More Chandramani B, Rao Naman R
Department of Oral Medicine and Maxillofacial Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth University, Piparia, Vadodara, Gujarat State, India.
Harvard Medical School, Boston, MA, USA.
J Oral Biol Craniofac Res. 2019 Oct-Dec;9(4):311-314. doi: 10.1016/j.jobcr.2019.06.016. Epub 2019 Jul 2.
Oral Submucous Fibrosis (OSMF) is an insidious, chronic, complex, crippling, debilitating, irreversible, progressive, scarring, potentially malignant and collagen metabolic disorder, induced by a known carcinogen areca nut; wherein the oral mucosa, and occasionally the pharynx and esophagus is subjected to various pathological changes with significant clinical manifestations at different stages of progression, leading to functional morbidity; and with a risk of malignant transformation in the overlying epithelium. Although the condition is mainly diagnosed based on classic clinical manifestations, the commonly used existing definition for oral submucous fibrosis is primarily based on histological features. The authors have conducted extensive clinical research studies on OSMF and intends to propose a new clinical definition as 'a debilitating, progressive, irreversible collagen metabolic disorder induced by chronic chewing of areca nut and its commercial preparations; affecting the oral mucosa and occasionally the pharynx and esophagus; leading to mucosal stiffness and functional morbidity; and has a potential risk of malignant transformation.' Thus, a new clinical definition is put forward so as to assist the academicians, researchers and clinicians in terming and grouping this disease according to its clinical and biological behaviour for its subsequent management.
口腔黏膜下纤维化（OSMF）是一种隐匿性、慢性、复杂、致残、使人衰弱、不可逆、进行性、瘢痕性、具有潜在恶性的胶原代谢紊乱疾病，由已知致癌物槟榔诱发；其中口腔黏膜，偶尔还有咽和食管在疾病进展的不同阶段会出现各种病理变化，并伴有明显的临床表现，导致功能障碍；且其上皮存在恶变风险。尽管该病主要依据典型临床表现进行诊断，但现有的口腔黏膜下纤维化常用定义主要基于组织学特征。作者对OSMF进行了广泛的临床研究，并打算提出一个新的临床定义，即“一种因长期咀嚼槟榔及其商业制品而导致的使人衰弱、进行性、不可逆的胶原代谢紊乱疾病；累及口腔黏膜，偶尔累及咽和食管；导致黏膜僵硬和功能障碍；并具有恶变的潜在风险”。因此，提出这一新的临床定义，以协助院士、研究人员和临床医生根据该疾病的临床和生物学行为对其进行命名和分类，以便后续管理。
