Staines K, Rogers H
Oral Medicine, Bristol Dental Hospital and School, Lower Maudlin Street, Bristol, BS1 2LY, United Kingdom.
Br Dent J. 2017 Dec;223(9):655-661. doi: 10.1038/sj.bdj.2017.881. Epub 2017 Nov 3.
Objectives To provide an overview of the current thinking in terms of the diagnosis and management of oral leukoplakia and proliferative verrucous leukoplakia as relevant to general dental practitioners.Data sources, data selection, data extraction, data synthesis We searched the MEDLINE Ovid, EMBASE databases and the Cochrane Library, (1990 to 16 April 2017), restricting our search to English language with the following key words: leukoplakia, white patch, proliferative verrucous leukoplakia, precancerous lesion, premalignant lesions, potentially malignant oral conditions and potentially malignant oral disorders. The two authors selected key papers and engaged in collaborative data extraction and synthesis of the selected reference material.Conclusions General dental practitioners (GDPs) are likely to encounter patients with a known or yet undiagnosed oral leukoplakia in their clinical practice. The diagnosis is clinically based as there are no pathognomonic histopathological features. The definition of leukoplakia has evolved over the years. The importance of recognition and appropriate management relating to this condition is described particularly as it is one of the oral potentially malignant lesions. The inferred increased risk of malignant transformation is well documented however controversy still persists in terms of the appropriate management for these lesions. Proliferative verrucous leukoplakia is a recalcitrant, often widespread and multifocal distinct type of leukoplakia. It is considered to have a high rate of malignant transformation with implications in terms of lifelong monitoring both clinically and histopathologically. A high index of suspicion is important for general dental practitioners in order to identify such lesions that would require onward referral for further investigation and management.
目的 概述与普通牙科医生相关的口腔白斑和增殖性疣状白斑的诊断及管理方面的当前思路。
数据来源、数据选择、数据提取、数据合成 我们检索了MEDLINE Ovid、EMBASE数据库及Cochrane图书馆（1990年至2017年4月16日），将检索限制为英文，使用以下关键词：白斑、白色斑块、增殖性疣状白斑、癌前病变、潜在恶性口腔病变和潜在恶性口腔疾病。两位作者选择了关键论文，并共同进行了所选参考文献的数据提取和合成。
结论 普通牙科医生在临床实践中可能会遇到已知或尚未诊断出的口腔白斑患者。由于没有特征性的组织病理学特征，诊断基于临床。多年来白斑的定义已经演变。特别描述了识别和适当管理这种疾病的重要性，因为它是口腔潜在恶性病变之一。虽然恶性转化风险增加的推断有充分记录，但对于这些病变的适当管理仍存在争议。增殖性疣状白斑是一种顽固的、通常广泛且多灶性的独特类型的白斑。它被认为具有高恶性转化率，这在临床和组织病理学的终身监测方面都有影响。对于普通牙科医生来说，高度怀疑指数很重要，以便识别那些需要进一步转诊进行进一步调查和管理的病变。
