Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2019 Mar;58(3):296-301. doi: 10.1111/ijd.14215. Epub 2018 Sep 14.
Oral lichen planus (OLP) is a chronic inflammatory condition of the oral mucosa. Multiple studies have shown that approximately 1% of patients with OLP will develop oral squamous cell carcinoma (OSCC), however, no study has taken a population-based multicenter approach to demonstrate this association. Our main objective was to determine the incidence of OSCC in OLP in a specific population and secondarily to assist physicians regarding appropriate long-term monitoring of patients with OLP.
We conducted a population-based retrospective cohort study. Patients with OLP from 1986 through 2010 were identified using the Rochester Epidemiology Project (REP) for Olmsted County, Minnesota. For each OLP case (n = 303), we randomly selected two age- and gender-matched referents (n = 606). OLP diagnosis was established based on the World Health Organization (WHO) criteria. Medical records were reviewed for development of OSCCafter the OLP diagnosis (index date). The association between OLP and development of OSCC was assessed.
In total, 303 patients with incident OLP were identified; the overall incidence of OLP per 100,000 person-years was 11.4 (95% CI, 10.1-12.7). Among the OLP cohort, 7 had OSCC (incidence of OSCC, 3.1%; 95% CI, 0.6-6.4%) at 20 years after OLP diagnosis. Three OSCC cases were identified among the referents. Patients with OLP were 4.8 times more likely to have OSCC than the matched referents. The median time to OSCC development was 14.7 years earlier for the OLP cohort.
Patients with OLP, particularly the erosive type, have an increased incidence of OSCC development and should be monitored closely.
口腔扁平苔藓（OLP）是一种口腔黏膜的慢性炎症性疾病。多项研究表明，大约 1%的 OLP 患者会发展为口腔鳞状细胞癌（OSCC），但尚无研究采用基于人群的多中心方法来证明这种关联。我们的主要目的是确定特定人群中 OLP 发生 OSCC 的发生率，并为医生提供关于 OLP 患者进行适当长期监测的建议。
我们进行了一项基于人群的回顾性队列研究。通过明尼苏达州罗彻斯特流行病学项目（REP）识别了 1986 年至 2010 年间患有 OLP 的患者。对于每个 OLP 病例（n=303），我们随机选择了两个年龄和性别匹配的对照者（n=606）。OLP 诊断基于世界卫生组织（WHO）标准。在 OLP 诊断后（索引日期），对发生 OSCC 的情况进行了病历回顾。评估了 OLP 与 OSCC 发展之间的关联。
共确定了 303 例新诊断的 OLP 患者；OLP 每 100,000 人年的总发生率为 11.4（95%CI，10.1-12.7）。在 OLP 队列中，7 例患者在 OLP 诊断后 20 年内发生了 OSCC（OSCC 发生率为 3.1%，95%CI，0.6-6.4%）。在对照者中发现了 3 例 OSCC 病例。OLP 患者发生 OSCC 的可能性是匹配对照者的 4.8 倍。OLP 队列中 OSCC 发展的中位时间提前了 14.7 年。
OLP 患者，特别是糜烂型患者，发生 OSCC 的风险增加，应密切监测。
