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制定以患者为中心的口腔上皮发育异常临床随访方案的研究建议。

Recommendations for Research to Develop a Patient-Centered Clinical Follow-Up Protocol for Oral Epithelial Dysplasia.

作者信息

Güneri Pelin, Bolukbasi Gaye, Ilhan Betul, Epstein Joel B, Warnakulasuriya Saman

机构信息

Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ege University, Izmir, Turkiye.

City of Hope Comprehensive Cancer Center Duarte CA and Cedars Sinai Health System, Los Angeles, California, USA.

出版信息

Head Neck. 2025 Jan;47(1):7-13. doi: 10.1002/hed.28001. Epub 2024 Nov 18.

Abstract

Oral epithelial dysplasia (OED) is the primary histological marker for assessing the progression of oral potentially malignant disorders (OPMDs) to cancer. Despite challenges in grading and low inter-pathologist reproducibility, OED severity remains the key predictor of malignant transformation. However, globally accepted guidelines for OED monitoring are lacking, despite calls for individualized management based on host and lesion characteristics. The proposed research protocol involves acquiring high-quality intraoral images, assessing oral hygiene and periodontal status, eliminating chronic mechanical irritation and Candida infections, and applying adjunctive diagnostic methods like toluidine blue staining, optical evaluation, and brush cytology. Tailored follow-up regimens based on individual risk assessments are emphasized, with frequent monitoring for high-grade dysplasia or patients at higher risk of progression. Therefore, effective OED management should consider the patient's immune status, dietary habits, and oral microbiota, aiming to develop personalized treatment strategies that optimize patient-centered care.

摘要

口腔上皮发育异常(OED)是评估口腔潜在恶性疾病(OPMDs)向癌症进展的主要组织学标志物。尽管在分级方面存在挑战且病理医生之间的重复性较低,但OED的严重程度仍然是恶性转化的关键预测指标。然而,尽管有人呼吁根据宿主和病变特征进行个体化管理,但全球仍缺乏公认的OED监测指南。拟议的研究方案包括获取高质量的口腔内图像、评估口腔卫生和牙周状况、消除慢性机械刺激和念珠菌感染,以及应用诸如甲苯胺蓝染色、光学评估和刷片细胞学等辅助诊断方法。强调基于个体风险评估的定制化随访方案,对高级别发育异常或进展风险较高的患者进行频繁监测。因此,有效的OED管理应考虑患者的免疫状态、饮食习惯和口腔微生物群,旨在制定优化以患者为中心护理的个性化治疗策略。

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