差异与病变的临床外观或患者体内病变的相似性无关。
结论
同一患者的多处口腔病变在发育异常、高细胞周转率甚至诊断方面可能存在显著差异。必须进行多次活检，并且应针对每个单一病变而非每个个体患者制定诊断及恶性转化风险评估。
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