Background: The aim of this study was to evaluate the usefulness of close clinical surveillance intervals combined with oral brush biopsies to enable the early detection of malignant transformations in patients with oral lichen planus (OLP) performed in our oral medicine clinic. Methods: This retrospective study was carried out on 414 patients suffering from OLP, based on pre-established clinical and histopathological criteria, who received long-term follow-up between 1993–2022 (ranging from 6 months to 22.2 years). Results: A total of 297 patients were included in this study. Four people developed an oral squamous cell carcinoma (OSCC) during the observation period. Patients with close follow-up intervals were detected at early stages (two cases showed histologically SIN III and one patient was classified as having a pT1N0M0 tumour). One case was dropped in the consultation hour during the COVID19 pandemic and appeared again two years later, staged as a pT3N1M0 tumour based on an OLP. Three of the cases were clinically doubtful, which led to brush biopsies. Afterwards, additional DNA-image cytometry was performed, in which all the specimens of brush biopsies showed aneuploidy as a marker for malignancy, regarding both stem line and single cell aneuploidy. Conclusions: A careful surveillance programme consisting of check-ups every 3–4 months, oral brush biopsies, and static DNA image cytometry in cytologically diagnosed doubtful or suspicious cases assures the early detection of malignant transformation in the cancer’s early intraepithelial and microinvasive stages.
背景：本研究旨在评估我院口腔黏膜病门诊采用密切临床随访联合口腔刷检活检对口腔扁平苔藓（OLP）患者恶性转化的早期检测价值。方法：本研究为回顾性研究，纳入1993年至2022年间（随访时间6个月至22.2年不等）接受长期随访的414例符合既定临床与组织病理学诊断标准的OLP患者。结果：最终共297例患者纳入分析。观察期间有4例患者发展为口腔鳞状细胞癌（OSCC）。其中接受密切随访的患者均在早期阶段被检出（2例组织学诊断为SIN III级，1例为pT1N0M0期肿瘤）。另有1例在新冠疫情期间失访，两年后复诊时已进展为基于OLP的pT3N1M0期肿瘤。3例患者临床表现为可疑病变，遂行刷检活检。后续进行DNA图像细胞计量学检测，所有刷检标本均显示非整倍体（包括干系非整倍体与单细胞非整倍体）这一恶性肿瘤标志。结论：由每3-4个月定期复查、口腔刷检活检及对细胞学诊断可疑病例行静态DNA图像细胞计量学检测构成的严密监测方案，可确保在癌变早期（上皮内及微浸润阶段）实现恶性转化的早期发现。
肿瘤(癌症)患者之家