口腔上皮发育异常的恶性转化：组织病理学分级的真实世界评估
Malignant transformation of oral epithelial dysplasia: a real-world evaluation of histopathologic grading.
作者信息
Dost F, Lê Cao K, Ford P J, Ades C, Farah C S
机构信息
University of Queensland, UQ Centre for Clinical Research, Herston, Australia; University of Queensland, School of Dentistry, Brisbane, Australia.
University of Queensland, Queensland Facility for Advanced Bioinformatics, St Lucia, Australia.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Mar;117(3):343-52. doi: 10.1016/j.oooo.2013.09.017. Epub 2013 Oct 17.
OBJECTIVE
This study describes the predictive value of oral epithelial dysplasia (OED) grading as an indicator for malignant transformation and progression.
STUDY DESIGN
The records of an Australian-based pathology laboratory were searched for oral mucosal biopsies with a dysplastic or malignant diagnosis. Examination for an association with progression and malignant transformation without reinterpretation was performed. Analysis was undertaken using hazard ratios and the Fisher exact test.
RESULTS
A total of 368 patients with a diagnosis of OED were included. Twenty-six patients (7.1%) underwent progression or malignant transformation; the annual malignant transformation rate was 1%. No other characteristics were associated with a heightened risk of progression or transformation.
CONCLUSIONS
The severity of OED was not associated with risk of malignant transformation, suggesting that the current OED grading system is not useful for predicting patient outcomes or for determining management strategies. Definitive treatment of all OED is recommended, until a more reliable progression/transformation system is developed.
目的
本研究描述口腔上皮发育异常（OED）分级作为恶性转化和进展指标的预测价值。
研究设计
检索一家澳大利亚病理实验室的记录，查找诊断为发育异常或恶性的口腔黏膜活检样本。在不重新解读的情况下，检查其与进展和恶性转化的相关性。采用风险比和Fisher精确检验进行分析。
结果
共纳入368例诊断为OED的患者。26例（7.1%）发生进展或恶性转化；年恶性转化率为1%。没有其他特征与进展或转化风险增加相关。
结论
OED的严重程度与恶性转化风险无关，这表明当前的OED分级系统对于预测患者预后或确定管理策略并无用处。在开发出更可靠的进展/转化系统之前，建议对所有OED进行确定性治疗。
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