Chiang Chun-Pin, Yu-Fong Chang Julia, Wu Yu-Hsueh, Sun Andy, Wang Yi-Ping, Chen Hsin-Ming
Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
J Dent Sci. 2018 Mar;13(1):68-74. doi: 10.1016/j.jds.2018.02.001. Epub 2018 Mar 21.
BACKGROUND/PURPOSE: Previous studies showed that approximately 13-15% of male oral submucous fibrosis (OSF) patients are serum gastric parietal cell antibody (GPCA)-positive. This study assessed whether serum GPCA or OSF itself was a significant factor that caused hematinic deficiencies and anemia statuses in GPCA-positive or GPCA-negative OSF patients (GPCA/OSF and GPCA/OSF patients).
The frequencies of macrocytosis (mean corpuscular volume or MCV ≧ 100 fL) and blood hemoglobin (Hb), iron, vitamin B12 and folic acid deficiencies were determined and compared between any two of the four groups of 149 male OSF, 23 male GPCA/OSF, and 126 male GPCA/OSF patients and 149 age-matched male healthy control subjects.
All three groups of OSF patients (including 149 OSF, 23 GPCA/OSF, and 126 GPCA/OSF patients) had a significantly higher frequency of Hb, vitamin B12, or folic acid deficiency and of macrocytosis than 149 healthy control subjects (all -values < 0.05). The 23 GPCA/OSF patients did have a significantly lower mean serum vitamin B12 level and a significantly higher MCV or frequency of vitamin B12 deficiency than the 126 GPCA/OSF patients. Two of the 23 GPCA/OSF patients had pernicious anemia. Of the 126 GPCA/OSF patients, 6 had macrocytic anemia, 2 had iron deficiency anemia, and 4 had thalassemia trait-induced anemia.
We conclude that OSF itself does play a significant role in causing hematinic deficiencies and anemia in OSF, GPCA/OSF, and GPCA/OSF patients. The serum GPCA is the major factor that causes vitamin B12 deficiency, macrocytosis, and pernicious anemia in GPCA/OSF patients.
背景/目的：先前的研究表明，约13%-15%的男性口腔黏膜下纤维化（OSF）患者血清胃壁细胞抗体（GPCA）呈阳性。本研究评估血清GPCA或OSF本身是否是导致GPCA阳性或GPCA阴性OSF患者（GPCA⁺/OSF和GPCA⁻/OSF患者）出现造血物质缺乏和贫血状态的重要因素。
在149例男性OSF患者、23例男性GPCA⁺/OSF患者、126例男性GPCA⁻/OSF患者和149例年龄匹配的男性健康对照者这四组人群中，两两比较大细胞性贫血（平均红细胞体积或MCV≧100fL）以及血红蛋白（Hb）、铁、维生素B12和叶酸缺乏的发生率。
所有三组OSF患者（包括149例OSF患者、23例GPCA⁺/OSF患者和126例GPCA⁻/OSF患者）的Hb、维生素B12或叶酸缺乏以及大细胞性贫血的发生率均显著高于149例健康对照者（所有P值<0.05）。23例GPCA⁺/OSF患者的血清维生素B12平均水平显著低于126例GPCA⁻/OSF患者，且维生素B12缺乏的MCV或发生率显著更高。23例GPCA⁺/OSF患者中有2例患有恶性贫血。126例GPCA⁻/OSF患者中，6例患有大细胞性贫血，2例患有缺铁性贫血，4例患有地中海贫血特质性贫血。
我们得出结论，OSF本身在导致OSF、GPCA⁺/OSF和GPCA⁻/OSF患者出现造血物质缺乏和贫血方面确实起重要作用。血清GPCA是导致GPCA⁺/OSF患者维生素B12缺乏、大细胞性贫血和恶性贫血的主要因素。
