González-Moles Miguel Ángel, Ramos-García Pablo, Warnakulasuriya Saman
School of Dentistry, University of Granada, 18010 Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.
Cancers (Basel). 2021 Jul 21;13(15):3669. doi: 10.3390/cancers13153669.
Proliferative verrucous leukoplakia (PVL) is considered as an oral potentially malignant disorder (OPMD) that presents with a high tendency to recurrence after treatment and has the highest malignant transformation ratio among all OPMD (50%). Evidence-based publications have indicated that the malignant evolution reported is significantly related to the inconsistent diagnostic criteria used in primary-level studies; so, it has been hypothesized that the risk of oral cancer for this disease could even be underestimated. This is important because PVL requires specific management protocols, evidence-based, aimed at the early diagnosis of cancer developing in these lesions. We present a scoping review-a novel approach to mapping the available literature on a given topic to provide an overview of the available research evidence and to highlight possible gaps in the evidence-especially related in our study to the diagnostic aspects of PVL, and to issue a conceptual proposal and diagnostic criteria for PVL. We conclude that PVL is a white, multifocal and progressive lesion with a high malignant transformation rate which is diagnosed mainly around the age of 60 years without any specific histological characterization. We also advise a personal reflection on the level of certainty with which the clinician makes the diagnosis of a particular case of PVL.
增殖性疣状白斑（PVL）被视为一种口腔潜在恶性疾病（OPMD），其治疗后复发倾向较高，且在所有OPMD中具有最高的恶变率（50%）。循证出版物表明，所报道的恶性进展与基层研究中使用的诊断标准不一致显著相关；因此，有人推测这种疾病的口腔癌风险甚至可能被低估。这一点很重要，因为PVL需要特定的循证管理方案，旨在早期诊断这些病变中发生的癌症。我们进行了一项范围综述——一种绘制给定主题可用文献的新方法，以提供现有研究证据的概述，并突出证据中可能存在的差距——在我们的研究中尤其与PVL的诊断方面相关，并发布了PVL的概念提案和诊断标准。我们得出结论，PVL是一种白色、多灶性且进行性的病变，恶变率高，主要在60岁左右被诊断出来，没有任何特定的组织学特征。我们还建议临床医生对诊断特定PVL病例时的确定程度进行个人反思。
