Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.
Clin Oral Investig. 2021 Apr;25(4):2249-2256. doi: 10.1007/s00784-020-03541-9. Epub 2020 Aug 25.
Oral submucous fibrosis (OSF) is an oral mucous disease caused by betel quid chewing. It is controversial whether OSF can transform into oral squamous cell carcinoma (OSCC).
In this prospective study, a group of 567 patients with OSF were enrolled from 1986 to 2017 and followed-up until 2019. The cancerous information was collected and analyzed.
OSF transformed into OSCC in 32 cases (32/567, 5.6%). The patient's age ranged from 20 to 69 years, and the average age was 52 years. The time taken for transformation ranged from 2 to 24 years, the average being 8.6 years. The cancerous transformation occurred in 18 patients (56%) from years 2 to 9, in 13 patients (41%) from years 10-19 and in 1 patient (3%) from 24 years. We analyzed the betel quid chewing habits and found all 32 patients with OSCC-chewed betel quid. Betel quid chewing was most prevalent in patients aged 40-69 years. Sixteen patients had chewed betel quid for 10-19 years (16/32, 50%) and 19 patients (60%) chewed 10-19 slices each day. The OSCC was located in the left or right buccal regions in 23 patients (23/32; 72%) and in the left or right lingual regions in 4 patients (4/32; 12%). Well, moderately and poorly differentiated squamous cell carcinoma was present in 23 patients (23/32; 72%), 4 patients (3/32; 9%), and 5 patients (5/32; 16%), respectively.
Our findings supported that OSF is a real oral premalignant disorder.
The long duration of the transformation from the OSF to OSCC suggests more frequent examinations and corresponding treatments are necessary for OSF patients.
口腔黏膜下纤维性变（OSF）是一种由咀嚼槟榔引起的口腔黏膜疾病。OSF 是否会转化为口腔鳞状细胞癌（OSCC）存在争议。
本前瞻性研究纳入了 1986 年至 2017 年间的 567 例 OSF 患者，并随访至 2019 年。收集并分析了癌症相关信息。
32 例（5.6%）OSF 转化为 OSCC。患者年龄 20-69 岁，平均 52 岁。转化时间 2-24 年，平均 8.6 年。癌症转化发生在 2 年的 18 例患者（56%）、10-19 年的 13 例患者（41%）和 24 年的 1 例患者（3%）。我们分析了嚼槟榔习惯，发现所有 32 例 OSCC 患者均嚼槟榔。40-69 岁患者嚼槟榔最为普遍。16 例患者嚼槟榔 10-19 年（16/32，50%），19 例患者（60%）每天嚼 10-19 片。23 例患者（23/32；72%）的 OSCC 位于左侧或右侧颊部，4 例患者（4/32；12%）位于左侧或右侧舌部。23 例患者（23/32；72%）为高分化鳞状细胞癌，4 例患者（3/32；9%）为中分化鳞状细胞癌，5 例患者（5/32；16%）为低分化鳞状细胞癌。
我们的研究结果支持 OSF 是一种真正的口腔癌前病变。
从 OSF 到 OSCC 的转化时间较长，提示 OSF 患者需要更频繁的检查和相应的治疗。
