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口腔白斑病的临床与组织病理学特征相关性研究。

Associations between clinical and histopathological characteristics in oral leukoplakia.

机构信息

Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Department of Otolaryngology/Head & Neck Surgery, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands.

出版信息

Oral Dis. 2023 Mar;29(2):696-706. doi: 10.1111/odi.14038. Epub 2021 Oct 14.

Abstract

OBJECTIVES

To identify possible associations between patients' demographics and habits and the clinical aspects and histopathological characteristics of oral leukoplakia (OL) at patients' first visit.

METHOD

A total of 140 consecutive patients with OL at a single institute between 1997 and 2019. All biopsies were microscopically examined for classic dysplasia (CD) (WHO definition oral epithelial dysplasia) and differentiated dysplasia (DD) known from differentiated vulvar intraepithelial neoplasia. Clinical characteristics were correlated to histopathological diagnosis and odds ratios (OR) were calculated.

RESULTS

A total of 96 females and 44 males, mean age 58 years, were presented. OLs were found mainly on the tongue (41%) and floor of mouth (FOM) (18%). Homogeneous OLs (58%) were associated with smoking, FOM and size <2cm and non-homogeneous OLs (42%) with non-smokers. No dysplasia was present in 40% and any dysplasia (AD) in 60%. Tongue OLs were correlated with AD (OR:6.0) and CD (OR:5.7). FOM OLs were correlated with CD (OR:4.5). DD was correlated with non-homogeneous OLs (OR:2.6).

CONCLUSIONS

CD was most frequently observed in tongue and FOM OLs, while DD was associated with non-homogeneous OLs. In this series of patients, there was no consistent reliable association between the clinical and histopathological features and clinical characteristics can therefore not substitute microscopic examination of biopsies.

摘要

目的

确定患者的人口统计学和习惯与口腔白斑(OL)患者首次就诊时的临床和组织病理学特征之间可能存在的关联。

方法

本研究共纳入了 1997 年至 2019 年期间在一家医院就诊的 140 例连续的 OL 患者。所有活检均进行了显微镜检查,以评估经典异型增生(CD)(WHO 定义的口腔上皮异型增生)和已知来源于分化型外阴上皮内瘤变的异型增生(DD)。对临床特征与组织病理学诊断进行了相关性分析,并计算了比值比(OR)。

结果

共纳入了 96 名女性和 44 名男性,平均年龄为 58 岁。OL 主要发生于舌部(41%)和口底(18%)。均质 OL(58%)与吸烟、口底和大小<2cm 相关,而非均质 OL(42%)与非吸烟者相关。40%的患者无异型增生,60%的患者存在任何异型增生(AD)。舌部 OL 与 AD(OR:6.0)和 CD(OR:5.7)相关。口底 OL 与 CD(OR:4.5)相关。DD 与非均质 OL 相关(OR:2.6)。

结论

CD 最常发生于舌部和口底 OL,而 DD 与非均质 OL 相关。在本系列患者中,临床和组织病理学特征之间没有一致的可靠关联,因此临床特征不能替代活检的显微镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0302/10078678/673bf16fb364/ODI-29-696-g003.jpg

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