Woo Sook-Bin, Grammer Rebecca L, Lerman Mark A
Associate Professor, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Associate Pathologist, StrataDx, Lexington, MA, USA; Attending Dentist, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
Resident in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Dec;118(6):713-24. doi: 10.1016/j.oooo.2014.09.016. Epub 2014 Sep 22.
The objectives were to (1) determine the frequency of specific diagnoses in a series of white lesions, and (2) describe the nature of keratotic lesions that are neither reactive nor dysplastic.
White lesions were analyzed and diagnosed as reactive keratoses, dysplastic/malignant, or keratoses of unknown significance (KUS).
Of the 1251 specimens that were evaluated, 703 met criteria for inclusion, and approximately 75% were reactive, 10% dysplastic/malignant, and 14% KUS. Excluding reactive keratoses, 43% were dysplastic/malignant and 57% were KUS.
Reactive keratoses were the most common white lesions followed by lichen planus. Dysplastic/malignant lesions constituted almost 50% of all true leukoplakias. KUS constituted the remaining cases and do not show typical reactive histopathology as well as clear dysplasia. They may represent evolving or devolving reactive keratoses but may also represent the very earliest dysplasia phenotype. Clinical findings may be helpful in differentiating the two.
(1)确定一系列白色病变中特定诊断的频率,(2)描述既非反应性也非发育异常的角化性病变的性质。
对白色病变进行分析并诊断为反应性角化病、发育异常/恶性病变或意义不明的角化病(KUS)。
在评估的1251个标本中,703个符合纳入标准,其中约75%为反应性病变,10%为发育异常/恶性病变,14%为KUS。排除反应性角化病后,43%为发育异常/恶性病变,57%为KUS。
反应性角化病是最常见的白色病变,其次是扁平苔藓。发育异常/恶性病变占所有真性白斑的近50%。KUS构成其余病例,不表现出典型的反应性组织病理学以及明确的发育异常。它们可能代表正在演变或退化的反应性角化病,但也可能代表最早的发育异常表型。临床发现可能有助于区分两者。