Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Arch Oral Biol. 2022 Nov;143:105544. doi: 10.1016/j.archoralbio.2022.105544. Epub 2022 Sep 14.
The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC).
A search of the Cochrane Library, PubMed, Embase, Web of Science, Scopus, and Livivo databases was performed on June 12, 2022, which retrieved 152 records without duplicates. Studies that analyzed FC in biopsies in clinically normal tissue opposite to primary OSCC were included. The search was conducted under the PRISMA guideline and the protocol was registered in PROSPERO (CRD42017077125).
Eight articles with 302 patients were included, 192 men and 110 women, mean age 57.1 years. Most patients had deleterious habits. All studies performed histopathological confirmation of OSCC and biopsies were obtained the clinically normal mirror mucosa. The meta-analysis carried out with eight studies. The studies showed 57.3 % of cases with histopathological changes of clinically normal mucosa opposite to primary OSCC (Confidence interval 95 %, 0.443-0.703; heterogeneity: Q value 18.715; I 73.284 %; n = 205). p53 and Ki-67 immunohistochemical analysis may be predictive for detecting changes. There was p53 immunoexpression in 41.3 % of cases (p = 0.872) (n = 55), ki-67 immunoexpression (< 20 %) in 68 % (p = 0.001) (n = 97) and ki-67 immunoexpression (> 20 %) in 28.4 % of cases (p = 0.000) (n = 110).
The findings suggest that FC can occur, and there are histopathological changes in clinically normal tissue opposite to primary OSCC. Nevertheless, the review showed that more longitudinal studies on FC are needed to draw a conclusive indication of the occurrence of FC in oral tissues opposite to OSCC.
描述原发性口腔鳞状细胞癌（OSCC）对侧临床正常黏膜是否存在 场癌变（FC）指标。
于 2022 年 6 月 12 日对 Cochrane 图书馆、PubMed、Embase、Web of Science、Scopus 和 Livivo 数据库进行了检索，共检索到 152 条无重复记录。纳入分析原发性 OSCC 对侧临床正常组织中 FC 的活检研究。该检索是在 PRISMA 指南下进行的，并在 PROSPERO（CRD42017077125）中进行了方案注册。
纳入 8 项研究共 302 例患者，男 192 例，女 110 例，平均年龄 57.1 岁。大多数患者有不良习惯。所有研究均对 OSCC 进行了组织病理学证实，并对临床正常镜下黏膜进行了活检。对 8 项研究进行了荟萃分析。这些研究显示，原发性 OSCC 对侧临床正常黏膜的组织病理学改变占 57.3%（95%置信区间，0.443-0.703；异质性：Q 值 18.715；I 73.284%；n=205）。p53 和 Ki-67 免疫组化分析可能有助于检测到这些改变。p53 免疫表达阳性占 41.3%（p=0.872）（n=55），Ki-67 免疫表达（＜20%）占 68%（p=0.001）（n=97），Ki-67 免疫表达（＞20%）占 28.4%（p=0.000）（n=110）。
这些发现表明 FC 可能发生，并且在原发性 OSCC 对侧的临床正常组织中存在组织病理学改变。然而，该综述表明，需要更多的关于 FC 的纵向研究，以得出 OSCC 对侧口腔组织发生 FC 的明确结论。
