Oral & Maxillofacial Surgery, University of Toronto, Toronto, Ontario, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Head Neck. 2021 Nov;43(11):3552-3561. doi: 10.1002/hed.26851. Epub 2021 Sep 1.
Factors that increase the risk of malignant transformation of oral epithelial dysplasia (OED) are not completely elucidated.
A retrospective chart review was performed assessing risk factors for transformation of OED, and cancer staging for transformed cases at Sunnybrook Health Sciences Centre.
Two-hundred four patients were diagnosed with OED, and 16.7% (34) underwent malignant transformation. Risk factors associated with transformation included: heavy tobacco smoking, excessive EtOH consumption, non-homogenous leukoplakia, size >200 mm , moderate dysplasia or greater than moderate, progression of dysplasia grades, and immunosuppression. Transformed cases followed for a dysplastic lesion were associated with a stage-I cancer diagnosis, and cancer cases with no prior biopsy were associated with a stage-IV diagnosis.
In addition to commonly cited risk factors, immunosuppression was associated with malignant transformation, including the use of topical steroids. Analyzing risk factors can help clinicians define risk of progression in patients with OED.
导致口腔上皮异型增生（OED）恶变的因素尚未完全阐明。
对 Sunnybrook 健康科学中心 OED 恶变患者的相关危险因素和癌变病例的癌症分期进行回顾性图表分析。
204 例患者被诊断为 OED，其中 16.7%（34 例）发生恶性转化。与恶变相关的危险因素包括：重度吸烟、大量饮酒、非均质性白斑、＞200mm 大小、中重度异型增生或以上、异型增生分级进展以及免疫抑制。随访观察到有异型增生病变的恶变病例与 I 期癌症诊断相关，而无先前活检的癌症病例与 IV 期诊断相关。
除了常见的危险因素外，免疫抑制与恶性转化相关，包括使用局部皮质类固醇。分析危险因素有助于临床医生评估 OED 患者的进展风险。
