Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

Oral potentially malignant disorders in a large dental population

Objectives

Oral cancer (OC) may be preceded by clinically evident oral potentially malignant disorders (OPMDs). Oral carcinogenesis is a multistep process that begins as epithelial hyperplasia and progresses to oral epithelial dysplasia and finally to fully malignant phenotypes. The aim of our study was to estimate the prevalence of OPMDs in a large population of dental patients.

Methods

Patients were seen in the Oral Diagnosis and Oral Medicine clinics at Boston University Henry M. Goldman School of Dental Medicine between July 2013 and February 2014 and received a comprehensive oral examination to identify any possible mucosal lesions. Patients with a suspected OPMD (submucous fibrosis, oral lichen planus, leukoplakia and erythroplakia) that did not resolve in 2–3 weeks received a biopsy for definitive diagnosis. Logistic regression models were used to explore the relationship between OPMDs and associated risk factors.

Results

A total of 3,142 patients received a comprehensive oral examination [median age: 43 (range: 18–97); 54.3% females]. Among these, 4.5% had an oral mucosal lesion with 0.9% being an OPMD (one submucous fibrosis, three epithelial dysplasias, fourteen with hyperkeratosis/epithelial hyperplasia and nine with oral lichen planus). Males and current smokers were associated with higher odds of having OPMD (OR 1.7, 95% CI 0.8–3.8; OR 1.9, 95%CI 0.8–4.1). Increasing age was associated with having OPMDs (p<0.01).

Conclusion

Optimal oral visual screening for OC remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. Although OPMDs were rare, our results confirm the importance of a thorough chairside screening by dentists and dental students to detect any mucosal changes.     

Oral potentially malignant disorders – An assessment of knowledge and attitude to future education in undergraduate dental students

Introduction

The aim of this study was to assess the knowledge and clinical experience of oral potentially malignant disorders (OPMDs) in undergraduate dental students in six European countries (Croatia, France, Italy, Portugal, Spain and United Kingdom) and assess student’s attitude and preference to future education on the topic. A secondary aim was to identify gaps in student’s knowledge and clinical practice. The study was a part of the Erasmus+ project “Oral Potentially Malignant Disorders: Healthcare Professionals Training“ (Grant No: 2020-1-UK01-KA202-078917).

Materials and Methods

An online questionnaire was distributed to all final-year students in six partner universities. This consisted of four parts assessing: (1) knowledge on OPMDs, (2) clinical experience with this group of patients, (3) self-rated competence in the management of OPMDs and (4) preferences with regard to future education.

Results

Two hundred and sixty final-year dental students from six partner universities responded to the questionnaire. Response rates varied from 12% to 92% between partner universities. Significant differences in clinical experience and knowledge were found between students. Students with more clinical exposure to OPMDs rated their knowledge and competence in the management of OPMDs higher than students with less clinical experience. The majority of students were interested in future education on OPMDs, preferably via short educational videos.

Conclusion

The majority of students have received theoretical knowledge of OPMDs during their undergraduate studies, however, not all had clinical exposure to this group of patients. Students were open to further education on OPMDs. Important deficiencies in knowledge were identified that need to be addressed and it is anticipated that the e-learning platform and e-book that are in development by partner institutions will help to improve overall knowledge of OPMDs.     

Oral leukoplakia classification and staging system with incorporation of differentiated dysplasia

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.     

OSF并存OLP34例回顾性分析

目的：总结口腔黏膜下纤维性变（OSF）并存口腔扁平苔藓（OLP）的临床特征,提高对该病的诊断和治疗水平。方法：对34例OSF并存OLP患者的临床资料进行回顾性分析。结果：34例OSF并存OLP患者表现为青壮年男性居多,均有进食刺激性食物和咀嚼槟榔史,29例（85.29%）有吸烟史,27例（79.41%）有饮酒史,28例（82.35%）OSF的病理分期为早期,6例（17.65%）为中期,发病部位以颊部和舌部为主,所有患者均无糜烂和张口受限,治疗后疼痛症状缓解,但白色条纹或斑点始终未消退,已消失的丝状乳头、菌状乳头亦未见恢复。结论：OSF并存OLP并非两种疾病的简单叠加,而是具有其特异性的表现,必要时可行两个典型部位活检进行诊断,治疗中及治疗后须戒烟、戒槟榔。     

Dental hygienists and dentists as providers of brush biopsies for oral mucosa screening

Background

Oral cancer is a severe and potentially fatal disease usually starting in the squamous epithelium lining the oral cavity. Together with oropharyngeal carcinoma, it is the fifth to sixth most common malignancy worldwide. To limit the increase in the global oral cancer incidence over the past two decades, the World Health Assembly adopted a resolution urging member states to integrate preventive measures such as engagement and training of dental personnel in screening, early diagnosis, and treatment into their national cancer control programs.

Aim

The aim of this study was to investigate if dental hygienists (DHs) and dentists (Ds) in general dental practice care can be entrusted to perform brush sampling of oral potentially malignant disorders (OPMDs), and to evaluate their level of comfort in performing brush biopsies.

Methods

Participants were five DHs and five Ds who received one day of theoretical and clinical training in oral pathology to identify OPMDs (leukoplakia [LP], erythroplakia [EP], and oral lichen planus [OLP]), and perform brush sampling for PAP cytology and high-risk human papillomavirus (hrHPV) analysis.

Results

Out of 222 collected samples, 215 were adequate for morphological assessment and hrHPV analysis. All the participants agreed that sample collection can be incorporated in DHs and Ds routine clinical duties, and most of them reported that sample collection and processing was easy/quite easy.

Conclusion

Dentists and DHs are capable of collecting satisfactory material for cytology and hrHPV analysis. All the participating DHs and Ds were of the opinion that brush sampling could be handled routinely by DHs and Ds in GDP.     

Health-Related Quality of Life and Its Associated Predictors in Patients with Oral Lichen Planus: A Cross-Sectional Study

ObjectivesTo investigate levels of quality of life (QoL) and determine associated predictors in patients with oral lichen planus (OLP).Materials and methodsA total of 300 patients with OLP at one tertiary Oral Medicine clinic in the UK were recruited in a cross-sectional study from January 2018 to July 2019. The 15-item Chronic Oral Mucosal Disease Questionnaire (COMDQ-15) and 14-item Oral Health Impact Profile (OHIP-14) were used to assess the level of QoL related to OLP. A number of potential determinants were considered, including patient demographics, treatment, the severity of oral symptoms, the clinical activity of the disease, and the patient psychological status, which were measured using the pain-Numerical Rating Scale, the Oral Disease Severity Score, the Hospital Anxiety and Depression Scale, and the 10-item Perceived Stress Scale. Multivariate linear regression was employed to identify independent determinants associated with overall and aspects of QoL.ResultsOn multivariate analyses, after adjusting for confounding variables, the QoL levels in patients with OLP were significantly associated with levels of oral pain, anxiety, stress and use of topical corticosteroids. The COMDQ-15 instrument performed better than OHIP-14 at capturing the association between QoL and pain and disease activity in patients with OLP.ConclusionClinicians should expect reduced QoL in OLP patients with high pain levels, high anxiety levels, high perceived stress and use of topical corticosteroids. The COMDQ-15 is best suited to measure QoL in this population.     

新疆部分维族、汉族口腔黏膜癌前病变及口腔鳞状细胞癌P16蛋白表达的研究

目的 探讨新疆维吾尔族、汉族口腔黏膜癌前病变及口腔鳞状上皮细胞癌的发生与发展过程中P16蛋白表达的意义。方法 采用免疫组化LSAB法对40例口腔扁平苔藓（维吾尔族20例，汉族20例），43例口腔白斑（维吾尔族23例，汉族20例）和60例口腔鳞状上皮细胞癌（维吾尔族24例，汉族41例）分别进行检测。结果口腔鳞状上皮细胞癌组织中P16蛋白阳性率为32．3％，明显低于口腔白斑（55．8％）和口腔扁平苔藓（72．5％），P＜0．005，维族与汉族之间的的差异均无统计学意义（P＞0．05）。结论 P16蛋白表达缺失在口腔鳞状上皮细胞癌的发生与发展过程中起重要作用；据本研究资料，尚不能认为P16蛋白的表达在维族与汉族之间的差异有显著性。     

Progressive increase of human papillomavirus carriage rates in potentially malignant and malignant oral disorders with increasing malignant potential

Introduction:  We investigated the potential role of human papillomaviruses (HPVs) in potentially malignant oral disorders, oral leukoplakia (OL) and oral lichen planus (OLP), and in oral squamous cell cancer (OSCC) in an Eastern Hungarian population with a high incidence of OSCC.
Methods:  Excised tumor samples (65 OSCC patients) and exfoliated cells from potentially malignant lesions (from 44 and 119 patients with OL and OLP, respectively) as well as from healthy controls (72 individuals) were analysed. OLPs were classified based on clinical appearance, 61 patients had erosive–atrophic lesions (associated with higher malignancy risk, EA-OLP) and 58 had non-erosive non-atrophic lesions (with lower risk of becoming malignant, non-EA-OLP), respectively. Exfoliated cells collected from apparently healthy mucosa accompanied each lesion sample. HPV was detected by MY/GP polymerase chain reaction (PCR) and genotyped by restriction analysis of amplimers. Copy numbers in lesions were determined using real-time PCR. Prevalence rates, copy number distributions, and association with risk factors and diseases were analysed using chi-square test, t -test, and logistic regression, respectively.
Results:  We detected HPVs significantly more frequently in lesions than in controls ( P  ≤ 0.001 in all comparisons). HPV prevalence increased gradually with increasing severity of lesions (32.8, 40.9, and 47.7% in OLP, OL, and OSCC, respectively). Copy number distribution patterns roughly corresponded to prevalence rates, but OLP and OL were comparable. HPV prevalence differed significantly between EA-OLP and non-EA-OLP groups (42.6 vs. 22.4%); EA-OLP group showed a prevalence similar to that found in OL.
Conclusion:  HPVs may be involved in the development or progression of not only OSCC but also of potentially malignant oral lesions.     

Associations between clinical and histopathological characteristics in oral leukoplakia

Objectives

To identify possible associations between patients’ demographics and habits and the clinical aspects and histopathological characteristics of oral leukoplakia (OL) at patients’ first visit.

Method

A total of 140 consecutive patients with OL at a single institute between 1997 and 2019. All biopsies were microscopically examined for classic dysplasia (CD) (WHO definition oral epithelial dysplasia) and differentiated dysplasia (DD) known from differentiated vulvar intraepithelial neoplasia. Clinical characteristics were correlated to histopathological diagnosis and odds ratios (OR) were calculated.

Results

A total of 96 females and 44 males, mean age 58 years, were presented. OLs were found mainly on the tongue (41%) and floor of mouth (FOM) (18%). Homogeneous OLs (58%) were associated with smoking, FOM and size <2cm and non-homogeneous OLs (42%) with non-smokers. No dysplasia was present in 40% and any dysplasia (AD) in 60%. Tongue OLs were correlated with AD (OR:6.0) and CD (OR:5.7). FOM OLs were correlated with CD (OR:4.5). DD was correlated with non-homogeneous OLs (OR:2.6).

Conclusions

CD was most frequently observed in tongue and FOM OLs, while DD was associated with non-homogeneous OLs. In this series of patients, there was no consistent reliable association between the clinical and histopathological features and clinical characteristics can therefore not substitute microscopic examination of biopsies.     

Serum interleukin-6 level is a useful marker in evaluating therapeutic effects of levamisole and Chinese medicinal herbs on patients with oral lichen planus

Background: Oral lichen planus (OLP) is a T cell‐mediated inflammatory disease. Interleukin‐6 (IL‐6) is a pro‐inflammatory cytokine that has effects on cellular and humoral immunities. Previous studies have shown that keratinocytes and tissue‐infiltrating mononuclear cells from OLP lesions can secrete IL‐6. In some OLP patients, the high serum IL‐6 levels are reduced after treatment, suggesting that IL‐6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP. Methods: In this study, we used a solid phase, two‐site sequential chemiluminescent immunometric assay to determine the baseline serum levels of IL‐6 in a group of 180 patients with erosive OLP (EOLP), nonerosive OLP (NEOLP), erythema multiforme (EM), traumatic ulcers (TU), oral submucous fibrosis (OSF), pemphigus vulgaris (PV), or Sjögren's syndrome (SS), and in 77 normal control subjects. Some OLP patients were treated with levamisole plus Chinese medicinal herbs or levamisole only for 0.5–5.5 months and their serum IL‐6 levels were measured after treatment. Results: We found that approximately 99% of the normal control subjects and the patients with EM, TU, or OSF had a normal serum IL‐6 level less than 5.0 pg/ml. However, 15% (22/149) OLP patients, 15% (20/136) EOLP patients, 20% (5/25) major type EOLP patients, 14% (15/111) minor type EOLP patients, 15% (2/13) NEOLP patients, 14% (1/7) EM patients, 43% (3/7) PV patients, and 100% (6/6) SS patients had a serum IL‐6 level greater than 5.0 pg/ml. The mean serum IL‐6 level in patients with OLP (3.4 ± 3.1 pg/ml, P < 0.001), EOLP (3.4 ± 3.2 pg/ml, P < 0.001), major type EOLP (4.9 ± 3.5 pg/ml, P < 0.001), minor type EOLP (3.0 ± 3.0 pg/ml, P < 0.01), or NEOLP (4.2 ± 1.5 pg/ml, P < 0.001) was significantly higher than that in normal control subjects (2.0 ± 1.5 pg/ml). A significant difference in the mean serum IL‐6 level was also found between major type and minor type EOLP patients (P < 0.01). The mean reduction of serum IL‐6 level in OLP patients treated with levamisole plus Chinese medicinal herbs was significantly higher (7.4 ± 4.7 pg/ml) than that in OLP patients treated with levamisole only (3.8 ± 2.3 pg/ml, P < 0.05), suggesting that the combination therapy was superior to levamisole only. Conclusion: We conclude that levamisole and levamisole plus Chinese medicinal herbs can modulate the serum IL‐6 level in OLP patients. IL‐6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP.     

Polymorphisms in the apoptosis‐associated genes FAS and FASL and risk of oral cancer and malignant potential of oral premalignant lesions in a Taiwanese population

J Oral Pathol Med (2010) 39: 155–161 Background: Our aim was to measure the relationship of FAS (?1377G>A and ?670A>G), FASL (?844C>T) gene variants and risk of oral cancer. Methods: Polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) analysis was used to determine the FAS and FASL polymorphisms in 294 oral squamous cell carcinoma (OSCC), 53 oral submucous fibrosis (OSF), and 84 oral leukoplakia (OL) patients, as well as in 333 healthy controls. A standardized questionnaire was applied to collect demographic data, and potential confounding factors. JMP statistical software was used to analyze the association. Results: FAS and FASL polymorphisms were not correlated with OSCC development or the malignant potential of OL by simple and multivariate logistic regression. However, a two‐ to fourfold difference in the risks of betel quid chewing, alcohol consumption, and smoking on OSCC development were observed between participants with different FAS polymorphisms. FAS polymorphisms were significantly correlated with the malignant potential of OSF. Multivariate logistic regression analysis indicated that FAS A_?1377‐G_?670 vs. G_?1377‐A_?670 haplotype (OR = 2.26, 95% CI = 1.16–4.41) was correlated with the malignant potential of OSF. Conclusions: We suggest that FAS and FASL polymorphisms are not significantly correlated with OSCC development or malignant potential of OL. The impact of substance usage on OSCC development could be differentiated by FAS polymorphisms. FAS A_?1377‐G_?670 haplotype may play a role in the malignant potential of OSF.     

口腔粘膜下纤维性变组织中内皮素1的免疫组织化学和定量研究

目的：探讨ＥＴ－１在口腔粘膜下纤维性变（ＯＳＦ）发病机制中的作用。方法：采用免疫组化染色ＳＡＢＣ法和图像分析技术,对ＯＳＦ早、中、晚期各１０例、口腔扁平苔藓（ＯＬＰ）１０例以及正常人１０例的颊粘膜组织中ＥＴ－１表达进行定量分析。结果：①ＯＳＦ组织中ＥＴ－１免疫阳性物质超量表达,正常及ＯＬＰ组织中ＥＴ－１表达微弱;②ＯＳＦ早、中、晚期组织中ＥＴ－１含量显著高于正常（Ｐ〈０．０１）,且早、中期显著高于晚期（Ｐ〈０．０１）;③ＯＳＦ早、中期组织ＥＴ－１含量显著高于ＯＬＰ（Ｐ〈０．０１）,晚期间质ＥＴ－１含量显著高于ＯＬＰ（Ｐ〈０．０５）,上皮ＥＴ－１含量两者差异不显著（Ｐ〉０．０５）;④口腔粘膜中上皮和间质的ＥＴ－１含量呈显著正相关（Ｐ〈０．０５）。结论：ＥＴ－１在ＯＳＦ的表达具有特异性,且可能影响ＯＳＦ病变的发生发     

Association between general and oral health-related quality of life in patients treated for oral cancer

Background

Less is known about the association between general health-related quality of life (HRQoL) and oral HRQoL (OHRQoL) among patients with specific diseases. The aim of this study was to assess the association between patient-centered outcome measurements (HRQoL and OHRQoL) of oral cancer patients at least 6 months after treatment.

Material and Methods

HRQoL was measured with the 12-Item Short Form Health Survey (SF-12); OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) and the Oral Impacts on Daily Performances (OIDP).

Results

Higher OHRQoL scores were associated with lower SF-12 domains scores. The OHIP-14 explained 16.5 % of the total variance of SF-12 Physical Component Summary (PCS) and the OIDP explained 16.1 %. In the SF-12 Mental Component Summary (MCS), the total variance explained was 23.9 % by the OHIP-14 and 21.8 % by the OIDP.

Conclusions

There was a significant association between long-term OHRQoL and HRQoL in oral and oropharyngeal cancer patients. These results may help to carry out new interventions aiming to improve patient´s life overall. Key words:Mouth neoplasms, quality of life, health status, oral health.     

Regression of oral lichenoid lesions after replacement of dental restorations

The aim of the study was to determine the prognosis and to evaluate the regression of lichenoid contact reactions (LCR) and oral lichen planus (OLP) after replacement of dental restorative materials suspected as causing the lesions. Forty‐four referred patients with oral lesions participated in a follow‐up study that was initiated an average of 6 years after the first examination at the Department of Odontology, i.e. the baseline examination. The patients underwent odontological clinical examination and answered a questionnaire with questions regarding dental health, medical and psychological health, and treatments undertaken from baseline to follow‐up. After exchange of dental materials, regression of oral lesions was significantly higher among patients with LCR than with OLP. As no cases with OLP regressed after an exchange of materials, a proper diagnosis has to be made to avoid unnecessary exchanges of intact restorations on patients with OLP.     

Levamisole and/or Chinese medicinal herbs can modulate the serum level of squamous cell carcinoma associated antigen in patients with erosive oral lichen planus

Abstract: The serum levels of squamous cell carcinoma associated antigen (SCCA) were determined by a microparticle enzyme immunoassay in a group of patients with stage I oral squamous cell carcinoma (OSCC), major or minor type erosive oral lichen planus (EOLP), recurrent aphthous stomatitis (RAS), Behçet’s disease (BD), oral leukoplakia (OL), or oral submucous fibrosis (OSF), and in normal control subjects. About 97% of the normal control subjects and the patients with minor type EOLP, RAS, BD, OL or OSF had a serum level of SCCA within the normal limit of 1.2 ng/ml. However, 6 of the 12 (50%) patients with stage I OSCC and 14 of the 31 (45.2%) patients with major type EOLP had a serum level of SCCA greater than 1.2 ng/ml. The mean serum level of SCCA in stage I OSCC patients (1.38±1.16 ng/ml) or in major type EOLP patients (1.32±1.23 ng/ml) was significantly higher than that in normal control subjects (P<0.001) and that in the patients with minor type EOLP (P<0.001), RAS (P<0.001), BD (P<0.05), OL (P<0.05), or OSF (P<0.05). Either major or minor type EOLP patients could obtain a significant mean reduction of the serum SCCA level of 0.34–0.63 ng/ml after treatment with levamisole and/or Chinese medicinal herbs for 1–30 months. Combination therapy with levamisole plus Chinese medicinal herbs could achieve a shorter duration of treatment to get complete remission than the single therapy with either levamisole only or Chinese medicinal herbs only. We conclude that levamisole and/or Chinese medicinal herbs can modulate the serum SCCA level in EOLP patients. SCCA may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of EOLP. For EOLP patients, the combination therapy is superior to the single therapy of levamisole or of Chinese medicinal herbs.     

Epstein–Barr virus prevalence in oral squamous cell cancer and in potentially malignant oral disorders in an eastern Hungarian population

We tested 65, 44, and 116 patients with oral squamous cell cancer (OSCC), oral leukoplakia (OL), and oral lichen planus (OLP) against 68 age-matched controls for the presence of Epstein–Barr virus (EBV). Apparently healthy mucosa was simultaneously sampled and examined in all patients. Paraffin-embedded tissue sections of all EBV-positive patients with OSCC were examined for latent membrane protein-1 (LMP-1) expression (demonstrable in most EBV-associated malignancies) using immunohistochemistry. The prevalence of EBV in the controls and in OSCC, OL, and OLP lesions was 19.1%, 73.8%, 29.5%, and 46.6%, respectively, and 66.2%, 22.7%, and 31.9% in the healthy mucosa of patients, respectively. The prevalence of EBV in OSCC patients was significantly higher than in controls or in respective samples of the other two patient groups both in the lesion and in the healthy mucosa. Comparisons including only patients with EBV-negative lesions yielded similar results. Lesions of patients with OLP, but not of patients with OL, differed significantly from controls in EBV prevalence. In OSCC, LMP-1 expression was not detected, and EBV carriage was not significantly associated with any risk factors and did not influence the outcome. Although a high prevalence of EBV was found in OSCC, comparable carriage rates on healthy mucosa of patients indicated that an aetiological role of EBV is unlikely.     

Autoimmune disorders in oral lichen planus: A systematic review and meta-analysis

Objectives

The association of OLP with other autoimmune processes points to the possibility that OLP-affected patients are actually developing an autoimmune status that predisposes them to autoaggression against different targets. This systematic review and meta-analysis aim to evaluate the current evidence on the prevalence of autoimmune disorders in patients with OLP and their magnitude of association.

Methods

We searched PubMed, Embase, Web of Science, Scopus databases for the studies published before May 2021, with no limitation in regards to their publication date or language. We evaluated the quality of studies, carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.

Results

Inclusion criteria were met by 153 studies (23,327 patients). Our results indicate the existence of high prevalence and a frequent association between OLP and some autoimmune disorders, especially in regards to thyroid disease (PP = 7.96%, 95% CI = 6.32–9.75; OR = 1.99, 95% CI = 1.60–2.49, p < 0.001) and diabetes mellitus (PP = 9.41%,95% CI = 8.16–10.74; OR = 1.64, 95% CI = 1.34–2.00, p < 0.001).

Conclusions

Our study demonstrates the existence of a comorbidity between autoimmune thyroid diseases as well as between diabetes mellitus and OLP respectively. Quality of evidence should be upgraded on other autoimmune diseases (fibromyalgia, gastrointestinal disorders, rheumatic diseases, Sjogren's syndrome, lupus erythematosus, and dermatological diseases) for which the current data do not allow us to know whether they are really associated with OLP.     

HPV DNA in clinically different variants of oral leukoplakia and lichen planus

OBJECTIVES: Our objectives were to determine the prevalence of human papillomavirus (HPV) infection in oral leukoplakia (OL) and oral lichen planus (OLP) in comparison with that in healthy oral mucosa, also conditionally to age, gender, smoking, and drinking habits of patients, so as to investigate any possible association of HPV infection with a specific clinical variant of OL or OLP. STUDY DESIGN: We did research on HPV DNA in 68 cases of OL (homogeneous form [H] in 45 cases and nonhomogeneous form [non-H] in 23 cases), and in 71 cases of OLP (nonatrophic/erosive form [non-AE] in 27 cases, atrophic/erosive form [AE] in 44 cases). HPV DNA was investigated in exfoliated oral mucosa cells by nested PCR (nPCR: MY09-MY11/GP5-GP6) and the HPV genotype determined by direct DNA sequencing. RESULTS: HPV DNA was found in 17.6% of OL, in 19.7% of OLP, and in 5.6% of controls, with a statistically significant higher risk of HPV infection in both lesion groups (for OL: P=.01; Odds Ratio [OR]=3.64; 95% CI: 1.21-10.80; for OLP: P=.005; OR=4.17; 95% CI: 1.41-12.18). Demographic variables analysis showed that the only significant association was between HPV status and current smoking in OL patients (OR'=3.40; 95% CI: 1.0-11.59). HPV DNA was found in 20% of H OL and 13% of non-H OL, without any association with the clinical variant (P=.73; OR=0.60; 95% CI: 0.14-2.48). HPV DNA was found in 18.5% of non-AE OLP and 20.4% of AE OLP, without any significant association with the clinical variant (P=.84; OR=1.13; 95% CI: 0.335-3.816). HPV-18 was the most frequently detected genotype (9/12 and 10/14 of HPV-positive OL and OLP, respectively), followed by HPV-16 (2/12 OL and 2/14 OLP), HPV-33 (1/12 OL), HPV-31 (1/14 OLP), and HPV-6 (1/14 OLP). CONCLUSIONS: An increased risk of HPV infection was found in OL and OLP; however, no specific clinical variant of OL or OLP was noted to be associated with HPV infection. It is not possible to predict the likelihood of HPV infection from the clinical features of OL and OLP.     

口腔白色病变间相互联系的初步分析

目的 探讨口腔粘膜白色病变-白斑（OLP）、慢性盘状红斑狼疮（DLE）和粘膜下纤维性变（OSF）可能存在的联系。方法 通过对1236例粘膜病的临床病理资料系统性回顾、分析、报道其中一些特殊病例。结果 发现OLK-OLP共存3例,OLP与DLE共存1例,OSF与OLP镜下有移行表现者1例,并对OSF与OLK伴发和几种疾病间的鉴别诊断进行了分析。结论 口腔粘膜白色病变虽然各自具有典型特点,但互相之间有时会出现融合、共存、移行、伴发、继发等表现,提示及时活检是必要的,治疗过程中应注意随访观察。