增殖性疣状白斑的管理：保守治疗方法的依据
Management of proliferative verrucous leukoplakia: Justification for a conservative approach.
作者信息
Borgna Scott C, Clarke Peter T, Schache Andrew G, Lowe Derek, Ho Michael W, McCarthy Caroline E, Adair Stephen, Field E Anne, Field John K, Holt Deborah, Risk Janet M, Rajlawat Bijay P, Triantafyllou Asterios, Shaw Richard J
机构信息
Royal Brisbane and Women's Hospital Metro North Hospital and Health Service, Department of Oral and Maxillofacial Surgery, Brisbane, Queensland, Australia.
Department of Restorative Dentistry, Central Manchester Foundation Trust, Manchester, United Kingdom.
出版信息
Head Neck. 2017 Oct;39(10):1997-2003. doi: 10.1002/hed.24845. Epub 2017 Jun 22.
BACKGROUND
Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic.
METHOD
Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset.
RESULTS
Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative.
CONCLUSION
Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.
背景
增殖性疣状白斑（PVL）是一种具有高恶变率的进行性、多灶性、外生性白斑形式。本研究的目的是评估一家三级转诊诊所中一组PVL患者。
方法
对符合公认诊断标准的病例进行病理学、人口统计学特征、治疗及结局方面的回顾。对一部分病例进行了人乳头瘤病毒（HPV）检测。
结果
48例PVL患者中近一半（48%；n = 23）在中位时间23.4个月后发生恶变。该队列的特征与先前描述的相似，但治疗明显更为保守。92%的患者采用了PVL的保守治疗，但临床结局似乎与先前描述的以手术切除为主治疗PVL的队列相当。所有HPV检测均为阴性。
结论
在PVL的癌前阶段进行积极的手术干预可能不会影响恶变率。
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