文章：

基于口腔扁平苔藓的口腔鳞状细胞癌转移

Metastases of OSCC Based on Oral Lichen Ruber Planus

原文发布日期：14 August 2023

DOI: 10.3390/cancers15164092

类型: Article

开放获取: 是

英文摘要：

Oral lichen ruber planus (OLP) is a poorly understood chronically inflammatory disease of the oral mucosa. Malignant transformation into oral squamous cell carcinoma (OSCC) is reported in between 1–2% of cases in the literature. After malignant transformation, surgical treatment—meaning tumor resection combined with neck dissection—is recommended. The recommended extent of treatment is controversial in the literature because this kind of OSCC is often a highly differentiated tumor with a lower risk for lymph nodal spreading. This study aims to overview 103 patients treated in our department due to OLP. The primary outcome parameter was the development of metastases in OLP patients compared to a group of OSCC patients without OLP and the comparison of survival in between both groups. Statistical analysis showed a significantly lower risk for patients with OSCC and with OLP for lymph nodal spreading (p= 0.013). Patients with OSCC and without OLP had a 4.76-higher risk for lymph nodal spreading. On the other hand, second metachronous tumor occurred more often in patients with OSCC and OLP. Overall, OSCC based on OLP occurs more often in female patients, is more highly differentiated and comes with a lower risk for metastases but has a higher risk for second metachronous tumors. Therefore, special attention should be paid to patients with OSCC based on OLP when planning adjuvant therapy and clinical follow-up. The indication for postoperative radiation should be made cautiously in this case, and clinical controls should be performed more closely due to the risk of recurrent disease or tumors at different locations.

摘要翻译： 

口腔扁平苔藓是一种发病机制尚不明确的口腔黏膜慢性炎症性疾病。文献报道其恶变为口腔鳞状细胞癌的比例约为1%-2%。恶变后推荐采用手术治疗，即肿瘤切除联合颈部淋巴结清扫术。由于此类口腔鳞状细胞癌通常分化程度较高、淋巴结转移风险较低，关于治疗范围的界定在文献中存在争议。本研究旨在回顾分析我科收治的103例口腔扁平苔藓患者。主要观察指标为：比较口腔扁平苔藓患者与无口腔扁平苔藓的口腔鳞状细胞癌患者的淋巴结转移发生率，并对比两组患者的生存情况。统计分析显示，合并口腔扁平苔藓的口腔鳞状细胞癌患者淋巴结转移风险显著降低（p=0.013）。无口腔扁平苔藓的口腔鳞状细胞癌患者淋巴结转移风险高出4.76倍。另一方面，合并口腔扁平苔藓的口腔鳞状细胞癌患者更易发生第二原发异时性肿瘤。总体而言，基于口腔扁平苔藓恶变的口腔鳞状细胞癌更常见于女性患者，肿瘤分化程度更高，转移风险较低，但第二原发异时性肿瘤风险较高。因此，在制定辅助治疗方案和临床随访计划时，应特别关注此类患者。对于此类病例，术后放疗指征应谨慎评估，且因存在复发或多部位肿瘤风险，临床随访应更为密切。

原文链接：

Metastases of OSCC Based on Oral Lichen Ruber Planus