Gonzalez-Moles M A, Gil-Montoya J A, Ruiz-Avila I, Bravo M
School of Dentistry, Instituto de Biomedicina de Granada, University of Granada, Granada, Spain.
Unidad de Gestión Clínica de Anatomía Patológica, Instituto de Biomedicina de Granada Complejo Hospitalario San Cecilio, Granada, Spain.
J Oral Pathol Med. 2017 Feb;46(2):148-153. doi: 10.1111/jop.12480. Epub 2016 Jul 18.
Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are considered potentially malignant disorders with a cancer incidence of around 1% of cases, although this estimation is controversial. The aim of this study was to analyze the cancer incidence in a case series of patients with OLP and OLL and to explore clinicopathological aspects that may cause underestimation of the cancer incidence in these diseases.
A retrospective study was conducted of 102 patients diagnosed with OLP (n = 21, 20.58%) or OLL (n = 81) between January 2006 and January 2016. Patients were informed of the risk of malignization and followed up annually. The number of sessions programmed for each patient was compared with the number actually attended. Follow-up was classified as complete (100% attendance), good (75-99%), moderate (25-74%), or poor (<25% attendance) compliance.
Cancer was developed by four patients (3.9%), three males and one male. One of these developed three carcinomas, which were diagnosed at the follow-up visit (two in lower gingiva, one in floor of mouth); one had OLL and the other three had OLP. The carcinoma developed in mucosal areas with no OLP or OLL involvement in three of these patients, while OLP and cancer were diagnosed simultaneously in the fourth. Of the six carcinomas diagnosed, five (83.3%) were T1 and one (16.7%) T2. None were N+, and all patients remain alive and disease-free.
The cancer incidence in OLP and OLL appears to be underestimated due to the strict exclusion criteria usually imposed.
口腔扁平苔藓（OLP）和口腔苔藓样病变（OLL）被认为是潜在恶性疾病，癌症发生率约为1%，尽管这一估计存在争议。本研究旨在分析一组OLP和OLL患者的癌症发生率，并探讨可能导致这些疾病癌症发生率被低估的临床病理因素。
对2006年1月至2016年1月期间诊断为OLP（n = 21，20.58%）或OLL（n = 81）的102例患者进行回顾性研究。告知患者恶变风险并每年进行随访。将为每位患者安排的就诊次数与实际就诊次数进行比较。随访分为完全依从（100%就诊）、良好依从（75 - 99%）、中等依从（25 - 74%）或差依从（<25%就诊）。
4例患者（3.9%）发生癌症，3例男性和1例女性。其中1例发生3种癌症，在随访时被诊断出来（2例在下牙龈，1例在口底）；1例患有OLL，另外3例患有OLP。在其中3例患者中，癌症发生在无OLP或OLL累及的黏膜区域，而第4例患者OLP和癌症同时被诊断出来。在诊断出的6种癌症中，5种（83.3%）为T1期，1种（16.7%）为T2期。均无N +，所有患者均存活且无疾病。
由于通常采用的严格排除标准，OLP和OLL的癌症发生率似乎被低估了。
