口腔扁平苔藓人乳头瘤病毒的检测

目的 探讨口腔扁平苔藓（OLP）和人乳头瘤病毒（HPV）的关系，从而为确定OLP的原因，诱因和发病机理提供理论依据。方法 应用通用引物（General Primer,GP)介导的PCR技术检测OLP和正常口腔黏膜的HPVDNA，并对HPV－16DNA进行特异性检测。结果 30例OLP检测到25例HPV－6，11，33DNA阳性，而对照组检测到5例，两者相比有显著性差异（P＜0．05）；OLP组检测到3例HPV－16，18DNA阳性，对照组1例，两者相比无显著性差异（P＞0．05）。结论 OLP是以低危型HPV感染为主，其中糜烂型OLP可检测到较高高危HPV16 DNA。因此，对OLP尤其是糜烂型OLP要进行HPV的检测，从而进行有效治疗。     

口腔鳞癌中人乳头瘤病毒的研究

为了探讨人乳头瘤病毒（ｈｕｍａｎｐａｐｉｌｏｍａｖｉｒｕｓ，ＨＰＶ）１６、１８型及其与癌的关系，作者采用聚合酶链反应（ｐｏｌｙｍｅｒａｓｅｃｈａｉｎｒｅａｃｔｉｏｎ，ＰＣＲ）技术，检测２３例口腔鳞状细胞癌（ｏｒａｌｓｑｕａｍｏｕｓｃｅｌｃａｒｃｉｎｏｍａ，ＯＳＣＣ），正常口腔粘膜（ｎｏｒｍａｌｏｒａｌｍｕｃｏｓａ，ＮＯＭ）中的ＨＰＶ１６型和１８型ＤＮＡ中的Ｅ６、Ｅ７基因片段，并对其ＰＣＲ产物进行Ｓｏｕｔｈｅｒｎ印迹杂交分析，以研究ＨＰＶ与ＯＳＣＣ的关系。结果显示：ＯＳＣＣ中ＨＰＶＤＮＡ阳性率４７．８％（１１／２３），其中ＨＰＶ１６型６例，ＨＰＶ８型３例，ＨＰＶ１６和１８型复合感染２例，ＮＯＭ中ＨＰＶ阳性率２０％（２／１０），２例阳性者，均为ＨＰＶ１６型。研究结果提示：高危型ＨＰＶ与口腔鳞癌可能有关，二者的确切关系尚需进一步研究。但ＨＰＶ致癌基因Ｅ６、Ｅ７片段在口腔鳞癌中的检出，为鳞癌的病因研究开辟了新的前景     

正常口腔黏膜和口腔鳞癌中人乳头瘤病毒感染率的研究进展

黏膜高危型HPV-16、HPV-18感染是宫颈癌的主要致病因素,且与口腔鳞癌的发生密切相关,但目前对口腔鳞癌中HPV的感染率和亚型的分布尚不十分清楚。作者系统查阅了目前已经发表的有关HPV在正常口腔黏膜或口腔鳞癌中感染率和亚型分布的文献资料,对正常口腔黏膜、口腔鳞癌中人乳头瘤病毒的感染率的研究进展进行了综述。     

口腔鳞状细胞癌中人乳头瘤病毒16型和人巨细胞病毒感染状况的初步研究

采用斑点杂交和PCR技术检测口腔粘膜组织中HPV_(16)DNA和 HCMV DNA,结果表明:在正常口腔粘膜组织、白斑及口腔鳞癌中HPV_(16)DNA和HCMV DNA感染率分别为0％,35.7％,50.0％和0％,14.3％,28.1％,此两种病毒的共同感染率分别为0％,14.3％,18.8%,口腔鳞癌及白斑组织中HPV_(16)DNA的检出率均高于正常口腔,且差别具有显著性(P<0.05);提示HPV_(16)感染与口腔鳞癌的发生相关;HCMV可能与HPV_(16)对口腔鳞癌的成癌起到协同促进作用。     

口腔颌面部病变组织中人乳头瘤病毒DNA的检测

为探讨人乳头瘤病毒（ＨＰＶ）和口腔颌面部肿瘤以及某些口腔粘膜病的关系，应用聚合酶链反应技术（ＰＣＲ）检测４型人乳头瘤病毒６，１１，１６，１８型ＤＮＡ．结果：４５例口腔颌面部良性病变和恶性肿瘤患者，４８份组织标本中的人乳头瘤病毒ＤＮＡ（ＨＰＶ－ＤＮＡ），总阳性率达７５．６％（３４／４５）．其中恶性肿瘤ＨＰＶ－ＤＮＡ阳性率为７６．９（２０／２６）．良性病变ＨＰＶ－ＤＮＡ阳性率为７３．７％（１４／１９）．恶性肿瘤和良性病变２组间ＨＰＶ－ＤＮＡ的型别有显著的差异，恶性肿瘤以ＨＰＶ１６和ＨＰＶ１８型为主，良性病变以ＨＰＶ１８和ＨＰＶ６为主．非肿瘤对照组共３０人ＨＰＶ－ＤＮＡ阳性率为１０％，均为ＨＰＶ１８型．ＨＰＶ１８在口腔颌面部恶性肿瘤和良性病变组织中阳性率均较高，但两者间无统计学差异     

无创检测口腔白斑及鳞癌中人乳头瘤病毒及其分型

[摘要] 目的 探讨口腔白斑（oral leukoplakia,OLK）和口腔鳞状细胞癌（oral squamous cell carcinoma,OSCC）中人乳头瘤病毒（human papillomavirus,HPV）及其分型和临床意义。方法 采用无创方法收集30例正常人,103例OLK,30例OSCC的口腔黏膜脱落细胞,采用聚合酶链反应（Polymerase chain reaction,PCR）结合导流杂交技术进行37种HPV基因型别的检测,对受检者进行相关资料分析。结果 正常人检出HPV阳性1例,检出率为3.33%（1/30）,OLK检出HPV阳性5例,检出率为4.85%（5/103）,OSCC检出HPV阳性1例,检出率为3.33%（1/30）,各组间差异无统计学意义（χ2=0.22,P=0.90＞0.05）。其中OLK中有4例为HPV单一型阳性,1例为HPV三重型别阳性。结论 PCR导流杂交检测技术能无创检测口腔HPV分型情况,可应用于临床。HPV在OLK、OSCC中检出率较低,可能与OLK、OSCC的发病关联性不强。     

桂林地区口腔黏膜白斑中人乳头瘤病毒的检测

目的:探讨桂林地区口腔黏膜白斑与人乳头瘤病毒(HPV)亚型的关系。方法:运用PCR-反向斑点杂交法,检测桂林地区15例口腔黏膜白斑患者和21例正常口腔黏膜标本的DNA,对两组的阳性率进行χ2检验。结果:口腔黏膜白斑组,15例病人5例HPV呈阳性,均为16型。21例正常口腔黏膜标本中,4例HPV呈阳性,均为16型。两组比较,χ2=0.3429,P>0.05。结论:口腔黏膜白斑的发生与HPV无确切关系,但不排除HPV是口腔黏膜白斑的发病因素之一。     

人乳头瘤病毒、疱疹病毒Ⅰ型及人巨细胞病毒与口腔鳞癌关系的研究

目的:研究口腔鳞癌与人乳头瘤病毒(HPV)、疱疹病毒Ⅰ型(HSV-Ⅰ)和人巨细胞病毒(HCMV)的关系.方法:采用斑点杂交和PCR技术检测32例口腔鳞癌、14例口腔白斑和10例正常口腔粘膜中HPV16、HSV-Ⅰ及HCMVDNA.结果:在正常口腔粘膜、白斑及口腔鳞癌中HPV16、HSV-Ⅰ及HCMVDNA感染率分别为0%、35.7%、50.0%,40.0%、50.0%、43.3%和0%、14.3%、28.1%,口腔鳞癌及白斑组织中HPV16-DNA的检出率均高于正常口腔,且差别具有显著性(p＜0.05);但HSV-Ⅰ和HCMVDNA在口腔疾患中的检出率与正常比较无显著差别(p＞0.05).结论:HPV16感染与口腔鳞癌的发生相关;HSV-Ⅰ和HCMV可能参予口腔鳞癌的发生及发展,并且与HPV16有协同致癌的作用.     

口腔鳞癌中人乳头瘤病毒感染及树突状细胞分布的相关性研究

目的：探讨口腔鳞癌（OSCC）中人乳头瘤病毒（HPV）感染与树突状细胞（DC）分布的关系。方法：采用原位杂交技术（IsH）检测56例OSCC、26例口腔白斑（OLK）和10例正常口腔黏膜中HPVl6／18的感染情况,免疫组化EnVision法观察其中DC的分布表达。结果：OSCC和OLK组HPVl6／18感染率显著高于正常组（P〈0．05）,HPVl6／18感染与吸烟有一定相关性（P〈0．05）。HPVI~5／18感染的OSCC组织中CDla低表达（P〈0．01）。结论：ISH是检测HPV较理想的方法,HPV感染是部分口腔鳞癌的病因学因素,HPV感染患者局部免疫功能低下可能导致肿瘤免疫逃逸。     

口腔扁平苔藓与过敏原

目的；研究口腔扁平苔藓的发生、发展与吸入性和食物性过敏原的关系。方法：应用20种食物性过敏原溶液和18种吸入性过敏原溶液，采用皮内注射法，对95例口腔扁平苔藓患者进行过敏原过敏反应检查。结果：95例全部呈现过敏反应。其中84例同时存在食物性和吸入性过敏原过敏反应。6例单纯对食物性过敏原过敏，5例单纯对吸入性过敏原过敏。部分食物过敏原呈现迟发性超敏反应。结论：口腔扁平苔藓的发生、发展与吸入性和食物性过敏原相关。限制接触过敏物质有益于口腔扁平苔藓的治疗。     

Immune mechanisms in oral lichen planus

Although we still don't know the cause, there has been much research into the immune and pathological mechanisms that underlie oral lichen planus (OLP) and it is now possible to piece together a much clearer picture of the disease process. There is consensus that in OLP there is chronic, cell-mediated, immune damage to basal keratinocytes in the oral mucosa that are recognized as being antigenically foreign or altered. In most cases, however, the identity of the target antigen remains unknown. It is likely that cytokines released by the affected keratinocytes, and the associated inflammatory infiltrate, play a key role in the selective recruitment of the T-cell-dominated infiltrate that characterizes OLP, through their ability to induce adhesion molecule expression as well as further cytokine and chemokine release. In susceptible individuals, chronic presentation of antigen by basal keratinocytes may perpetuate the condition and direct cell-mediated immune damage on the keratinocytes.     

丙型肝炎病毒在口腔扁平苔藓发病中的意义

目的：探索丙型肝炎病毒在口腔扁平苔藓发病中的意义。方法：应用ＰＣＲ技术对６０例口腔扁平苔藓患者进行了丙型肝炎病毒ＲＮＡ的检测。结果：在６０例口腔扁平苔藓患者中，其中７例丙型肝炎病毒ＲＮＡ阳性，与对照组相比具有显著性差异（Ｐ＜０．０５）；且丙型肝炎病毒ＲＮＡ阳性患者的损害均表现为白纹伴糜烂。结论：在口腔扁平苔藓中，尤其是在糜烂伴白纹的口腔扁平苔鲜患者中，应用敏感的ＰＣＲ技术检测血液中的丙型肝炎病毒ＲＮＡ，不仅对于防治慢性肝炎，而且对于探索口腔扁平苔藓的病因与治疗均具有重要意义。     

CD44在口腔扁平苔藓中的表达及意义

目的 探讨口腔扁平苔藓病变中粘附分子CD44H、CD44V3表达的意义。方法 应用免疫组织化学SP法对62例口腔扁平苔藓，其中糜烂型扁平苔藓14例，非糜烂型扁平苔藓48例，21例慢性盘状红斑狼疮，10例正常粘膜CD44H、CD44V3的表达进行观察。结果 扁平苔藓病损区组织的染色以基底细胞、棘层细胞下调明显。结论 CD44参与口腔扁平苔藓的发病过程。     

口腔扁平苔藓单核/巨噬细胞功能的研究

目的：探讨单核／巨噬细胞在口腔扁平苔藓中的作用。方法：利用细胞增殖法检测OLP患者外周血中单核／巨噬细胞的ADCC效应。结果：OLP患者单核／巨噬细胞的ADCC效应明显低于对照组。结论：说明OLP患者存在着免疫功能低下，同时支持OLP可能为免疫功能低下性疾病。     

朗格罕斯细胞的分布、变化与口腔扁平苔藓发病及病变程度的关系

目的：为进一步探讨口探扁平苔藓的发病机制。方法：采用免疫组织化学方法,使用朗格罕斯细胞特异性标记CD1a单克隆抗体对35例口腔扁平苔藓（oral lichen planus,OLP)进行研究,结果：CD1a^ 的朗格罕斯细胞（Langerhans cell,LC)较对照组明显增多,分布更趋于上棘层及粒层,树突增,增长,其数量和表达程度与OLP病程、病变程度相关,不同组间有高度显著性（P＜0．01）。结论：LC在OLP的发病,发展中具有重要作用。     

Psychosocial stressors in oral lichen planus

BACKGROUND: Psychosomatic factors and their association with dermatological disorders are well recognized, yet their importance in oral lichen planus (OLP) is still debated. This study was done to determine the importance of psychosocial stressors in patients with OLP. METHODS: An analytical age-sex matched double controlled study. Stratified serial random sampling was done for sample selection. The experimental group consisted of biopsy proven OLP subjects (n = 41), negative control consisted of apparently healthy general Out Patient Department (OPD) patients (n = 73) and positive controls were patients with burning mouth syndrome, atypical facial pain and myofacial pain dysfunction syndrome (n = 36). The General Health Questionnaire-version 28 (GHQ-28) and the Hospital Anxiety and Depression Scale (HADS) were used to evaluate psychosocial stressors in terms of stress, anxiety and depression respectively. RESULTS: The OLP patients had significantly higher stress (Z = 4.331; p < 0.05, significant), anxiety (Z = 4.260; p < 0.05, significant) and depression levels (Z = 4.942; p < 0.05, significant) than the negative controls when measured by GHQ and HADS respectively. Similar findings were noted between the two control groups, with higher stress (Z = 5.784; p < 0.05, significant), anxiety (Z = 6.416; p < 0.05, significant), and depression (Z = 4.841; p < 0.05, significant) levels in the positive control group. However, differences in stress (Z = 2.0416; p > 0.05, non-significant), anxiety (Z = 1.681; p > 0.05, non-significant) and depression levels (Z = 0.195; p > 0.05, non-significant) were found to be non-significant between OLP and positive control. CONCLUSION: Significantly higher stress, anxiety and depression levels were found in the OLP and positive control than the general population. No significant difference was noted between the OLP and the positive controls (in which psychosocial stressors are the sole etiology). These suggest that psychological stressors play an important role in the causation of OLP. It may be further hypothesized that these stressors form a starting point for the initiation of various autoimmune reactions, which have been shown to be contributory to the pathogenesis of OLP. Further longitudinal studies need to be done globally before definitive conclusions can be drawn.     

口腔扁平苔藓与HLA的相关性研究

目的：探讨口腔扁平苔藓与人类白细胞抗原的相关性。方法：应用微量淋巴细胞毒试验,检测１９例上海汉族人口腔扁平苔藓外周血的人类白细胞抗原（ＨＬＡ－Ａ、－Ｂ、－ＤＲ、－ＤＱ）的抗原频率。结果：患者组ＨＬＡ－ＤＲ１抗原频率（３６．８４％）较正常对照组（１．０８％）显著增高（Ｐ＜０．００１）。结论：ＨＬＡ－ＤＲ１与口腔扁平苔藓明显相关。带有ＨＬＡ－ＤＲｌ相关基因的个体对口腔扁平苔藓具有遗传易感性     

High percentage of oral lichen planus and lichenoid lesion in oral squamous cell carcinomas

Objective: Oral lichen planus (OLP) and lichenoid lesions (OLL) are regarded as precursor lesions of oral squamous cell carcinoma (OSCC) with potential for malignant transformation. This potential is not clear due to difficulties in diagnosis of OLP and OLL. Our aim was therefore to evaluate previously identified OLP and OLL as precursor lesions in OSCC and to identify cancer related etiological factors such as smoking and alcohol consumption.

Material and methods: We retrospectively reviewed all cases (total 323, comprising 164 females and 159 males) with OSCC treated at the Department of Oral and Maxillofacial Diseases and Surgery, Helsinki University Hospital during 2015. Confirmed by histopathological biopsy, 58 (17.9%) had OLP and 13 had OLL (4.0%) as precursor lesion.

Results: Patients with OLP were slightly older than those without it. OLP was more common in females than in males (p?p?=?.006) and cancer relapses less common (p?=?.005). Smoking was less frequent in patients with OLP and OLL (p?p?Conclusion: Our findings confirm the importance of active follow-up of all patients with OLP and OLL even in patients who do not fit a traditional high-risk category for OSCC.     

口腔扁平苔藓合并食道扁平苔藓的诊治及相关文献复习

目的总结分析口腔扁平苔藓（OLP）合并食道扁平苔藓（ELP）的临床发生率、诊出方法、治疗和恶变倾向。 方法对236例OLP确诊患者,根据主诉及问诊有胸部不适、胸前灼痛、烧灼感、吞咽困难、食道狭窄、进食不畅等症状,获得知情同意后进一步进行食道胃镜检查及病理活检,筛选合并ELP,进行规范治疗和追踪。 结果18例出现了ELP病损,OLP合并出现ELP发生率为7.6%（18/236）。其中2例11.1%（2/18）早于OLP出现食道非典型增生,1例5.5%（1/18）已早于OLP出现恶变为食道鳞状细胞癌。 结论扁平苔藓是全身性疾病,ELP和OLP均属于黏膜的慢性炎症性疾病,两者间存在关联性。口腔科医生接诊OLP患者时,应该关注其全身其他部位的病损,尽早发现其他部位早期而隐匿的恶变,以免造成误诊和漏诊。