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二氧化碳激光治疗口腔白斑:65例患者的回顾性研究

The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients.

作者信息

Mogedas-Vegara Alfonso, Hueto-Madrid Juan-Antonio, Chimenos-Küstner Eduardo, Bescós-Atín Coro

机构信息

Oral and Maxillofacial Department, Vall D'Hebron University Hospital, Universidad Autónoma de Barcelona, Passeig de la Vall D'Hebron 119-129, Barcelona 08035, Spain.

Oral and Maxillofacial Department, Vall D'Hebron University Hospital, Universidad Autónoma de Barcelona, Passeig de la Vall D'Hebron 119-129, Barcelona 08035, Spain.

出版信息

J Craniomaxillofac Surg. 2015 Jun;43(5):677-81. doi: 10.1016/j.jcms.2015.03.011. Epub 2015 Mar 26.

Abstract

The use of CO2 laser has become a routine procedure for the treatment of oral leukoplakia. In this retrospective study, we evaluated 65 patients with oral leukoplakia treated with CO2 laser vaporization. The main location was the tongue (n = 21/65, 32.3%). The initial biopsy showed mild/moderate dysplasia in almost half the patients (n = 29, 44.6%) and hyperplasia without dysplasia in around a third of the patients (n = 21, 32.3%). The recurrence and malignant transformation rates were 33.8% (n = 22) and 15.4% (n = 10), respectively. The follow-up mean (standard deviation) was 15.0 (10.6) months. The procedure-related complications rate was 7.7% (n = 5). The Kaplan-Meier curves for time to recurrence showed differences only for gingiva lesions compared to tongue lesions (log rank, p = 0.032). Malignant leukoplakia transformation is independent of treatment, although it seems advisable to treat leukoplakia with or without dysplasia.

摘要

二氧化碳激光的使用已成为治疗口腔白斑的常规程序。在这项回顾性研究中,我们评估了65例接受二氧化碳激光汽化治疗的口腔白斑患者。主要发病部位是舌头(n = 21/65,32.3%)。初次活检显示,近半数患者(n = 29,44.6%)为轻度/中度发育异常,约三分之一患者(n = 21,32.3%)为无发育异常的增生。复发率和恶变率分别为33.8%(n = 22)和15.4%(n = 10)。平均(标准差)随访时间为15.0(10.6)个月。与手术相关的并发症发生率为7.7%(n = 5)。复发时间的Kaplan-Meier曲线显示,与舌部病变相比,牙龈病变存在差异(对数秩检验,p = 0.032)。恶性白斑转化与治疗无关,不过,无论有无发育异常,治疗白斑似乎都是可取的。

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