Cox S C, Walker D M
Faculty of Dentistry, University of Sydney, Westmead Hospital Dental Clinical School, NSW.
Aust Dent J. 1996 Oct;41(5):294-9. doi: 10.1111/j.1834-7819.1996.tb03136.x.
Oral submucous fibrosis (OSF) affects an estimated 2.5 million people, mostly in the Indian subcontinent. Limitation of oral opening resulting in difficulty in eating is the main presenting feature. Although nutritional deficiencies and immunological processes may play a part in the pathogenesis, the available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSF. Genetically determined susceptibility could explain why only a small fraction of those using betel quid develop the disease. In OSF there is an incidence of oral cancer of 7.6 per cent for a median 10-year follow-up period. Risk markers for malignant transformation in OSF include epithelial dysplasia, silver binding nucleolar organizer region counts, and sister-chromatid exchange frequencies; p53 tumour suppressor gene mutations may be involved in these potentially malignant changes.
口腔黏膜下纤维化（OSF）估计影响250万人，主要集中在印度次大陆。张口受限导致进食困难是主要的临床表现。虽然营养缺乏和免疫过程可能在发病机制中起一定作用，但现有的流行病学证据表明，咀嚼槟榔（含槟榔果、烟草、熟石灰或其他品种）是OSF的一个重要危险因素。遗传易感性可以解释为什么只有一小部分嚼槟榔的人会患上这种疾病。在OSF中，中位10年随访期的口腔癌发病率为7.6%。OSF恶性转化的风险标志物包括上皮发育异常、银结合核仁组织区计数和姐妹染色单体交换频率；p53肿瘤抑制基因突变可能参与这些潜在的恶性变化。
