Professor and Kelly L. Krahwinkel Endowed Chairman, Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN.
President, Minnesota Oral and Facial/Head and Neck Surgery, Fellowship Director, Oral/Head and Neck Oncologic and Reconstructive Surgery, Minneapolis, MN.
J Oral Maxillofac Surg. 2023 Aug;81(8):1042-1054. doi: 10.1016/j.joms.2023.04.017. Epub 2023 May 6.
Oral potentially malignant disorders (OPMDs) of the oral mucosa include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral lichenoid lesions, each with varying incidences of dysplastic disease at the time of presentation and each with observed incidences of malignant transformation over time. The primary goal of the management of dysplasia, therefore, includes their early detection and treatment prior to malignant transformation. The recognition and management of these OPMDs and an understanding of their potential progression to oral squamous cell carcinoma will reduce the morbidity and mortality associated with these lesions with expedient and properly executed treatment strategies that will have a positive effect on patient survival. It is the purpose of this position paper to discuss oral mucosal dysplasia in terms of its nomenclature, epidemiology, types, natural history, and treatment to acquaint clinicians regarding the timing of biopsy, type of biopsy, and follow-up of patients with these lesions of the oral mucosa. This position paper represents a synthesis of existing literature on this topic with the intention of closing gaps in our understanding of oral mucosal dysplasia while also stimulating new thinking to guide clinicians in the proper diagnosis and management of OPMDs. The fifth edition of the World Health Organization classification of head and neck tumors published in 2022 represents new information regarding this topic and a construct for this position paper.
口腔黏膜潜在恶性疾病(OPMD)包括白斑、红斑、红白斑、扁平苔藓和口腔类扁平苔藓病变,每种疾病在出现时都有不同的发育不良疾病发生率,并且随着时间的推移都有观察到恶性转化的发生率。因此,发育不良疾病管理的主要目标包括在恶性转化之前早期发现和治疗。识别和管理这些 OPMD 并了解它们向口腔鳞状细胞癌的潜在进展将通过及时和正确执行的治疗策略来降低与这些病变相关的发病率和死亡率,从而对患者的生存产生积极影响。本立场文件旨在讨论口腔黏膜发育不良的术语、流行病学、类型、自然史和治疗,以使临床医生了解对这些口腔黏膜病变进行活检的时间、活检类型以及对患者的随访。本立场文件综合了现有文献,旨在缩小我们对口腔黏膜发育不良理解的差距,同时激发新的思维,指导临床医生正确诊断和管理 OPMD。2022 年发布的世界卫生组织第五版头颈部肿瘤分类提供了关于这个主题的新信息,并为这份立场文件提供了一个结构。