Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain.
King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.
J Oral Pathol Med. 2021 Nov;50(10):962-970. doi: 10.1111/jop.13200. Epub 2021 Jun 9.
To discuss the terminology to define and classify actinic cheilitis (AC) and to build a consensus on the diagnostic and therapeutic approaches to AC.
Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts' agreement was rated using a Likert scale (1-7).
A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6-7)) and the lowest dispersion (VC = 21.33). 'Potentially malignant disorder' was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV < 50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4-7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5-7), particularly by inspection and palpation (median: 5; IQR: 4-6). Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5-7), even for homogeneous lesions (median: 5; IQR: 3.5-6). Consensus was reached on all treatment statements (VC < 50).
AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorder.
讨论光化性唇炎（AC）的术语定义和分类，并就 AC 的诊断和治疗方法达成共识。
采用问卷进行两轮德尔菲研究，问卷包括 34 个封闭句（9 个关于术语和分类，5 个关于恶性转化的可能性，12 个关于诊断方面，8 个关于治疗）和 8 个开放式问题。使用李克特量表（1-7 分）对专家的意见进行评分。
在 34 个陈述中有 24 个达成共识（73.5%），8 个封闭式问题中有 5 个达成共识（62.5%）。两轮的回复率相同（流失率为 0%）。AC 是最具共识的术语（中位数为 7（强烈同意；IQR：6-7）），分散度最低（VC=21.33）。“潜在恶性疾病”是 AC 的首选分类组（中位数为 7），62.5%的参与者表示有一定程度的同意（CV<50）。专家（66.75%）认为 AC 是一个临床术语（中位数：7；IQR：4-7），并认为可以通过临床检查（中位数：6；IQR：5-7），特别是通过观察和触诊（中位数：5；IQR：4-6）做出明确诊断。组织病理学确认对于 AC 的管理是强制性的（中位数：5；IQR：2.5-7），即使是对于同质病变（中位数：5；IQR：3.5-6）也是如此。所有治疗陈述都达成了共识（CV<50）。
AC 是一种潜在的恶性疾病，在诊断标准、程序、活检指征以及协助活检的技术重要性方面存在严重的不一致意见。在该疾病的命名和管理方面达成了共识。
