评估先前患有口腔鳞状细胞癌的患者口腔白斑恶变的风险。

Risk assessment of malignant transformation of oral leukoplakia in patients with previous oral squamous cell carcinoma.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology-Head and Neck Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.

Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Int J Oral Maxillofac Surg. 2022 Nov;51(11):1394-1400. doi: 10.1016/j.ijom.2022.02.006. Epub 2022 Mar 3.

DOI:10.1016/j.ijom.2022.02.006

PMID:35249786

Abstract

The aim of this study was to identify the risk factors associated with developing oral squamous cell carcinoma (OSCC) from surgically excised oral leukoplakia (OL) in patients with previous oral cavity cancer. Clinicopathological data of 84 patients who were treated for OL between July 2002 and July 2020 and who had previously received treatment for OSCC were reviewed retrospectively. The follow-up time ranged from 0.69 to 17.99 years (mean 6.78 ± 4.25 years). The overall cumulative malignant transformation rate was 25% and the annual transformation rate was 5.73%. Kaplan-Meier survival analysis and the log-rank test showed that Candida infection (P = 0.010) was a risk factor associated with malignant transformation. In the multivariate Cox regression analysis, tongue and floor of the mouth as the location of the leukoplakia (P = 0.039), multifocal lesions of OL (P = 0.047), and Candida infection (P = 0.018) were the three independent prognostic factors related to the development of OSCC from the treated OL. A cautious approach to OL of the tongue with Candida infection or multifocal disease in this group of patients would be appropriate.

摘要

本研究旨在确定与既往口腔癌患者手术切除口腔白斑（OL）后发生口腔鳞状细胞癌（OSCC）相关的风险因素。回顾性分析了 2002 年 7 月至 2020 年 7 月期间因 OL 接受治疗且既往接受过 OSCC 治疗的 84 例患者的临床病理资料。随访时间为 0.69 至 17.99 年（平均 6.78 ± 4.25 年）。总的累积恶变率为 25%，年转化率为 5.73%。Kaplan-Meier 生存分析和对数秩检验显示，念珠菌感染（P = 0.010）是与恶变相关的危险因素。多因素 Cox 回归分析显示，白斑位于舌部和口底（P = 0.039）、OL 多灶性病变（P = 0.047）和念珠菌感染（P = 0.018）是与治疗后 OL 发生 OSCC 相关的三个独立预后因素。对于这组患者中舌部伴有念珠菌感染或多灶性疾病的 OL，应谨慎处理。