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Galib R, Ahmed A, Gupta N, Khan R, Sharma SC. A Comparative Study of the Treatment of Oral Premalignant Lesions with Surgical Excision and Medical Therapy. Indian J Otolaryngol Head Neck Surg 2024; 76:1965-1971. [PMID: 38566720 PMCID: PMC10982230 DOI: 10.1007/s12070-023-04467-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/21/2023] [Indexed: 04/04/2024] Open
Abstract
Introduction Potentially malignant oral epithelial lesions are a group of oral conditions with an altered morphological state of the normal mucosal lining and include different lesions such as leukoplakia, erythroplakia, submucosal fibrosis, and lichen planus. Aim To compare the outcome of premalignant oral lesions after medical therapy consisting of submucosal intralesional injection of triamcinolone with hyaluronidase and surgical excision. Materials and Methods This was a comparative prospective interventional study and the study was conducted among 50 patients presented to the Department of Otorhinolaryngology with premalignant oral lesions from the year 2020 to 2022. Patients were divided into two groups by random allocation, group A was treated with medical therapy, and Group B was treated with surgical excision and followed for a minimum of 6 months and the outcome has been categorized. Results All patients were divided into two groups-group A and group B, group A consisted of 22 (44%) patients who were given medical therapy, and group B consisted of 28 (56%) patients who underwent surgical excision. In group A, the clinical response was seen in 8 (36.36%) and in group B, the clinical response was seen in 18 (64.29%) patients. Conclusion Surgical excision was found to be better with more cases of clinical response (64.29%) when compared to medical treatment (36.36%) with a p value of 0.0497 which is significant whereas malignant transformation was almost equal in medical therapy and surgical treatment which was 13.64% and 14.28%, respectively.
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Affiliation(s)
- Rubina Galib
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Aftab Ahmed
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Nainsi Gupta
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Roobina Khan
- Department of Pathology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - S. C. Sharma
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
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Khan AS, Khan ZA, Nisar M, Saeed S, Maryam H, Haq M, Naushin T, Issrani R. Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate. J Cancer Res Ther 2023; 19:S724-S730. [PMID: 38384046 DOI: 10.4103/jcrt.jcrt_969_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/06/2022] [Indexed: 02/23/2024]
Abstract
OBJECTIVE This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates. MATERIALS AND METHODS This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs. RESULTS The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs. CONCLUSIONS Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.
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Affiliation(s)
- Abbas Saleem Khan
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Zafar Ali Khan
- Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Kingdom of Saudi Arabia
| | - Muhammad Nisar
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Saleha Saeed
- Department of Oral Pathology, Faryal Dental College, Lahore, Pakistan
| | - Hoor Maryam
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Mohsina Haq
- Department of Microbiology, Peshawar Medical College, Riphah International University, Islamabad, Pakistan
| | - Tehmina Naushin
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Rakhi Issrani
- Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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Faria MHD, Silva LMAC, Mafra RP, Santos MMD, Soares SCM, Moura JMBDO. Actinic cheilitis in rural workers: prevalence and associated factors. EINSTEIN-SAO PAULO 2022; 20:eAO6862. [PMID: 35649060 PMCID: PMC9126600 DOI: 10.31744/einstein_journal/2022ao6862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the prevalence of actinic cheilitis in rural workers and factors associated with the development of this condition. Methods A cross-sectional study was conducted in a city in Northeastern Brazil. Data were collected by clinical examination and use of a questionnaire validated with 300 rural workers. The χ2 test was employed to identify possible associations between the presence of actinic cheilitis and clinical and demographic variables. Multiple logistic regression analysis was performed using forward stepwise selection. A p value of 0.05 was considered significant. Results The prevalence of actinic cheilitis was 12.0% in the sample. The highest prevalence of actinic cheilitis was observed in white males, with low educational level, and an approximately 40-year history of sun exposure. Chronic lesions were commonly found in the lower lip and were characterized by scaling, dryness, and mild edema. Skin color, sex, educational level of patients, and cumulative sun exposure (in years), were identified as predictors of development of actinic cheilitis. Conclusion Our results suggest the need to implement educational health strategies aimed to orient the population about risk factors and preventive measures of the disease. Appropriate clinical management of patients with actinic cheilitis is important for prevention of lip cancer.
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CAMPOS WGD, ESTEVES CV, GALLO CDB, DOMANESCHI C, ARANHA ACC, LEMOS CA. Treatment of oral leukoplakia with CO2 laser (10,600 nm): analysis of 37 cases. Braz Oral Res 2022; 36:e014. [DOI: 10.1590/1807-3107bor-2022.vol36.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/01/2021] [Indexed: 11/22/2022] Open
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Moon SH, Sangha A, Ravichandran M, Samuela AV, Tso S, Sharma D, Ariyawardana A. Use of Lip Protecting Agents in the Prevention of Actinic Cheilitis, Herpes Labialis and Cancer of Lip: A Systematic Review. Open Dent J 2021. [DOI: 10.2174/1874210602115010428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Actinic cheilitis, herpes labialis and lip cancer are relatively common conditions presenting on the lips associated with exposure to periods of sun exposure and thereby ultraviolet radiation.
Objective:
This systematic review aimed to determine the efficacy of the application of sunscreen-containing lip-protecting agents (LPA) in the prevention of actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC).
Methods:
This review was conducted in accordance with the PRISMA guidelines and registered with the PROSPERO database. A literature search was conducted using SCOPUS, Google Scholar, Medline (Ovid), Pubmed, CINAHL, Cochrane Library databases and manual search using search terms actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC) along with lip protecting agents and their variations as keywords. A total of 1,567 papers were yielded. Of them, nine studies were eligible for qualitative data synthesis.
Results:
Nine articles (3 AC, 5 RHL, 1 LC) were deemed eligible and thus selected for qualitative synthesis. Three studies on AC identified approximately 21.7% lower prevalence of lesions when some form of lip protection was used. Eighty percent of studies on RHL identified that the application of LPA is effective in preventing RHL. Subjects who applied LPA more than once daily only had half the risk of having LC compared to those who applied once daily.
Conclusion:
This review of randomised controlled trials (RCTs) and observational studies supports the use of LPA as an effective method in preventing lip-associated lesions. Further, RCTs and observational studies should aim at determining a definitive LPA application regime and optimal SPF strength to prevent lip-associated lesions.
This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO): Registration Number - CRD42020177484. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020177484
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Garofalo V, Cannarozzo G, Del Duca E, Sannino M, Mazzilli S, Dattola A, Nisticò SP, Campione E, Bianchi L. Combination of Laser Therapy and Photodynamic Therapy with 5-Aminolevulinic Acid Patch for the Treatment of Actinic Cheilitis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:303-307. [PMID: 33844608 DOI: 10.1089/photob.2020.4853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Actinic cheilitis (AC) is a premalignant lesion of the lips that can evolve into squamous cell carcinoma. Among nonsurgical treatments, photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) patch might represent a new noninvasive therapeutic approach for AC. Objective: We sought to investigate the potential role of fractional CO2 laser pretreatment in boosting ALA penetration and distribution into AC treated with PDT. Methods: We report a case of a woman with AC on the lower lip, treated with ablative fractional CO2 laser to boost drug delivery of 5-ALA patch before PDT treatment. Reflectance confocal microscopy was performed to assess diagnosis and treatment response. Results: We detected a good clinical and cosmetic outcome after two applications of combined treatment. Erythema, crust, and edema were reported as side effects. Conclusions: This case report shows that ablative fractional CO2 laser-assisted PDT might be an effective therapeutic alternative for patients with AC who refuse or are contraindicated for surgical procedures.
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Affiliation(s)
- Virginia Garofalo
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | | | - Ester Del Duca
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Mario Sannino
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Sara Mazzilli
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Elena Campione
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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Torabi M, Afshar MK, Afshar HM, Mohammahzadeh I. Correlation Between Clinical and Histopathologic Diagnosis of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Molook Torabi
- Kerman University of Medical Sciences, Iran; Kerman University of Medical Sciences, Iran
| | - Marzieh Karimi Afshar
- Kerman University of Medical Sciences, Iran; Kerman University of Medical Sciences, Iran
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Histological Effects of an Innovative 445 Nm Blue Laser During Oral Soft Tissue Biopsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082651. [PMID: 32294912 PMCID: PMC7215754 DOI: 10.3390/ijerph17082651] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/26/2022]
Abstract
Continuously evolving laser devices can be used in various fields; they are an alternative to the traditional cold blade surgery to perform biopsies of oral soft tissues. The aspect focused on in this paper is the possibility to use the 445 nm diode laser (Eltech K-Laser srl, Treviso, Italy) in complete safety, by evaluating its thermal effects during microscopy. A histological evaluation of the alteration of the peri-incisional edges on 10 samples was realized. All excisional biopsies were related to clinically unsuspected lesions and performed by the same expert operator. The surgical procedure was performed with the same laser parameters and the same pathologist evaluated the thermal effect on the samples. An average value of the detected tissue alteration was calculated; the average damage of the epithelium was 650.93 μm, while in the connective tissue it was 468.07 μm. In all the cases a clear diagnosis was possible, and no clinical complications were observed; so, the 445 nm diode laser proved to be a device that can be safely used for biopsies of clinically unsuspicious lesions. Due to the small number of cases, this in vivo preliminary experience needs to be extended.
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Hóstio BM, de Macedo Bernardino Í, Pereira JV, Bento PM, Godoy GP, de Castro Gomes DQ. Oral cancer and potentially malignant disorders: a 12-year epidemiological and clinical analysis in a metropolitan region of northeastern Brazil. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01054-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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Gomez-Armayones S, Chimenos-Küstner E, Marí A, Tous S, Penin R, Clavero O, Quirós B, Pavon MA, Taberna M, Alemany L, Servitje O, Mena M. Human papillomavirus in premalignant oral lesions: No evidence of association in a Spanish cohort. PLoS One 2019; 14:e0210070. [PMID: 30650110 PMCID: PMC6335078 DOI: 10.1371/journal.pone.0210070] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/17/2018] [Indexed: 01/25/2023] Open
Abstract
Background Human papillomavirus (HPV) is the cause of a fraction of head and neck squamous cell carcinoma. Although this relation is well-known, it is still not clear the role of HPV in premalignant oral lesions such as oral lichen planus (OLP) and dysplasia. We aimed to evaluate the HPV-DNA prevalence and type distribution in a set of oral biopsies obtained from patients diagnosed with OLP and dysplasia, as well as the role of HPV in these lesions. Methods A retrospective cohort of all premalignant oral lesions consecutively diagnosed from March 30th 1995 to May 21st 2014 at Hospital of Bellvitge and Odontological University Hospital of Bellvitge was identified and classified in four groups: OLP (groups 1 and 2) and dysplasias (groups 3 and 4) that progressed or not to invasive cancer during follow-up. A random selection targeting 25 cases was aimed to be performed for each group. All selected cases were subjected to pathological evaluation, DNA quality control and HPV-DNA detection. HPV-DNA positive samples were further subject to p16INK4a analysis. Results A total of 83 cases yielded a valid HPV-DNA result. From those, 7 and 34 cases were OLP that progressed or not to invasive cancer during follow-up, whereas 24 and 18 cases were displasias that progressed or not to invasive cancer during follow-up, respectively. HPV-DNA was detected in 4 samples (3 dysplastic lesions and 1 OLP). Two samples were HPV16 positive (2%), 1 sample HPV18 positive (1%) and 1 sample (1%) was HPV indeterminate. Two out of four HPV-DNA positive cases had high p16INK4a expression and none of the HPV positive cases progressed to invasive cancer during long-term follow-up. Conclusions We found a low HPV-DNA attributable fraction in premalignant lesions of the oral cavity, suggesting that HPV is unlikely to play a significant role in oral carcinogenesis in our setting.
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Affiliation(s)
- Sara Gomez-Armayones
- Department of Dermatology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- * E-mail:
| | - Eduardo Chimenos-Küstner
- Department of Odontostomatology, Odontological University Hospital of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Marí
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department Oral and Maxillofacial Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Sara Tous
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Rosa Penin
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Pathology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Omar Clavero
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Beatriz Quirós
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Miguel Angel Pavon
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Miren Taberna
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- Epidemiology and Public Health, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Octavio Servitje
- Department of Dermatology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Marisa Mena
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
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BRITO LNS, BONFIM ACEDA, GOMES DQDC, ALVES PM, NONAKA CFW, GODOY GP. Clinical and histopathological study of actinic cheilitis. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.00519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Actinic cheilitis is a inflammatory condition affecting mainly the lower lip and it is caused by chronic and excessive exposure of the lips to the ultraviolet radiation in sunlight. Objective Identifying clinical and histopathologic characteristics in 40 cases histopathologically diagnosed as actinic cheilitis. In addition, to investigate possible associations between these aspects. Method Defined as an observational, transversal, retrospective and descriptive study, it registered data regarding age, gender, occupation, symptomatology, records of sun exposure, frequency of sunblock use, tabagism, skin color, clinical aspect and histopathological classification. The data was submitted to the chi square test of Pearson (p<0.05). Result There was a predominance of male gender, leucodermia, and ages ranging between 50 and 60 years. The most common occupation was farming. From our sample, 85% had history of chronic sun exposure, in which 50% reported the use of some type of sunblock and only 25% were smokers. The main clinical condition was non-ulcerated leukoplakia and in the histopathological study, the hyperkeratosis were more common. A correlation between the degree of tissue alteration verified in the histopathological diagnosis and the studied clinical variables was not established (p=0.112). Conclusion The clinical aspect of the wound can conceal tissue alterations in different stages, emphasizing the importance of a premature diagnosis.
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Chen M, Li C, Yang Y, Cheng L, Wu H. A morphological classification for vocal fold leukoplakia. Braz J Otorhinolaryngol 2018; 85:588-596. [PMID: 30166121 PMCID: PMC9443019 DOI: 10.1016/j.bjorl.2018.04.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/21/2018] [Accepted: 04/25/2018] [Indexed: 12/29/2022] Open
Abstract
Introduction There is still no general method for discriminating between benign and malignant leukoplakia and identifying vocal fold leukoplakia. Objective To evaluate the reliability of a morphological classification and the correlation between morphological types and pathological grades of vocal fold leukoplakia. Methods A total of 375 patients with vocal fold leukoplakia between 2009 and 2015 were retrospectively reviewed. Two observers divided the vocal fold leukoplakia into flat and smooth, elevated and smooth, and rough type on the basis of morphological appearance. The inter-observer reliability was evaluated and the results of classification from both observers were compared with final pathological grades. Clinical characteristics between low risk and high risk group were also analyzed. Results The percentage inter-observer agreement of the morphological classification was 78.7% (κ = 0.615, p < 0.001). In the results from both observers, the morphological types were significantly correlated with the pathological grades (p1 < 0.001, p2 < 0.001, Kruskal–Wallis test; r1 = 0.646, p1 < 0.001, r2 = 0.539, p2 < 0.001, Spearman Correlation Analysis). Multivariate analysis showed patient's age (p = 0.018), the size of lesion (p < 0.001), and morphological type (p < 0.001) were significantly different between low risk group and high risk group. Combined receiver operating characteristic curve analysis of significant parameters revealed an area under the receiver operating characteristic curve of 0.863 (95% CI 0.823–0.903, p < 0.001). Conclusions The proposed morphological classification of vocal fold leukoplakia was consistent between observers and morphological types correlated with pathological grades. Patient's age, the size of lesion, and morphological type might enable risk stratification and provide treatment guidelines for vocal fold leukoplakia.
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Affiliation(s)
- Min Chen
- Fudan University, Eye, Ear, Nose, and Throat Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Clinical, Disciplines of Otorhinolaryngology, Shanghai, China
| | - Changjiang Li
- Fudan University, Eye, Ear, Nose, and Throat Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Clinical, Disciplines of Otorhinolaryngology, Shanghai, China
| | - Yue Yang
- Fudan University, Eye, Ear, Nose, and Throat Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Clinical, Disciplines of Otorhinolaryngology, Shanghai, China
| | - Lei Cheng
- Fudan University, Eye, Ear, Nose, and Throat Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Clinical, Disciplines of Otorhinolaryngology, Shanghai, China.
| | - Haitao Wu
- Fudan University, Eye, Ear, Nose, and Throat Hospital, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; Shanghai Key Clinical, Disciplines of Otorhinolaryngology, Shanghai, China.
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Dancyger A, Heard V, Huang B, Suley C, Tang D, Ariyawardana A. Malignant transformation of actinic cheilitis: A systematic review of observational studies. ACTA ACUST UNITED AC 2018; 9:e12343. [DOI: 10.1111/jicd.12343] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 03/31/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Alex Dancyger
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
| | - Victoria Heard
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
| | - Baikai Huang
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
| | - Cameron Suley
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
| | - Dorothy Tang
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
| | - Anura Ariyawardana
- College of Medicine and Dentistry; James Cook University; Cairns Queensland Australia
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Intraoral Potentially Malignant Disorders in a Brazilian Oral Pathology Service: Epidemiological, Clinical, and Histopathological Findings. JOURNAL OF ONCOLOGY 2018; 2018:2325808. [PMID: 29686705 PMCID: PMC5852874 DOI: 10.1155/2018/2325808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/28/2017] [Accepted: 01/30/2018] [Indexed: 12/12/2022]
Abstract
The aim of this study was to investigate the characteristics of individuals with intraoral potentially malignant disorders (IOPMD) in an oral pathology service in Brazil. Cases were screened based on clinical diagnosis of leukoplakia (LKP), erythroleukoplakia (ELKP), and erythroplakia (EP). Clinical data and information regarding associated factors were gathered from biopsy reports. Histological diagnoses were collected from histopathological records. Among 208 IOPMD cases, 84.13% involved LKP; 11.1%, ELKP; and 4.8%, EP. The most affected sites were the gingiva and buccal mucosa. Histologically, epithelial dysplasia was present in 66.8% of the lesions, acanthosis and hyperkeratosis without epithelial dysplasia were present in 27.9%, and squamous cell carcinoma was present in 2.9%. Most patients were males, fair-skinned, with mean age of 53.4 years. Chronic smokers represented 73% of subjects, of which 30% also consumed alcohol. Smokers and drinkers were mostly males (p < 0.001). EP and ELKP represented histologically more severe degrees of epithelial dysplasia than LKP (p < 0.001). In conclusion, individuals with IOPMD were more frequently fair-skinned men in the sixth decade of life, with smoking habit. Special attention is required to clinical diagnoses of ELKP and EP since the prevalence of severe epithelial dysplasia, in situ carcinoma, and squamous cell carcinoma is higher than in LKP.
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Richard MA, Amici JM, Basset-Seguin N, Claudel JP, Cribier B, Dreno B. Management of actinic keratosis at specific body sites in patients at high risk of carcinoma lesions: expert consensus from the AKTeam™ of expert clinicians. J Eur Acad Dermatol Venereol 2018; 32:339-346. [PMID: 29235161 DOI: 10.1111/jdv.14753] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022]
Abstract
Actinic keratoses (AK) arise on sun-exposed regions of the skin. If left untreated, AK may progress to invasive squamous cell carcinoma (SCC), although the rate of progression is low. A practical treatment algorithm for the treatment of AK in standard situations has been published by the AKTeam™ expert panel. However, management of particular situations of AK with increasing/higher carcinoma risk or AK progressing into carcinomas with increased aggressiveness due to their anatomical location (risky areas), or in patients with an increased risk of SCC requires further discussion. These include AK on the dorsal hands, forearms, legs, periorbital region, eyelids, ears, or lips, and organ transplant recipients, patients undergoing treatment with carcinogenic agents and patients with chronic lymphocytic leukaemia. The main objective was to propose therapeutic strategies for the treatment of AK located in risky areas and in patients with more invasive/aggressive lesions and a higher risk of progression to SCC. A systematic review of the literature was initially performed, and results were discussed by the experts to propose best management practices in specific situations. Finally, adapted management strategies for AK occurring in risky areas and in high-risk patients are presented, taking into account the experts' own clinical experience and current guidelines. In most of these 'at-risk' situations, patients can be treated according to the AKTeam™ treatment algorithm. Difficult-to-treat lesions should be treated more aggressively due to their higher risk of transformation. For patients with skin that is highly susceptible to actinic damage, monitoring and sun protection strategies are mandatory, and patients should undergo more regular follow-up. Further assessment of newer therapies in clinical trials is necessary to determine optimal treatment conditions. This expert consensus provides guidance for the management of AK in risky body sites and in patients with an increasing/higher risk for SCCs.
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Affiliation(s)
- M A Richard
- Dermatology Department, UMR 911, INSERM CRO2, "Center for Research in Biological Oncology and Oncophamacology", Timone Hospital, Public Hospitals of Marseille, Aix-Marseille University, Marseille, France
| | - J M Amici
- Private Office of dermatology Rive Droite, Cenon, France.,Dermatology Department, Hôpital Saint-Andre, Bordeaux, France
| | - N Basset-Seguin
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France
| | - J P Claudel
- Private Office of Dermatology, Tours, France.,Dermatology Department, CHU Clocheville, Tours, France
| | - B Cribier
- Dermatology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - B Dreno
- Department of Dermato cancerology, University Hospital Hotel Dieu, Nantes, France
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Hadzic S, Gojkov-Vukelic M, Pasic E, Dervisevic A. Importance of Early Detection of Potentially Malignant Lesions in the Prevention of Oral Cancer. Mater Sociomed 2017; 29:129-133. [PMID: 28883777 PMCID: PMC5544450 DOI: 10.5455/msm.2017.29.129-133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: The aim of this study was to assess the importance of early diagnosis of potentially malignant lesions in the prevention of oral cancer. Material and methods: In order to achieve the set objectives, we selected our participant pool. Of the 340 patients who came to the initial examination at the Clinic for Oral Medicine and Periodontology, we selected 40 patients with potentially malignant oral lesions (PMOL) of both sexes and of different ages. After an extensive anamnesis and a clinical examination of all mucous membranes, we documented potentially malignant lesions, their localization, subjective and objective symptoms, duration of pathological lesion, and bad habits (smoking and alcohol). All lesions were colored with Toluidine blue, which indicates malignancy in 75% of cases. Patients who had a positive Toluidine blue staining test were sent to biopsy and pathohistological analysis. Results: The most common potentially malignant lesions are Lichen reticularis (25%), Lichen erosivus (20%), and Leukoplakia (15%). The most common localization of lesions is the buccal mucosa bilaterally (26%), buccal mucosa unilaterally (10%), and the lower lip (10%). The staining test with Toluidine blue was positive at 23% PMOLs. In patients with positive Toluidine staining findings, biopsy and pathohistological analysis were performed, which showed that 20% of all lesions are carcinoma (CIS, Baseocellular Carcinoma, Squamocellular Carcinoma), while 14% are mucosal epithelial dysplasia. Statistical analysis confirmed the significance of positive staining of Toluidine blue and Leukoplakia (Spearman’s coefficient = 0.427, p = 0.006, N = 40), and statistically significant positive association of Squamocellular Carcinoma and Toluidine blue staining (Spearman’s coefficient = 0.619, p = 0.000, N = 40). Conclusion: Most oral cancers are caused by potentially malignant lesions, which is why a very detailed clinical examination with the visualization of pathological lesions is very important. Toluidine blue test can be an auxiliary tool for clinical diagnosis but does not replace the pathohistological finding. Biopsy and pathohistological findings are the gold standard in the diagnosis of oral cancers, as confirmed in our research.
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Affiliation(s)
- Sanja Hadzic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Hercegovina
| | - Mirjana Gojkov-Vukelic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Hercegovina
| | - Enes Pasic
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Hercegovina
| | - Almir Dervisevic
- Maxillofacial surgery Clinical Center of Sarajevo, Bosnia and Hercegovina
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da Silva SR, Juliano Y, Novo NF, Weinfeld I. Comparative study of knowledge about oral cancer among undergraduate dental students. EINSTEIN-SAO PAULO 2016; 14:338-345. [PMID: 27759821 PMCID: PMC5234744 DOI: 10.1590/s1679-45082016ao3729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/15/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: To evaluate and compare the knowledge of dental undergraduate students about oral cancer. METHODS: The students were divided into two groups according to semester attended in the undergraduate course: Group A, the first semester; and Group B, seventh semester. They were asked to answer a questionnaire about epidemiology, risk factors, clinical aspects, therapeutic solutions and oral self-examination. For statistical analysis, the Fisher's exact test, the Cochran's G test and Kendall's concordance test were used, with significance level set at 0.05. RESULTS: Regarding the prevalent sex, only 8.0% of Group A and 56.0% of Group B judged males as the frequent affected by the disease (p=0.0006). In terms of age, 84.0% of the Group B and 44.0% of the Group A estimated that most cases were diagnosed over 40 years (p=0.0072). Smoking was identified as the major risk factor for 64.0% and 91.6% of Groups A and B, respectively (p=0.0110). On issues related to sex, ethnicity, age, risk factors, self-examination, treatment, professional responsible for treatment and profile of an individual with the disease, the seventh-semester showed significantly higher correct answer percentages than first-semester undergraduates. CONCLUSION: There was significant correlation between the right and wrong answers given by first and seventh semester students, making necessary a specific approach directed to their lack of knowledge. OBJETIVO: Avaliar e comparar o conhecimento de acadêmicos de odontologia sobre câncer bucal. MÉTODOS: Os acadêmicos foram divididos em dois grupos, de acordo com o semestre cursado na graduação: Grupo A, primeiro semestre; e Grupo B: sétimo semestre. Eles foram convidados a responderem um questionário referente a epidemiologia, fatores de risco, aspectos clínicos, soluções terapêuticas e autoexame bucal. Para a análise estatística dos resultados, foram utilizados o teste exato de Fisher, o teste G de Cochran e o teste de concordância de Kendall, com nível de significância estabelecido em 0,05. RESULTADOS: Somente 8,0% do Grupo A e 56,0% do Grupo B julgaram o sexo masculino como aquele frequentemente acometido pela lesão (p=0,0006). Em relação à faixa etária, 84,0% do Grupo B e 44,0% do Grupo A estimaram que a maioria dos casos era diagnosticada acima dos 40 anos (p=0,0072). O tabagismo foi apontado como principal fator de risco por 64,0% e 91,6% dos alunos dos Grupos A e B, respectivamente (p=0,0110). Nas questões referentes a sexo, etnia, faixa etária, fatores de risco, autoexame, tratamento, profissional responsável pelo tratamento e perfil de um indivíduo portador da lesão, os alunos do sétimo semestre apresentaram percentagens de respostas corretas significantemente maiores que as dos discentes do primeiro semestre. CONCLUSÃO: Houve significativa concordância entre os erros e acertos dos discentes do primeiro e sétimo semestres, sendo necessária uma abordagem específica direcionada à deficiência por eles apresentadas.
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