Yeh Chien-Yang, Lin Chien-Ling, Chang Mei-Chi, Chen Hsin-Ming, Kok Seng-Heng, Chang Shu-Hui, Kuo Ying-Shiung, Hahn Liang-Jiunn, Chan Chiu-Po, Lee Jang-Jaer, Jeng Jiiang-Huei
School of Dentistry and Department of Dentistry, National Taiwan University Medical College and National Taiwan University Hospital, Taipei, Taiwan.
Department of Dentistry, Mackay Memorial Hospital, Hsinchu, Taiwan.
J Formos Med Assoc. 2016 Apr;115(4):263-8. doi: 10.1016/j.jfma.2015.07.017. Epub 2015 Sep 26.
BACKGROUND/PURPOSE: In Taiwan, the combination of betel quid chewing, alcohol consumption, and smoking habits increases oral cancer risk by 123-fold compared to persons without these habits. Lymphocyte populations in patients may potentially affect the malignant transformation of oral precancer.
A total of 28 patients with oral precancer from our previous cohort were enrolled in this study, and their personal information and oral habits were documented. Their lymphocyte populations (CD4+, CD8+, CD19+, and CD56+) and activation markers (CD25 and CD69) were determined by flow cytometry from 1999 to 2004. After follow up till December 2014, data of patients with/without malignant transformation were recorded, and the relation between oral habits and percentage of initial lymphocyte markers was evaluated using the Student t test and Fisher's exact test.
Ten precancer patients developed oral squamous cell carcinoma with a mean period of malignant transformation of 6.8 ± 2.1 years. Patients with malignant transformation had a mean age of 48.4 ± 5.0 years (n = 10), relatively more than that of patients without malignant transformation (41.6 ± 6.3 years, n = 18) (p < 0.05). An increase was noted in the population of peripheral blood mononuclear cells expressing CD4+CD69+, CD19+CD69+, and CD56+CD69+ (p < 0.05) in precancer patients with malignant transformation. Alcohol consumption showed an association with the malignant transformation of patients with precancer (p = 0.030), whereas betel quid and smoking showed little effect.
These results suggest that age, alcohol consumption, and early activation of T cells, B cells, and natural killer cells are crucial in the malignant transformation of oral precancer. Analysis of patient's lymphocyte populations may help predict the malignant transformation of oral precancer.
背景/目的：在台湾，与无这些习惯的人相比，嚼食槟榔、饮酒和吸烟习惯相结合会使口腔癌风险增加123倍。患者的淋巴细胞群体可能会潜在影响口腔癌前病变的恶性转化。
本研究纳入了我们之前队列中的28例口腔癌前病变患者，并记录了他们的个人信息和口腔习惯。在1999年至2004年期间，通过流式细胞术测定他们的淋巴细胞群体（CD4 +、CD8 +、CD19 +和CD56 +）和活化标志物（CD25和CD69）。随访至2014年12月后，记录有/无恶性转化患者的数据，并使用Student t检验和Fisher精确检验评估口腔习惯与初始淋巴细胞标志物百分比之间的关系。
10例癌前病变患者发生口腔鳞状细胞癌，恶性转化的平均时间为6.8±2.1年。发生恶性转化的患者平均年龄为48.4±5.0岁（n = 10），相对高于未发生恶性转化的患者（41.6±6.3岁，n = 18）（p <0.05）。发生恶性转化的癌前病变患者中，表达CD4 + CD69 +、CD19 + CD69 +和CD56 + CD69 +的外周血单个核细胞群体增加（p <0.05）。饮酒与癌前病变患者的恶性转化相关（p = 0.030），而嚼食槟榔和吸烟影响较小。
这些结果表明，年龄、饮酒以及T细胞、B细胞和自然杀伤细胞的早期活化在口腔癌前病变的恶性转化中至关重要。分析患者的淋巴细胞群体可能有助于预测口腔癌前病变的恶性转化。
