光动力疗法的完整疗程降低了口腔白斑恶变为恶性肿瘤的风险。
A complete course of photodynamic therapy reduced the risk of malignant transformation of oral leukoplakia.
机构信息
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Stomatology Hospital, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou 310000, China.
出版信息
Photodiagnosis Photodyn Ther. 2024 Oct;49:104338. doi: 10.1016/j.pdpdt.2024.104338. Epub 2024 Sep 21.
BACKGROUND
Photodynamic therapy (PDT) has shown good short-term efficacy in the treatment of oral leukoplakia (OLK). However, the malignant transformation of OLK was seldom evaluated in most PDT studies. Therefore, this study evaluated the effect of PDT on the risk of malignant transformation of OLK.
METHODS
Kaplan-Meier survival analysis, COX regression, and sensitivity analysis were used to evaluate the effects of PDT on the risk of malignant transformation of OLK. Subgroup analyses were performed to explore the role of PDT in OLK patients with different clinical characteristics.
RESULTS
OLK patients with older age (HR=1.032, P = 0.018) and non-homogeneous lesion (HR=2.104, P = 0.044) had higher risk of malignant transformation. Patients who had finished a complete course of PDT (HR=0.305, P = 0.006) had a significant lower risk of malignant transformation, while those who hadn't finished a complete course of PDT (HR=0.692, P = 0.352) cannot be considered to have such a protective effect. In the subgroup analyses, complete PDT course showed a significant protective effect on malignant transformation of OLK in patients with female sex, no smoking or drinking habits, non-homogeneous lesions, lesions on oral mucosa outside the dangerous region, and any grade of epithelial dysplasia.
CONCLUSIONS
A complete course of PDT could significantly reduce the risk of malignant transformation of OLK, especially in those patients with risk factors of malignant transformation.
背景
光动力疗法（PDT）在治疗口腔白斑病（OLK）方面显示出良好的短期疗效。然而，在大多数 PDT 研究中，OLK 的恶性转化很少得到评估。因此，本研究评估了 PDT 对 OLK 恶性转化风险的影响。
方法
采用 Kaplan-Meier 生存分析、COX 回归和敏感性分析评估 PDT 对 OLK 恶性转化风险的影响。进行亚组分析以探讨 PDT 在具有不同临床特征的 OLK 患者中的作用。
结果
年龄较大（HR=1.032，P=0.018）和病变不均匀（HR=2.104，P=0.044）的 OLK 患者恶性转化风险较高。完成完整 PDT 疗程的患者（HR=0.305，P=0.006）恶性转化风险显著降低，而未完成完整 PDT 疗程的患者（HR=0.692，P=0.352）则不能认为具有这种保护作用。在亚组分析中，完整的 PDT 疗程对女性、无吸烟或饮酒习惯、病变不均匀、危险区域外口腔黏膜病变和任何上皮异型增生程度的 OLK 恶性转化均具有显著的保护作用。
结论
完整的 PDT 疗程可显著降低 OLK 的恶性转化风险，尤其是在具有恶性转化危险因素的患者中。
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