Department of Otolaryngology Head and Neck Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA.
Department of Diagnostic and Biological Sciences, University of Minnesota, 515 Delaware St SE, Minneapolis, MN 55455, USA.
Am J Otolaryngol. 2022 Jan-Feb;43(1):103270. doi: 10.1016/j.amjoto.2021.103270. Epub 2021 Oct 20.
Oral cancers lack standardized monitoring systems. Our institution has developed an active surveillance system which provides detailed monitoring and follow up of patients with oral preneoplastic lesions (OPL). We examined a historic cohort of patients with OPL seen by regional dental professionals and a current cohort of clinic patients. The major aim was to examine follow up practices for biopsy proven dysplasia to gauge appropriateness of an active monitoring system for oral carcinoma.
Questionnaires regarding patients with OPL were sent to 285 dentists who had requested oral pathology services from our institution. The follow up practices of 141 dentists were evaluated for patients with OPL. We then examined our current clinic referral patterns for the number of dental referrals after the creation of an oral carcinoma active surveillance clinic.
There were 76.5% (108/141) of patients who received follow up after diagnosis of preneoplastic oral lesions with 14.1% who underwent repeat biopsy. There was a malignant transformation rate of 11.3% including transformation of 42.8% of severe dysplasias into carcinoma within 2 years. After establishment of a dental referral clinic, 21.8% of tumor visits in a six-week period were referred from the regional dental community.
A high rate of transformation of OPL to cancer in this cohort may support a role for joint dental and otolaryngology surveillance of dysplasia with longitudinal follow up.
口腔癌缺乏标准化的监测系统。我们的机构开发了一种主动监测系统，为口腔癌前病变（OPL）患者提供详细的监测和随访。我们检查了一组由区域牙科专业人员观察的 OPL 患者的历史队列和当前的诊所患者队列。主要目的是检查活检证实的异型增生的随访实践，以评估口腔癌的主动监测系统的适当性。
向要求我们机构进行口腔病理学服务的 285 名牙医发送了有关 OPL 患者的问卷。评估了 141 名牙医的 OPL 患者的随访实践。然后，我们检查了我们当前的诊所转诊模式，以了解在创建口腔癌主动监测诊所后牙科转诊的数量。
有 76.5%（108/141）的患者在诊断为癌前口腔病变后接受了随访，其中 14.1%的患者进行了重复活检。恶性转化率为 11.3%，包括在 2 年内严重异型增生的转化率为 42.8%。在建立牙科转诊诊所后，在六周的时间内，21.8%的肿瘤就诊来自区域牙科社区。
在该队列中，OPL 向癌症的高转化率可能支持牙科和耳鼻喉科联合监测异型增生并进行纵向随访。
