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巴西 107 例口腔白斑的流行病学调查及组织化学分析。

Oral leukoplakia-epidemiological survey and histochemical analysis of 107 cases in Brazil.

机构信息

Post-Graduate Program in Oral Diagnosis, Faculty of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.

Faculty of Dentistry, University of Passo Fundo, Passo Fundo, Brazil.

出版信息

Clin Oral Investig. 2021 Apr;25(4):1859-1867. doi: 10.1007/s00784-020-03488-x. Epub 2020 Aug 6.

Abstract

OBJECTIVE

To perform an epidemiological survey comparing the cell proliferative activity of 107 cases of oral leukoplakia with their clinical and histopathological characteristics.

MATERIALS AND METHODS

A cross-sectional, observational, and histological-histochemical study. The cases came from the Histopathological Diagnostic Service of UPF/RS and the School of Dentistry of Araçatuba FOA/UNESP/SP (1986-2016). The histopathological sections were stained using the silver staining (AgNOR) technique and the nuclei of 100 epithelial cells selected randomly were recorded to count the number of nucleolar organizer regions (NORs). The mean NORs per lesion were correlated to clinical and histological characteristics using ANOVA, at 5% significance.

RESULTS

Most of the cases included men (62.62%), white (64.49%), and with an average age of 53.94 years. The most probable etiological factors were smoking (44.7%) and alcohol consumption (9.85%). The evolution time of most lesions was fast (33.65%), manifesting mainly in the form of plaques (70.37%) and without symptoms (58.88%). They were located mainly in the cheek mucosa (26.62%) and presented white color (66.35%), well-defined edges (59.81%), firm consistency (47.5%), and keratinized surface (49.53%). Etiological factor (p = 0.003), evolution time (p = 0.006), symptoms (p = 0.029), location (p = 0.020), consistency (p = 0.047), histopathological characteristics (p = 0.004), and superficial keratinization (p = 0.001) were statistically significant regarding the mean NORs of the leukoplakias studied.

CLINICAL RELEVANCE

Oral leukoplakias caused by alcohol consumption and/or tobacco use, considering an evolution time of fewer than 12 months, asymptomatic, located in the lower lip or tongue, and with a firm consistency and increased superficial keratinization should be treated more aggressively by the clinician to avoid cancerization.

摘要

目的

对 107 例口腔白斑患者的细胞增殖活性进行流行病学调查,并与临床和组织病理学特征进行比较。

材料和方法

这是一项横断面、观察性和组织化学研究。病例来自 UPF/RS 的组织病理学诊断服务和 Araçatuba FOA/UNESP/SP 的牙科学院(1986-2016 年)。使用银染(AgNOR)技术对组织病理学切片进行染色,随机选择 100 个上皮细胞的细胞核进行记录,以计算核仁组成区(NORs)的数量。使用方差分析(ANOVA)将病变的平均 NOR 与临床和组织学特征相关联,显著性水平为 5%。

结果

大多数病例为男性(62.62%)、白种人(64.49%),平均年龄为 53.94 岁。最可能的病因因素是吸烟(44.7%)和饮酒(9.85%)。大多数病变的演变时间较快(33.65%),主要表现为斑块(70.37%),无症状(58.88%)。它们主要位于颊黏膜(26.62%),呈白色(66.35%),边界清晰(59.81%),质地坚实(47.5%),表面角化(49.53%)。病因因素(p=0.003)、演变时间(p=0.006)、症状(p=0.029)、位置(p=0.020)、质地(p=0.047)、组织病理学特征(p=0.004)和表面角化(p=0.001)与研究的口腔白斑的平均 NOR 有统计学意义。

临床意义

由酒精和/或烟草使用引起的口腔白斑,考虑到少于 12 个月的演变时间、无症状、位于下唇或舌部、质地坚实和表面角化增加,临床医生应更积极地治疗,以避免癌变。

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