Chiang Wei-Fan, Liu Shyun-Yeu, Lin Jen-Fen, Chiu Sheng-Fu, Gou Shin-Bin, Chiou Chang-Ta, Chang Chi-Hua
Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center, Liouying, Taiwan.
School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
Head Neck. 2020 Jan;42(1):67-76. doi: 10.1002/hed.25973. Epub 2019 Oct 7.
Although survival rate and quality of life are improved if patients with oral carcinoma can be detected early, however, such lesions are usually asymptomatic; therefore, it is hard to raise awareness. Screening has proved to be cost-effective for early detection.
Sixty-two patients with oral carcinomas and 555 patients with oral potentially malignant disorders (OPMDs) who were detected through screening were examined the relationship between clinicopathological features and follow-up outcomes.
The 5-year cumulative cancer-free interval rate was 94.1%, and the annual malignant transformation rate was 1.16%. The rate of interval carcinoma development from Candida hyperplasia, oral submucous fibrosis, homogeneous leukoplakia, non-homogenous leukoplakia, and verrucous hyperplasia, was 13.6%, 5.7%, 4.6%, 12.1%, and 21.3%, respectively. Significant independent risk factors for interval carcinoma development were heavy betel quid chewing, verrucous hyperplasia, and surgery refusal.
Well-designed risk assessment, treatment, and surveillance program could lead to earlier cancer detection and thereby reduce mortality and morbidity.
尽管口腔癌患者若能早期发现，生存率和生活质量会得到改善，然而，此类病变通常无症状；因此，难以提高人们的认识。筛查已被证明对早期发现具有成本效益。
对通过筛查发现的62例口腔癌患者和555例口腔潜在恶性疾病（OPMDs）患者进行了临床病理特征与随访结果之间关系的研究。
5年累积无癌间隔率为94.1%，年恶变率为1.16%。念珠菌增生、口腔黏膜下纤维化、均质型白斑、非均质型白斑和疣状增生发展为间隔癌的发生率分别为13.6%、5.7%、4.6%、12.1%和21.3%。间隔癌发生的显著独立危险因素为重度嚼槟榔、疣状增生和拒绝手术。
精心设计的风险评估、治疗和监测方案可实现癌症的早期发现，从而降低死亡率和发病率。
