口腔潜在恶性疾病中微浸润癌风险因素分析：一项横断面研究。

Profiling risk factors of micro-invasive carcinoma within oral potentially malignant disorders: a cross-sectional study.

机构信息

Department of Oral and Maxillofacial-Head and Neck Oncology, Fengcheng Hospital, Fengxian District, Shanghai, China.

Department of Oral and Maxillofacial-Head and Neck Oncology, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Clin Oral Investig. 2020 Oct;24(10):3715-3720. doi: 10.1007/s00784-020-03568-y. Epub 2020 Sep 9.

DOI:10.1007/s00784-020-03568-y

PMID:32902677

Abstract

OBJECTIVES

To investigate the clinicopathological profile and risk factors of micro-invasive carcinoma within oral potentially malignant disorders (OPMD).

METHODS

Micro-invasive carcinomas were identified in a large prospective series of OPMD patients (n = 810) from eastern China. Logistic regression was applied to evaluate odds ratios (OR) with 95% confidence interval (CI) for indicative of malignant risk in general OPMD.

RESULTS

Leukoplakia (41.4%), lichen planus (28.0%), and lichenoid lesion (23.7%) were the most 3 clinical subtypes of OPMD. A total of 62 (7.7%) micro-invasive carcinomas within OPMD were identified, and 96.8% of micro-invasive carcinoma was found within leukoplakia and erythroplakia. Multivariate regression analysis revealed that the risk of malignant change within OPMD located on lateral/ventral tongue (OR, 15.1; 95% CI, 1.85-122.8; P = 0.011) was higher than other sites. The risk of malignant change within non-homogenous type (OR, 103.3; 95% CI, 13.39-796.7; P < 0.001) was strikingly higher than other subtypes of OPMD, respectively. Intriguingly, the risk of micro-invasive carcinoma diagnosed in current smoker (OR, 3.96; 95% CI, 1.31-12.02; P = 0.015) was higher than non-smoker.

CONCLUSION

This large-scale cross-sectional study elucidated the clinical factors and risk assessment of micro-invasive carcinoma within OPMD.

CLINICAL RELEVANCE

Non-homogenous lesions located on lateral/ventral tongue might be monitored at closer intervals, and the need for rigorous management to detect malignant changes.

摘要

目的

研究口腔潜在恶性疾病（OPMD）内微浸润性癌的临床病理特征和危险因素。

方法

在中国东部的一项大型前瞻性 OPMD 患者（n=810）系列中确定了微浸润性癌。应用逻辑回归评估一般 OPMD 中指示恶性风险的优势比（OR）及其 95%置信区间（CI）。

结果

白斑（41.4%）、扁平苔藓（28.0%）和类扁平苔藓病变（23.7%）是 OPMD 最常见的 3 种临床亚型。在 OPMD 中总共发现了 62 例（7.7%）微浸润性癌，其中 96.8%的微浸润性癌发生在白斑和红斑中。多变量回归分析显示，位于侧/腹舌部的 OPMD 发生恶性变化的风险（OR，15.1；95%CI，1.85-122.8；P=0.011）高于其他部位。非均质型（OR，103.3；95%CI，13.39-796.7；P<0.001）发生恶性变化的风险明显高于其他 OPMD 亚型。有趣的是，当前吸烟者（OR，3.96；95%CI，1.31-12.02；P=0.015）诊断为微浸润性癌的风险高于非吸烟者。