口腔潜在恶性疾病:世界卫生组织合作中心口腔癌会议召集的国际研讨会关于命名和分类的共识报告。
Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer.
机构信息
The WHO Collaborating Centre for Oral Cancer and Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
UWA Dental School, The University of Western Australia, Perth, WA, Australia.
出版信息
Oral Dis. 2021 Nov;27(8):1862-1880. doi: 10.1111/odi.13704. Epub 2020 Nov 26.
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with "oral lichenoid lesions" and among those diagnosed with oral manifestations of 'chronic graft-versus-host disease'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
口腔潜在恶性疾病(OPMD)与唇或口腔癌发生的风险增加有关。本文根据英国世界卫生组织(WHO)口腔癌合作中心工作组的一次研讨会的讨论结果,主要基于其临床特征,就 OPMD 的命名和分类提出了一份最新报告。2005 年在伦敦举行的第一次研讨会考虑了一个广泛的疾病谱,使用术语“口腔黏膜潜在恶性疾病”(PMD)(现在称为口腔潜在恶性疾病:OPMD),包括白斑、红斑、增殖性疣状白斑、口腔扁平苔藓、口腔黏膜下纤维化、逆吸烟者的腭部病变、红斑狼疮、大疱性表皮松解症和先天性角化不良。在此期间发表的任何新证据都被认为对 2007 年的分类进行了必要的更改。在本次更新中,大多数实体都保留了其定义的微小变化。有足够的证据表明,诊断为“口腔类病损”和口腔表现为“慢性移植物抗宿主病”的患者发生口腔癌的风险增加。这些现在已被添加到 OPMD 列表中。目前,关于慢性增生性念珠菌病和口腔外生性疣状增生的恶性潜能的证据不足,不足以将这些情况视为 OPMD。此外,由于大疱性表皮松解症缺乏 OPMD 的明确证据,因此将其移至证据有限的类别。我们建议建立一个全球性的研究联盟,根据这里提出的分类和命名法,进一步研究 OPMD 的自然史。这将需要多中心的纵向研究,使用统一的诊断标准,以提高 OPMD 患者的识别和癌症风险分层,将其与基于证据的干预措施联系起来,以促进唇和口腔癌的预防和管理。