口腔扁平苔藓中人乳头瘤病毒的检测

为研究口腔扁平苔藓（OLP）与人乳头瘤病毒（HPV）的关系．作者采用聚合酶链（PCR）技术，对22例OLP中的HPV低危型──11型以及高危型—16型DNA分别进行了检测，并以10例正常口腔粘膜（NOM）作为对照。结果表明：PCR是检测OLP中HPV较为理想的方法。OLP中的HPV与NOM相比较，11型相对升高。OLP各临床分型中，网纹型的HPV阳性百分比最高，该型的病程迁延．治疗后易复发，可能与HPV的潜伏和感染有关，4例糜烂型，即有2例含有HPV16，提示糜烂型与癌变的关系。HPV在NOM中的存在。表明HPV可以无症状或以潜伏的形式存在于口腔粘膜。     

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）、孢疹病毒Ｉ型（ＨＳＶ－Ｉ）和人巨细胞病毒（ＨＣＭＶ）的关系。方法：采用斑点杂交和ＰＣＢ技术检验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－１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     

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。     

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。     

人乳瘤病毒16型和EB病毒感染与口腔鳞癌关系

用多聚酶链反应技术为２１例口腔鳞癌及癌旁正常组织成对标本中的人乳头瘤病毒１６型（ＨＰＶ１６）和ＥＢ病毒（ＥＢＶ）ＤＮＡ作检测。结果口腔鳞癌和癌旁正常组织ＨＰＶ１６ＤＮＡ阳性率分别为５２．４％和１４．３％，ＥＢＶ为８５．７％和３３．３％，ＨＰＶ１６和ＥＢＶ均为阳性者分别为４７．６％和９．５％，癌组织和癌旁正常组织间统计学上均有显著性差异。提示口腔粘膜ＨＰＶ１６或ＥＢＶ感染均与口腔鳞癌发生有关。ＨＰＶ１６和ＥＢＶ在口腔粘膜感染可能有协同致口腔鳞癌作用。     

表皮生长因子受体在口腔扁平苔藓、口腔乳头瘤及口腔鳞状细胞癌中的表达

目的:研究表皮生长因子受体(epidermal growth factor receptor,EGFR)在口腔扁平苔藓(OLP)、口腔鳞状细胞乳头瘤(SCP)及口腔鳞状细胞癌(SCC)中的表达,探讨其在口腔黏膜炎症、增生及癌发生过程中的意义.方法:用免疫组化方法检测EGFR在20例口腔黏膜扁平苔藓(单纯增生10例,伴糜烂10例)、20例口腔乳头瘤、20例口腔鳞状细胞癌及5例正常口腔黏膜中的表达.采用Fromowitz法计数阳性细胞.应用SPSS11.5软件包分析EGFR在不同病变中的表达差异.结果:EGFR在非糜烂型扁平苔藓组主要表现为弱阳性表达;糜烂型扁平苔藓组强阳性表达率为20％;乳头瘤组的强阳性表达率为25％;鳞状细胞癌的强阳性表达率为60％.扁平苔藓糜烂组和非糜烂组之间EGFR强阳性表达率有显著差异(P＜0.05);糜烂组OLP与乳头瘤组的强阳性表达率无显著差异;口腔鳞癌组的强阳性表达率显著高于扁平苔藓组及乳头瘤组.结论:EGFR可能成为口腔鳞癌化学预防作用的重要靶点.     

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。     

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。     

Oral cancer development in patients with oral lichen planus

There has been considerable controversy as to whether oral lichen planus (LP) has a premalignant potential. This study retrospectively examined the records of 241 British patients with histologically confirmed LP seen during the 10-year period 1982–92. Nine patients (3.7%) were known to have developed well-differentiated invasive carcinoma or carcinoma in situ in an area of LP. Most carcinomas at presentation were in areas of atrophic and/or erosive LP, 6 were in patients older than 65 years, and 6 were on the tongue. The results support a small but clinically important premalignant potential for LP.     

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。     

Keratin staining pattern in clinically normal and diseased oral mucosa of lichen planus patients

The keratin pattern in oral epithelia is related to the type of terminal differentiation observed morphologically (keratinization/nonkeratinization) and to the presence or absence of epithelial dysplasia. Furthermore, it has been suggested recently that inflammatory phenomena influence the keratin expression in human gingiva. The aim of the present study was to describe the keratin pattern in oral lichen planus (OLP) lesions, which are well known to be characterized by hyperkeratinization and severe inflammatory changes, in order to elucidate the role of inflammation in keratin expression of oral epithelia. Tissue sections were stained with antikeratin antibodies directed to groups of keratins (AE1 and AE2) and to single keratin proteins (Nos. 5, 8, 13, and 19). The keratin pattern in OLP lesions differed in some respects from that of leukoplakias and frictional keratoses as characterized in previous studies. No consistent patterns for use in a diagnostic context were found. However, the changes in OLP lesions did not mimic those previously described in inflamed gingival specimens and in oral epithelial dysplasias. Thus, the results encourage further studies on the potential diagnostic use of keratin expression in premalignant oral lesions. Furthermore, the study suggests that the inflammatory reaction seen in OLP lesions does not influence keratin expression in a way comparable with the suggested influence of inflammation in gingival specimens.     

HLA-DR and DQ antigens in Chinese patients with oral lichen planus

A study of HLA-DR and DQ typing in 44 patients with oral lichen planus (OLP) (28 women and 16 men) and in 107 normal controls of both sexes was performed by using Terasaki's oriental tray. Twenty-eight patients had erosive forms of lichen planus (OLPe). Serologic typing revealed a highly significant increase of HLA-DR 9 and Te 22 antigens in the patient group. Considering our findings and those in other autoimmune diseases, it is hypothesized that OLP is a localized autoimmune disease and the HLA-DR9 in Chinese takes the place of HLA-DR3 in Caucasians in carrying the genes which predispose to the development of autoimmune disease.     

Possible premalignant character of oral lichen planus the Amsterdam experience

In the present paper the 21-yr experience of the Department of Oral and Maxillofacial Surgery and Oral Pathology, and the Department of Otorhinolaryngology of the Free University Hospital, Amsterdam, is reported with regard to the possible premalignant character of oral lichen planus. The study consists of two parts: 1) the follow-up of 113 patients with histopathologically proven oral lichen planus, and 2) a search for lichen planus in 727 patients who have been admitted for oral cancer. Three patients with histopathologically proven lichen planus developed a squamous cell carcinoma in an average follow-up period of 7 yr. In the 727 patients with oral cancer, two additional patients with the simultaneous occurrence of oral lichen planus were observed. Our experience gives some but not very strong support to the hypothesis that oral lichen planus is a premalignant condition.     

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。     

表皮生长因子受体在口腔扁平苔藓组织中的表达

目的探讨口腔扁平苔藓(OLP)癌变及发病机制。方法采用免疫组化法检测10例正常口腔黏膜,16例扁平苔藓,10例扁平苔藓伴不典型增生,14例口腔鳞癌上皮组织中表皮生长因子受体(EGFR)的表达水平。结果OLP伴不典型增生组织中EGFR的表达高于正常黏膜(P<0.05)。口腔鳞癌中EGFR的表达高于正常黏膜及OLP(P<0.01)。结论EGFR的过表达在OLP的发生、发展过程中可能起着重要的作用。     

The frequency of Candida in oral lichen planus

ABSTRACT – Histologic material of typical lichen planus lesions from 43 patients was studied. Two sections of each specimen were stained with hematoxylin-eosin and 10 sections by the PAS method. Only 1 of 43 biopsies was invaded by Candida, and hyphae were present in all of the 10 PAS-stained sections of this case. The results show that oral lichen planus has a considerably lesser susceptibility than oral leukoplakia to invasion by Candida albicans.     

Psychological profile in oral lichen planus

AIM: Oral lichen planus (OLP) is an oral lesion with an enigmatic etiology. To explore the possibility of psycho-somatization, we evaluated the psychological personality profiles of OLP patients. METHODS: Twenty patients with reticular; 20 with erosive form of OLP, and 25 controls were tested with the psychological Minnesota Multiphasic Personality Inventory (MMPI)-202 test. Eight clinical scales (hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania) as well as cortisol level, CD3, CD4, CD8, and CD16 markers by group were compared. Psychosomatization was evaluated by the use of internalization ratio (IR) Index. RESULTS: A characteristic MMPI profile was noted in the OLP groups with high IR index value. Significant differences among the groups were detected for cortisol, CD4, CD8, and CD16 counts. Mean values for hypochondriasis, depression, and hysteria were all significantly different with significantly higher mean scores for both reticular and erosive OLP subjects compared with controls. CONCLUSIONS: Prolonged emotive stress in many OLP patients may lead to psychosomatization and may contribute to the initiation and clinical expression of this oral disorder. Clinical significance: If additional research involving a larger and more diverse sample of patients confirms these findings, clinical trials will be needed to determine whether adjunctive psychological intervention provides a benefit in treating patients with OLP.     

Assessment of the value of immunofluorescence microscopy in the diagnosis of oral mucosal lichen planus

Accurate diagnosis of oral mucosal lichen planus (OMLP) is essential if appropriate management is to be instituted. Direct immunofluorescence microscopy (DIF) has facilitated the diagnosis of some dermatologic diseases with oral manifestations, but its use in the diagnosis of OMLP is less well documented. In the present study, 165 biopsies from consecutive cases for which a provisional diagnosis of OMLP was suggested clinically or on the basis of routine histopathologic, or DIF assessment were studied. In 27 cases the results of DIF were non-contributory. In 13 cases the diagnosis could only be established by DIF examination. Nine cases clinically diagnosed as OMLP were assigned to a different condition on the basis of routine histology and DIF. It was concluded that DIF was an integral step in the diagnosis of OMLP.