School of Dentistry, University of Granada, Granada, Spain.
Biohealth Research Institute (IBS), Granada, Spain.
Oral Dis. 2021 Nov;27(8):1919-1935. doi: 10.1111/odi.13812. Epub 2021 Mar 11.
A systematic review of systematic reviews-aka overview of reviews, a novel type of study design providing a tertiary level of evidence-is presented on systematic reviews (SR) and meta-analyses (MTA) evaluating the cancer development in oral lichen planus (OLP), oral lichenoid lesions (OLL), and oral lichenoid reactions (OLR). We searched for SR-MTA published before January 2021. We evaluated the methodological quality of SR-MTA using AMSTAR2 and checked the quality of evidence. Inclusion criteria were met by seven SR-MTA. Oral cancer ratios ranged between 0.44% and 2.28% for OLP, between 1.88% and 3.80% for OLL, and 1.71% for OLR. Significant factors on cancer development reported in SR-MTA were the presence of epithelial dysplasia, the consumption of tobacco and alcohol, the infection by the hepatitis C virus, the presence of atrophic and erosive lesions, and the location on the tongue. Only, one of the SRs assessed the quality of evidence, and most of them were judged to be of critically low methodological quality. In conclusion, based on the reported evidence on cancer incidence in OLP, our results reaffirm classifying OLP as an oral potentially malignant disorder. In relation to OLLs and OLRs, larger studies are necessary to provide further scientific evidence in this regard. Future follow-up studies on OLP and related lesions should be carried out under stricter criteria that improve their quality of evidence and methodological quality.
一项系统综述——又名综述概述,是一种新型的研究设计,提供了三级证据水平——介绍了关于口腔扁平苔藓 (OLP)、口腔类扁平苔藓病变 (OLL) 和口腔类扁平苔藓反应 (OLR) 中癌症发展的系统评价 (SR) 和荟萃分析 (MTA)。我们搜索了截至 2021 年 1 月之前发表的 SR-MTA。我们使用 AMSTAR2 评估了 SR-MTA 的方法学质量,并检查了证据质量。有七项 SR-MTA 符合纳入标准。OLP 的口腔癌比例在 0.44%至 2.28%之间,OLL 的口腔癌比例在 1.88%至 3.80%之间,OLR 的口腔癌比例为 1.71%。SR-MTA 中报告的癌症发展的显著因素包括上皮异型增生、吸烟和饮酒、丙型肝炎病毒感染、萎缩性和侵蚀性病变的存在以及舌部位置。只有一项 SR 评估了证据质量,而且它们大多被认为具有严重的低方法学质量。总之,根据 OLP 癌症发病率的报告证据,我们的结果再次证实将 OLP 归类为口腔潜在恶性疾病。关于 OLLs 和 OLRs,需要进行更大规模的研究,以提供这方面的进一步科学证据。应在更严格的标准下对 OLP 和相关病变进行未来的随访研究,以提高其证据质量和方法学质量。
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