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Kokubun K, Nakajima K, Akashi Y, Yamamoto K, Katakura A, Matsuzaka K. Clinicopathological evaluation of oral leukoplakia: a single-center study of 676 cases in Japan. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:529-536. [PMID: 38553305 DOI: 10.1016/j.oooo.2024.02.022] [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: 10/30/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 06/19/2024]
Abstract
OBJECTIVES To analyze the clinical and histopathological characteristics of oral leukoplakia (OL) in the Japanese population and investigate the prevalence and risk factors for epithelial dysplasia (ED) and carcinoma within lesions. STUDY DESIGN Data, including age, sex, lesion site, and histopathological features, of 676 cases diagnosed with OL over the previous 10 years were analyzed. Dysplasia and carcinoma prevalence were determined. RESULTS In male patients, the most affected site was the gingiva (42.7%), whereas in females, it was the tongue (47.6%). Moreover, ED was more prevalent in males (41.9%), whereas epithelial hyperplasia was more common in females (44.7%). A significant difference was observed between affected sites with regard to the presence of dysplasia. The ED rates by site were 64.6% and 33.7% for the tongue and gingiva, respectively (P < 0.05). The squamous cell carcinoma rates by site were 23.4%, 5.4%, and 3.4% for the tongue, buccal mucosa, and gingiva, respectively (P < 0.05). Logistic regression analysis revealed a higher prevalence of dysplasia in males than it did in females and that the risk for both dysplasia and carcinoma was highest in the tongue. CONCLUSIONS Dysplasia is common in OL cases, often showing carcinoma. Early biopsy and interventions are key in OL management.
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Affiliation(s)
- Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan.
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Kei Yamamoto
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
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2
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Brouns ER, Evren I, Wils LJ, Poell JB, Brakenhoff RH, Bloemena E, de Visscher JGAM. Oral leukoplakia classification and staging system with incorporation of differentiated dysplasia. Oral Dis 2023; 29:2667-2676. [PMID: 35765231 DOI: 10.1111/odi.14295] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/15/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A classification and staging system for oral leukoplakia (OL) was introduced to promote uniform reporting. In this system, size and the histopathologic diagnosis are assessed and combined in a staging system. The various stages could be predictive for malignant transformation of OL. Differentiated dysplasia (DD) was recently recognized as an important architectural pattern of dysplasia and is highly associated with malignant transformation (MT) of OL. In the present study, DD was incorporated in the OL-system. The aim of the present study was to test the adapted system on a cohort of patients with OL. PATIENT AND METHODS The group consisted of 140 patients. The size, absence or presence and degree of classic dysplasia (CD) and DD were incorporated into the OL-system. RESULTS In 31/140 patients, MT occurred. Size was not statistically significant with MT (p = 0.422). The presence of dysplasia was predictive for MT (p = 0.003), whereby severe CD and DD were highly statistically significant for MT (p = 0.008). Stage IV was statistically significant for MT (p = 0.011). CONCLUSIONS The present study emphasizes the value of the slightly modified OL-system with incorporation of DD in uniform reporting of OL and the value in predicting MT.
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Affiliation(s)
- Elisabeth R Brouns
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ilkay Evren
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Leon J Wils
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jos B Poell
- Department of Otolaryngology / Head & Neck Surgery, Amsterdam UMC, Location VUmc and Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology / Head & Neck Surgery, Amsterdam UMC, Location VUmc and Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
- Department of Pathology, Amsterdam UMC, Location VUmc and Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery / Oral Pathology, Amsterdam UMC, Location VUmc and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Paglioni MDP, Khurram SA, Ruiz BII, Lauby-Secretan B, Normando AG, Ribeiro ACP, Brandão TB, Palmier NR, Lopes MA, da Silva Guerra EN, Meleti M, Migliorati CA, Carvalho AL, de Matos LL, Kowalski LP, Santos-Silva AR. Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:573-587. [PMID: 36153299 DOI: 10.1016/j.oooo.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]). STUDY DESIGN We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT. RESULTS Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT). CONCLUSIONS Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD.
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Affiliation(s)
- Mariana de Pauli Paglioni
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Blanca Iciar Indave Ruiz
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Béatrice Lauby-Secretan
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Ana Gabriela Normando
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | | | - Thais Bianca Brandão
- São Paulo Cancer Institute (ICESP), Dentistry Department, São Paulo, Brazil; Odontologia Oncológica D'or, São Paulo, Brazil
| | - Natália Rangel Palmier
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | | | - Marco Meleti
- Cantro Universitario di Odontoiatria-Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | | | - Leandro Luongo de Matos
- Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School, São Paulo, Brazil; Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Rubert A, Bagán L, Bagán JV. Retraction: Oral leukoplakia, a clinical-histopathological study in 412 patients. J Clin Exp Dent 2021; 13:e426-e432. [PMID: 33981388 PMCID: PMC8106929 DOI: 10.4317/jced.532746] [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: 03/26/2020] [Accepted: 04/26/2020] [Indexed: 11/05/2022] Open
Abstract
The authors detected some minor errors in the published manuscript (Rubert A, Bagán L, Bagán JV. Oral leukoplakia, a clinical-histopathological study in 412 patients. J Clin Exp Dent. 2020 Jun 1;12(6):e540-e546. doi: 10.4317/jced.57091. PMID: 32665812; PMCID: PMC7335600.) and have requested that the entire article be republished with these errors already rectified. Background A retrospective clinical-histopathological study was made of the evolution of oral leukoplakia over time, staging the disease according to the classification of van der Waal. Material and Methods A study was made of 412 patients with oral leukoplakia, analyzing the corresponding clinical factors and histopathological findings; assessing associations between the different clinical presentations and epithelial dysplasia; and evaluating the factors influencing malignant transformation of the lesions. Results Clinically, homogeneous presentations were seen to predominate (n = 336, 81.6%), while histologically most of the lesions exhibited no dysplastic changes (n = 271; 65.7%). Stage 1 of the van der Waal classification was the most common presentation (n = 214; 51.9%). The lesion malignization rate was 8.5%, and the factors associated to a significantly increased malignization risk were non-homogeneous OL lesions (p=0.00), lesion location in the tongue (p=0.00), and the presence of epithelial dysplasia (p=0.00). Conclusions In our series of patients with oral leukoplakia, malignization was associated to the less common clinical presentations of the disease, i.e., non-homogeneous lesions, and the latter tended to exhibit high grade epithelial dysplasia. Key words:Oral leukoplakia, potentially malignant disorders, malignant transformation.
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Affiliation(s)
- Andrea Rubert
- Assistant Professor of Oral Medicine. European University of Valencia
| | - Leticia Bagán
- Associate Professor of Oral Medicine. University of Valencia. Av. de Blasco Ibáñez, 15, 46010 València
| | - Jose V Bagán
- Chairman of Oral Medicine. University of Valencia. Head of the Department of Stomatology and Maxillofacial Surgery University General Hospital. Valencia (Spain) Fundación de Investigación del Hospital General Universitario of Valencia, CIBERONC, Valencia, Spain
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5
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Tuominen H, Rautava J. Oral Microbiota and Cancer Development. Pathobiology 2020; 88:116-126. [PMID: 33176328 DOI: 10.1159/000510979] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 12/24/2022] Open
Abstract
Oral microbiota are among the most diverse in the human body. More than 700 species have been identified in the mouth, and new sequencing methods are allowing us to discover even more species. The anatomy of the oral cavity is different from that of other body sites. The oral cavity has mucosal surfaces (the tongue, the buccal mucosa, the gingiva, and the palate), hard tissues (the teeth), and exocrine gland tissue (major and minor salivary glands), all of which present unique features for microbiota composition. The connection between oral microbiota and diseases of the human body has been under intensive research in the past years. Furthermore, oral microbiota have been associated with cancer development. Patients suffering from periodontitis, a common advanced gingival disease caused by bacterial dysbiosis, have a 2-5 times higher risk of acquiring any cancer compared to healthy individuals. Some oral taxa, especially Porphyromonas gingivalis and Fusobacterium nucleatum, have been shown to have carcinogenic potential by several different mechanisms. They can inhibit apoptosis, activate cell proliferation, promote cellular invasion, induce chronic inflammation, and directly produce carcinogens. These microbiota changes can already be seen with potentially malignant lesions of the oral cavity. The causal relationship between microbiota and cancer is complex. It is difficult to accurately study the impact of specific bacteria on carcinoma development in humans. This review focuses on the elucidating the interactions between oral cavity bacterial microbiota and cancer. We gather literature on the current knowledge of the bacterial contribution to cancer development and the mechanisms behind it.
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Affiliation(s)
- Heidi Tuominen
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.,Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Jaana Rautava
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland, .,Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland,
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6
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Rubert A, Bagán L, Bagán JV. Oral leukoplakia, a clinical-histopathological study in 412 patients. J Clin Exp Dent 2020; 12:e540-e546. [PMID: 32665812 PMCID: PMC7335600 DOI: 10.4317/jced.57091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background A retrospective clinical-histopathological study was made of the evolution of oral leukoplakia over time, staging the disease according to the classification of van der Waal.
Material and Methods A study was made of 412 patients with oral leukoplakia, analyzing the corresponding clinical factors and histopathological findings; assessing associations between the different clinical presentations and epithelial dysplasia; and evaluating the factors influencing malignant transformation of the lesions.
Results Clinically, homogeneous presentations were seen to predominate (n = 336, 81.6%), while histologically most of the lesions exhibited no dysplastic changes (n = 271; 65.7%). Stage 1 of the van der Waal classification was the most common presentation (n = 214; 51.9%). The lesion malignization rate was 8.3%, and the factors associated to a significantly increased malignization risk were non-homogeneous OL lesions (p=0.00), lesion location in the tongue (p=0.00), and the presence of epithelial dysplasia (p=0.00).
Conclusions In our series of patients with oral leukoplakia, malignization was associated to the less common clinical presentations of the disease, i.e., non-homogeneous lesions, and the latter tended to exhibit high grade epithelial dysplasia. Key words:Oral leukoplakia, potentially malignant disorders, malignant transformation.
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Affiliation(s)
- Andrea Rubert
- Assistant Professor of Oral Medicine. European University of Valencia
| | - Leticia Bagán
- Associate Professor of Oral Medicine. University of Valencia. Av. de Blasco Ibáñez, 15, 46010 València
| | - Jose V Bagán
- Chairman of Oral Medicine. University of Valencia. Head of the Department of Stomatology and Maxillofacial Surgery University General Hospital. Valencia (Spain) Fundación de Investigación del Hospital General Universitario of Valencia
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Giudice LW, Graff EA, Haripersad Y, Frydrych AM, Parsons R, Kujan O, Farah CS. Chronic disease comorbidity in patients with oral leukoplakia: A matched case-control study. Oral Dis 2020; 26:894-902. [PMID: 32106348 DOI: 10.1111/odi.13315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/11/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the presence of chronic diseases in patients with oral leukoplakia (OL) compared to controls matched for age group, gender, smoking and alcohol use. SUBJECTS AND METHODS This case-control study examined the general demographics, medical and social histories of 105 OL cases and 391 controls matched for age group, gender, tobacco and alcohol use. All OL cases were diagnosed based on both clinical and histopathological findings. RESULTS Chronic diseases were significantly associated with OL, namely dyslipidaemia (p < .0001), musculoskeletal diseases (p = .0101) and asthma (p = .0052). The use of ACE inhibitors (p = .0177), opioid analgesics (p = .0300), anticoagulants (p = .0055) and statins (p = .0010) was significantly associated with OL. Dyslipidaemia (p < .0001; odds ratio [95% CI]: 6.4 [3.5-11.6]) and asthma (p = .0110; odds ratio [95% CI]: 2.2 [1.2-4.0]) were identified as independent predictors of OL in multivariate analysis, both of which were significantly more common amongst cases than controls. CONCLUSIONS Results from this first Australian study suggest that dyslipidaemia and asthma may constitute independent predictors for the presence of OL. However, longitudinal studies are needed to ascertain the temporal relationship between OL and chronic disease comorbidity and the mechanisms underlying these associations.
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Affiliation(s)
- Lance W Giudice
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Emrik A Graff
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Yasmita Haripersad
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | | | - Richard Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia.,Oral, Maxillofacial and Dental Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia
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8
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Shekar P, Ramya N, Reddy BR. Reporting frequency of potentially malignant oral disorders and oral cancer: A 10-year retrospective data analysis in a teaching dental institution. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2020. [DOI: 10.4103/jdrntruhs.jdrntruhs_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Mustafa MB, Hassan MO, Alhussein A, Mamoun E, El Sheikh M, Suleiman AM. Oral leukoplakia in the Sudan: clinicopathological features and risk factors. Int Dent J 2019; 69:428-435. [DOI: 10.1111/idj.12509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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10
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Frydrych AM, Kujan O, Farah CS. Chronic disease comorbidity in patients with oral leukoplakia. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41548-018-0015-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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11
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Yen AMF, Wang ST, Peng BY, Cheng YC, Siewchaisakul P, Hsu CY, Chen SLS. Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males. Oral Dis 2018; 25:750-757. [PMID: 30592115 DOI: 10.1111/odi.13028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers. MATERIALS AND METHODS A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death. RESULTS A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25-10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17-21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death. CONCLUSIONS Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.
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Affiliation(s)
- Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sen-Te Wang
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ya-Chung Cheng
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pallop Siewchaisakul
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Yang Hsu
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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12
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Mello FW, Miguel AFP, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra ENS, Rivero ERC. Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis. J Oral Pathol Med 2018; 47:633-640. [PMID: 29738071 DOI: 10.1111/jop.12726] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2018] [Indexed: 01/28/2023]
Abstract
Oral potentially malignant disorders (OPMD) are chronic conditions, which have a higher risk of transformation to oral squamous cell carcinoma. The aim of this systematic review and meta-analysis was to answer the question: "What is the prevalence of oral potentially malignant disorders among adults?" Studies reporting the prevalence of these conditions (leukoplakia, erythroplakia, oral submucous fibrosis [OSMF], and actinic cheilitis) were selected, only studies in which a clinical assessment and histopathological confirmation were performed were included. Of the 5513 studies, 22 met the inclusion criteria for qualitative and quantitative analyses. The risk of bias (RoB) of the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Seven studies were classified as high risk, 12 as moderate risk, and 3 as low RoB. The meta-analysis showed that the prevalence of OPMD was 4.47% (95% CI = 2.43-7.08). The most prevalent OPMDs were OSMF (4.96%; 95% CI = 2.28-8.62) and leukoplakia (4.11%; 95% CI = 1.98-6.97). OPMDs were identified more commonly in males (59.99%; 95% CI = 41.27-77.30). Asian and South American/Caribbean populations had the highest prevalence rates of 10.54% (95% CI = 4.60-18.55) and 3.93% (95% CI = 2.43-5.77), respectively. The overall prevalence of OPMD worldwide was 4.47%, and males were more frequently affected by these disorders. The prevalence of OPMD differs between populations; therefore, further population-based studies may contribute to the better understanding of these differences.
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Affiliation(s)
- Fernanda Weber Mello
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Kamile Leonardi Dutra
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - André Luís Porporatti
- Brazilian Centre for Evidence-based Research, Florianópolis, Brazil.,Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London, London, UK.,WHO Collaborating Centre for Oral Cancer, London, UK
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Elena Riet Correa Rivero
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
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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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14
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The Epidemiological Pattern of Premalignant and Malignant Epithelial Lesions in Northeast of Iran: A 43-Year Evaluation. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.5403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Syomkin VA, Rabinovich OF, Babichenko II, Bezrukov AA. [Leukoplakia: clinical and pathological diagnosis]. STOMATOLOGIIA 2017; 96:72-76. [PMID: 36475409 DOI: 10.17116/stomat201796172-76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Leukoplakia is one of the most common obligate precancerous lesions of the oral mucosa. leukoplakia treatment is carried out in conjunction with surgery. Removed tissues are sent to pathological examination. The article describes clinical signs and corresponding pathological processes most often revealed by histological study.
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Affiliation(s)
- V A Syomkin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O F Rabinovich
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - I I Babichenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A A Bezrukov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Mohan SP, Chitturi RT, Ragunathan YT, Lakshmi SJ, Nallusamy J, Joseph I. Minor Salivary Gland Changes in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma - A Histopathological Study. J Clin Diagn Res 2016; 10:ZC12-5. [PMID: 27630945 DOI: 10.7860/jcdr/2016/20218.8116] [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: 03/18/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The most common etiology for Oral Squamous Cell Carcinoma (OSCC) is tobacco and tobacco related products which cause nuclear damage to the keratinocytes. The chemical carcinogens not only affect the lining of oral epithelium but also affect the lining epithelium of the excretory ducts of the salivary glands. Thus, there is a possibility of epithelial dysplasia of the salivary duct epithelium which may lead to potential malignant transformation. AIM The study was performed to see the changes in the minor salivary glands and excretory ducts in cases of oral epithelial dysplasia and OSCC. MATERIALS AND METHODS A total of 278 archival cases of mild, moderate and severe epithelial dysplasia, carcinoma in situ, OSCC including verrucous carcinoma were histopathologically evaluated to observe changes in the excretory ducts and the minor salivary glands. RESULTS In the study there were 56.5% males and 43.5% females. The age group that was most commonly affected in both the sexes was 50-60 yr old. Buccal mucosa was the most common site of involvement. Ductal changes observed in the excretory duct include simple hyperplasia, metaplastic changes such as mucous, oncocytic & squamous, and infiltration of inflammatory cells and malignant cells. Acinar changes observed were degeneration, squamous metaplasia, myoepithelial cell proliferation and inflammatory cell infiltration. Both the excretory ducts and ducts within the gland showed dysplasia. CONCLUSION According to observations in our study it is suggested that histopathological interpretation for oral mucosal lesions especially oral epithelial dysplasias and OSCC should also include changes related to salivary gland tissue to provide a better treatment plan and prevent recurrence of the malignant tumours.
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Affiliation(s)
- Sunil Paramel Mohan
- Head of Department, Deparment of Oral Pathology, Director, Department of Stem Cells and Regenerative Medicine, Dean, Sree Anjaneya Institute of Dental Sciences , Calicut, Kerala, India
| | - Ravi Teja Chitturi
- Lecturer, Department of Oral Biology, School of Dentistry, Faculty of Medical Sciences, The University of the West Indies , St. Augustine Campus, Trinidad and Tobago
| | | | - Suman Jhansi Lakshmi
- Professor, Department of Oral Medicine and Radiology, K S R Institute of Dental Science and Research , Tiruchengode, Tamilnadu, India
| | - Jaisanghar Nallusamy
- Professor, Department of Oral Medicine and Radiology, Sree Anjaneya Institute of Dental Sciences , Calicut, Kerala, India
| | - Isaac Joseph
- Professor and Head, Department of Oral Pathology, Sree Moogambigai Dental College , Kulasekharam, Tamil Nadu, India
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Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. MENOPAUSE REVIEW 2015; 14:188-91. [PMID: 26528108 PMCID: PMC4612556 DOI: 10.5114/pm.2015.54344] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/03/2015] [Accepted: 07/02/2015] [Indexed: 12/02/2022]
Abstract
Aim of the study Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. Material and methods Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound. Surgically removed uteri and ovaries were sent for histopathological examination. Results of histopathological examination as gold standard were compared with conventional gynecological screening methods. Results Histopathological examination of surgically removed uteri and ovaries after vaginal hysterectomy for uterovaginal prolapse showed abnormal findings in 61.25% (49/80) of studied cases (10 chronic cervicitis; 20 cervical intra-epithelial neoplasia-1 [CIN-1]; 5 CIN-2; 2 CIN-3; 10 simple endometrial hyperplasia without atypia and 2 simple serous ovarian cyst). Also, histopathological examination showed premalignant changes in 33.75% (27/80) of studied cases (20 CIN-1; 5 CIN-2 and 2 CIN-3), which mean 50% sensitivity of pre-operative Pap smear to detect premalignant cervical changes. Conclusions Asymptomatic women with utero-vaginal prolapse may have associated premalignant lesions which may not be detected by conventional screening methods, and this should be explained preoperatively for women undergoing surgery, especially if conservative management was considered.
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Estimation of oral leukoplakia treatment records in the research of the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk. Postepy Dermatol Alergol 2015; 32:114-22. [PMID: 26015781 PMCID: PMC4436228 DOI: 10.5114/pdia.2014.40791] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/02/2013] [Accepted: 11/20/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral cavity. Aim The purpose of the study was clinical and epidemiological analysis of patients with OL diagnosed and treated in the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk, comparison of effectiveness of treatment methods, defining whether van der Waal level of OL influences treatment effectiveness, correlation between localization of OL and treatment effectiveness, and defining the optimal OL therapeutic method. Material and methods Among 55 911 patients diagnosed and treated in the Department in the years 1999–2009, 204 people with OL were selected (104 women, 100 men, average age: 58.1 years). Treatment and observation period of 6 months was completed by 178 (87.25%) patients. Seventy-four patients were treated with cream containing 0.05% tretinoin. Sixty-three patients underwent cryosurgery, and 41 surgery. Control visits were made in week 2, 4, 6 and 8 and 6 months after completed treatment. Results Three hundred and twenty lesions of OL were diagnosed. According to van der Waal classification, the largest group of patients was classified into stage I and II. The percentage of totally cured patients was 90.07%. There were no statistic differences in effectiveness between surgical and cryosurgical treatment. Conclusions Evaluation of OL treatment methods depends on localization of the lesions and its stage of progression. The effectiveness of treatment with locally applied tretinoin is smaller in comparison to surgery and cryosurgery. It allows to reduce the number and size of OL lesions, what makes it possible to reduce the number of ablative procedures.
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