Lorenzo-Pouso Alejandro I, Pérez-Jardón Alba, Caponio Vito Carlo Alberto, Spirito Francesca, Chamorro-Petronacci Cintia M, Álvarez-Calderón-Iglesias Óscar, Gándara-Vila Pilar, Lo Muzio Lorenzo, Pérez-Sayáns Mario
Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 A Coruña, Spain.
Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain.
J Fungi (Basel). 2022 Oct 17;8(10):1093. doi: 10.3390/jof8101093.
Chronic hyperplastic candidiasis (CHC) is a prototypical oral lesion caused by chronic infection. A major controversy surrounding CHC is whether this oral lesion owns malignant transformation (MT) potential. The aim of the present study was to evaluate current evidence on the MT of CHC and to determine the variables which have the greatest influence on cancer development. Bibliographical searches included PubMed, Embase, Web of Science, Scopus and LILACS. The cohort studies and case series used to investigate the MT of CHC were deemed suitable for inclusion. The quality of the enrolled studies was measured by the Joanna Briggs Institute scale. Moreover, we undertook subgroup analyses, assessed small study effects, and conducted sensitivity analyses. From 338 studies, nine were finally included for qualitative/quantitative analysis. The overall MT rate for CHC across all studies was 12.1% (95% confidential interval, 4.1-19.8%). Subgroup analysis showed that the MT rate increased when pooled analysis was restricted to poor quality studies. It remains complex to affirm whether CHC is an individual and oral, potentially malignant disorder according to the retrieved evidence. Prospective cohort studies to define the natural history of CHC and a consensus statement to clarify a proper set of diagnostic criteria are strongly needed. PROSPERO ID: CRD42022319572.
慢性增生性念珠菌病（CHC）是一种由慢性感染引起的典型口腔病变。围绕CHC的一个主要争议是这种口腔病变是否具有恶性转化（MT）潜能。本研究的目的是评估关于CHC恶性转化的现有证据，并确定对癌症发展影响最大的变量。文献检索包括PubMed、Embase、Web of Science、Scopus和LILACS。用于调查CHC恶性转化的队列研究和病例系列被认为适合纳入。纳入研究的质量通过乔安娜·布里格斯研究所量表进行衡量。此外，我们进行了亚组分析，评估了小研究效应，并进行了敏感性分析。从338项研究中，最终纳入9项进行定性/定量分析。所有研究中CHC的总体恶性转化率为12.1%（95%置信区间，4.1 - 19.8%）。亚组分析表明，当汇总分析仅限于质量较差的研究时，恶性转化率会升高。根据检索到的证据，要确定CHC是否是一种独立的、口腔潜在恶性疾病仍然很复杂。强烈需要前瞻性队列研究来确定CHC的自然史，并需要一份共识声明来阐明一套适当的诊断标准。PROSPERO注册号：CRD42022319572。
