Yu Chuan-Hang, Lin Hung-Pin, Cheng Shih-Jung, Sun Andy, Chen Hsin-Ming
School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan.
Department of Dentistry, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan; School of Dentistry, College of Medicine, China Medical University, Taichung, Taiwan.
J Formos Med Assoc. 2014 May;113(5):272-7. doi: 10.1016/j.jfma.2014.01.014. Epub 2014 Feb 20.
Previous studies have used cryotherapy for the treatment of oral precancers including oral leukoplakia (OL) and oral verrucous hyperplasia (OVH) as well as oral cancers including oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC). Cryotherapy is a method that locally destroys lesional tissues by freezing in situ. It can be carried out by either an "open" or a "closed" system. Lesional tissues are destroyed mainly through disruption of cell membrane, cellular dehydration, enzyme and protein damage, cell swelling and rupture, thermal shock injury to cells, damage to vasculature, and immune-mediated cytotoxicity. Cryotherapy is used frequently for the treatment of OL lesions with promising results. It can also be used to treat OVH and OVC lesions. Because OVH and OVC lesions are usually fungating and bulky, a combination therapy of shave excision and cryotherapy is needed to achieve a complete regression of the lesion. OSCCs have also been treated by cryotherapy. However, cryotherapy is not the main-stream treatment modality for OSCCs. Cryotherapy seems suitable for treatment of thin or relatively thick plaque-typed lesions such as OL lesions. By careful selection of patients, cryotherapy is a simple, safe, easy, conservative, and acceptable treatment modality for certain benign oral lesions and oral precancers.
先前的研究已将冷冻疗法用于治疗口腔癌前病变，包括口腔白斑（OL）和口腔疣状增生（OVH），以及口腔癌，包括口腔疣状癌（OVC）和口腔鳞状细胞癌（OSCC）。冷冻疗法是一种通过原位冷冻局部破坏病变组织的方法。它可以通过“开放式”或“封闭式”系统进行。病变组织的破坏主要通过细胞膜破坏、细胞脱水、酶和蛋白质损伤、细胞肿胀和破裂、细胞热休克损伤、血管损伤以及免疫介导的细胞毒性来实现。冷冻疗法常用于治疗OL病变，效果良好。它也可用于治疗OVH和OVC病变。由于OVH和OVC病变通常呈蕈状且体积较大，需要采用刮除术和冷冻疗法的联合治疗才能使病变完全消退。OSCC也已采用冷冻疗法进行治疗。然而，冷冻疗法并非OSCC的主流治疗方式。冷冻疗法似乎适用于治疗薄的或相对较厚的斑块型病变，如OL病变。通过仔细挑选患者，冷冻疗法对于某些良性口腔病变和口腔癌前病变而言是一种简单、安全、便捷、保守且可接受的治疗方式。
