口腔黏膜下纤维性变治疗的研究进展

口腔黏膜下纤维性变 (OSF)是一种慢性、隐匿性 ,具有癌变可能的疾病。OSF的发生与咀嚼槟榔习惯有关 ,其发病机理尚不清楚 ,OSF的治疗方法很多 ,但疗效不够理想 ,本文将近年来OSF治疗进展作一综述     

口腔黏膜下纤维性变的治疗研究进展

本文回顾了近些年国内外临床上治疗口腔黏膜下纤维性变的方法,总结出目前口腔黏膜下纤维性变仍然缺乏特效治疗手段的结论。该病应在患者戒除咀嚼槟榔习惯的前提下,根据病情采用多种治疗方法进行综合治疗。     

丹参治疗前后口腔黏膜下纤维性变超微结构的研究

目的：观察丹参治疗口腔黏膜下纤维性变（OSF）前后内皮细胞、成纤维细胞、上皮细胞超微结构的变化,验证丹参对OSF的临床治疗作用。方法：选取经丹参治疗前后的OSF颊黏膜组织做透射电镜观察。结果：OSF经丹参治疗后的内皮细胞、成纤维细胞、上皮细胞超微结构可接近正常细胞。结论：丹参治疗OSF临床有效。     

口腔黏膜下纤维性变癌变的发生机制研究进展

口腔黏膜下纤维性变(oral submucous fibrosis, OSF)是口腔鳞状细胞癌(oral squamous cell carcinoma, OSCC)的主要癌前病变之一,其癌变过程复杂,癌变机制尚不明确。本文从咀嚼槟榔与OSF恶性进展、低氧与血管生成、上皮-间质转化和表观遗传调控等方面,对OSF癌变机制的最新研究进展作一综述。     

口腔黏膜下纤维性变恶变机制的研究进展

口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、进行性、与咀嚼槟榔有关的口腔黏膜疾病,主要表现为口腔黏膜苍白、进食刺激性食物时口腔黏膜烧灼疼痛、张口受限、软腭区水疱等.OSF具有恶变倾向,其恶变率为7％～13％.因此,WHO将其列入口腔潜在恶性疾患的范畴.OSF的恶变机制尚未完全...     

微血管病变与口腔黏膜下纤维性变

微血管病变能引起局部组织缺血、缺氧,激活血管内皮细胞分泌生物活性物质,激发凝血、纤溶、补体及免疫系统,参与口腔黏膜下纤维性变（oral submucous fibrosis,OSF）的发生,活血化淤及扩血管药物治疗OSF有疗效。     

口腔黏膜下纤维性变癌变防治策略研究进展

口腔黏膜下纤维性变（OSF）是一种癌前病变,其恶性进展与多种内、外因素有关,包括咀嚼槟榔、饮食习惯和不良口腔环境等,尤其与咀嚼槟榔关系最为密切。我国湖南、海南等地居民有咀嚼槟榔的习惯,导致OSF和口腔癌高发,且呈逐年上升趋势。尽管目前口腔癌的治疗方法有所发展,但其5年生存率依然较低。因此,要提高OSF癌变患者的生存率和生活质量,应力争做到早发现、早诊断和早治疗。本文就目前OSF癌变防治策略研究进展相关问题进行综述。     

口腔黏膜下纤维性变癌变的回顾性研究

目的 :探讨湖南地区口腔黏膜下纤维性变 (OSF)癌变情况。方法 :对近 2 0年来就诊于湖南数家大医院 1166名OSF病例及其癌变病例进行分析。结果 :1166例OSF患者 ,有 2 0例伴有口腔鳞状细胞癌 ,癌变率为1.7% ,其中男 18例 ,女 2例 ,癌变病例主要来源于湘潭地区 ,均为长期咀嚼槟榔者 ,18例 (90 % )有 15年以上吸烟史 ,癌变部位主要位于颊部 ,患者均存在不同程度的张口受限。另外 ,还有 74例 (6.3 % )伴有口腔白斑 ,3 7例(3 .2 % )伴有口腔扁平苔藓。结论 :OSF是一种与嚼槟榔有关的癌前状态 ,可以出现癌变。     

泼尼松龙治疗口腔黏膜下纤维性变的临床效果观察

目的 探究泼尼松龙治疗口腔黏膜下纤维性变的临床效果.方法 随机选取我院2016年12月至2018年12月的收治的50例口腔黏膜下纤维性变的患者,按照完全随机法分为常规用药组和泼尼松龙组,各25例,常规用药组使用复方丹参注射液+利多卡因治疗,泼尼龙松组在常规用药基础上使用醋酸泼尼松龙注射液治疗.采用酶联免疫吸附试验法检测...     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的炎性疾病.患者进食刺激性食物时口内疼痛,口腔黏膜苍白僵硬,触摸有条索感,舌运动、张口受限,以致咀嚼、吞咽困难,有的甚至发生癌变,严重影响患者的生存质量和身心健康.复杂的发病机制导致该病至今尚无满意的治疗方法.本文介绍了目前主要的治疗方法,包括药物治疗、物理治疗和手术治疗等,主张根据病变发展的阶段,采用多种方法联合治疗.     

Current protocols in the management of oral submucous fibrosis: An update

Oral submucous fibrosis (OSMF) is a debilitating condition of oral cavity which has significant potential for malignant transformation. In spite of over 20 years of research, the pathogenesis of the condition is still obscure and no single management modality is effective. Many OSMF treatment protocols have been proposed to alleviate the signs and symptoms of the disorder and there is overwhelming evidence that as areca nut is primary cause, stopping its use may have a considerable effect on symptoms rather than reversing pre‐existing fibrosis. We present a review of the current protocols for managing OSMF.     

Auto-fluorescence spectra of oral submucous fibrosis

BACKGROUND: Oral submucous fibrosis (OSF) is a chronic oral mucosal disease characterized by progressive deposition of collagen in the subepithelial connective tissue and epithelial atrophy. Previous studies have shown that at 330-nm excitation, the 380- and 460-nm emission peaks of the auto-fluorescence spectra for oral mucosal tissues reflect the collagen content in the subepithelial connective tissue and the nicotinamide adenine dinucleotide phosphate (NADH) content in the epithelial cells, respectively. Therefore, at 330-nm excitation OSF mucosa may have a higher 380-nm emission peak and a lower 460-nm emission peak than the normal oral mucosa (NOM). METHODS: To test the above hypothesis, we measured the in vivo auto-fluorescence spectra of 59 OSF mucosal sites and compared the measured spectra with auto-fluorescence spectra obtained from 15 NOM samples from 15 healthy volunteers, five samples of friction hyperkeratosis (histologic diagnosis, hyperkeratosis and acanthosis) on OSF buccal mucosa (FHOSF), and 29 samples of oral leukoplakia (histologic diagnosis, hyperkeratosis and acanthosis) on OSF buccal mucosa (OLOSF). RESULTS: We found that the spectrum of the OSF mucosa had a significantly higher 380-nm emission peak and a significantly lower 460-nm emission peak than the spectra of NOM, FHOSF, and OLOSF samples. When the mean (+/-SD) fluorescence intensities at 380 +/- 15 nm (I380 +/- 15 nm) and 460 +/- 15 nm (I460 +/- 15 nm) emission peaks and the mean ratio of I460 +/- 15 nm/I380 +/- 15 nm were compared between groups, we found that OSF group had a significantly higher mean value of I380 +/- 15 nm, a significantly lower mean value of I460 +/- 15 nm, and a significantly lower mean ratio of I460 +/- 15 nm/I380 +/- 15 nm than the NOM, FHOSF, and OLOSF groups (P < 0.001). However, no significant differences in the mean values of I380 +/- 15 nm, I460 +/- 15 nm, and ratio of I460 +/- 15 nm/I380 +/- 15 nm were found between NOM and FHOSF or OLOSF samples as well as between FHOSF and OLOSF samples (P > 0.05). CONCLUSION: Because OSF mucosa has a very unique pattern of auto-fluorescence spectrum, we conclude that auto-fluorescence spectroscopy is a good method for real-time diagnosis of OSF.     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的口腔黏膜病。本文对OSF的病名来由、病因、发病机制和病变的性质进行了系统的描述。     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性且具有癌变倾向的疾病,主要发生于印度、巴基斯坦等东南亚国家以及我国湖南、台湾两省。OSF病因不明,咀嚼槟榔是其最主要的致病因素,且咀嚼槟榔的频率越高、年限越长,越易患OSF。所有OSF患者都有咀嚼槟榔史,咀嚼槟榔还与口腔白斑、口腔癌发病高度相关。此外,OSF的发生还与遗传因素、免疫反应、胶原相关性基因,营养缺乏等有关。本文就OSF致病因素做一简单介绍。     

HLA-antigens in oral submucous fibrosis

HLA–typing was carried out on 122 areca nut chewers who attended hospitals for complaints unrelated to the habit. The subjects were South Africans of Indian extraction. The study did not include haplotypes. Palpable fibrous bands in the mouth indicated oral submucous fibrosis. The subjects were divided into 4 groups based on specific oral symptoms and signs. Groups A and B were without fibrous bands. Group A (47 subjects) included those with one or no symptoms while group B (28 subjects) suffered from 2 to 7 oral symptoms. Group C (17 subjects) had oral symptoms and represented early or mild oral submucous fibrosis and exhibited at least one discrete palpable fibrous hand. Group D (30 subjects) were classic oral submucous fibrosis cases with multiple bands. The high occurrence of oral submucous fibrosis in this study group (39%) is similar to the occurrence in comparable age groups reported earlier–n South Africa and is conceivably due to the higher age range of the subjects and their relatively long exposure to the area nut. We were unable to demonstrate a specific pattern of HLA–antigen frequencies in chewers with or without the disease. Furthermore, there were no differences between the study population and the controls. It is concluded that there is not necessarily a HLA–associated susceptibility in oral submucous fibrosis.     

The fibroblast population in oral submucous fibrosis

The purpose of the investigation was to compare the morphology of fibroblasts cultured from healthy oral mucosa and mucosa of patients with oral submucous fibrosis (OSF) and to collate the occurrence of cell types of similar morphology. Cells cultured from biopsy specimens from the buccal mucosa of six subjects who did not chew the areca nut and six patients with OSF who chewed areca nut were grown according to standard techniques. Ninety cells per cell line were recorded daily for 8 days, classified into types F1, F2 and F3 according to their morphology, and the results statistically analyzed. We found that there was a relative increase of F3 cells in relation to Fl cells in OSF resulting in the ratio of F3 to F1 cells being significantly larger in OSF than the ratio in the controls. As it has been reported that F3 cells m rat connective tissues produce significantly more collagen types I and III than F1 cells, we concluded that a change of fibroblast population has occurred in OSF and that this relative increase of F3 cells in humans, which could be committed to the production of large quantities of collagen, can be an explanation for the excessive collagen formation in OSF.     

HLA typing in Taiwanese patients with oral submucous fibrosis

BACKGROUND: A significant association of certain human leukocyte antigens (HLA) and haplotypic pairs with oral submucous fibrosis (OSF) has been reported. However, controversial result of no HLA association with OSF has also been reported. In this study, the phenotype and haplotype frequencies of HLA-A, -B, -C, -DRB1, and -DQB1 in 135 Taiwanese OSF patients were calculated and compared with those in 540 healthy control Taiwanese. METHODS: The analysis of HLA-A, -B, and -C antigens, and of HLA-DRB1 and -DQB1 alleles in OSF patients and healthy control subjects, was performed by serologic typing and DNA typing using polymerase chain reaction with sequence-specific primers (PCR-SSP), respectively. RESULTS: We found that the phenotype frequency of HLA-B76 (3.0%) in OSF patients was significantly greater than that (0%) in healthy control subjects (corrected P (Pc) = 0.000). In addition, the haplotype frequencies of HLA-B48/Cw7 (3.0%), -B51/Cw7 (6.7%), and -B62/Cw7 (8.2%) in OSF patients were significantly greater than the corresponding haplotype frequencies (0, 0.7, and 1.9%, respectively) in healthy control subjects (Pc = 0.000). The relative risk (RR) values of haplotypes B51/Cw7 (9.57) and B62/Cw7 (4.7) were greater than the RR values of phenotypes B51 (1.81), B62 (2.31), and Cw7 (1.91) in OSF patients. In addition, the etiologic fraction (EF) value of haplotype B51/Cw7 (0.63) was higher than the EF values of phenotypes B51 (0.2) and Cw7 (0.59). CONCLUSIONS: We conclude that some Taiwanese areca quid (AQ) chewers with particular HLA phenotypes and haplotypes are prone to have OSF. In addition, some particular HLA haplotypes may play more important roles than the individual HLA phenotypes for the genetic susceptibility to OSF. However, the significantly increased HLA phenotype B76 and three of the common HLA haplotypes detected are present in only about 20% of incident cases of OSF.     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的口腔黏膜疾病。其主要临床表现为口腔黏膜纤维化、进食刺激性食物时口内疼痛,严重者可致张口和进食困难。目前,OSF的诊断手段主要包括临床检查和病理诊断。本文旨在结合笔者的临床经验和最新的相关文献,评述OSF诊断方法的研究进展,如分子生物学方法在OSF诊断中的应用、OSF合并症的诊断等。     

High incidence of autoantibodies in Taiwanese patients with oral submucous fibrosis.

BACKGROUND: Previous study has shown a high incidence of autoantibodies including antinuclear (ANA), antismooth muscle (SMA), antigastric parietal cell (GPCA), antithyroid microsomal (TMA), and antireticulin antibodies in a small group of 26 patients with oral submucous fibrosis (OSF). The reasons why some of the OSF patients have high titers of autoantibodies in serum have not been completely explained and no further study on autoantibodies in OSF patients has been done in a large group of patients. METHODS: In this study, we determined the serum levels of ANA, SMA, GPCA, and TMA in a large group of 109 male Taiwanese patients with OSF by an indirect immunofluorescence technique (for ANA, SMA, and GPCA), and by a semiquantitative microtiter particle agglutination test (for TMA). The presence of serum autoantibodies in OSF patients was further correlated with patients' oral habits and the severity of OSF measured by maximum mouth opening (MMO) and sites of involvement. RESULTS: We found that the frequencies of presence of serum ANA (23.9%), SMA (23.9%), and GPCA (14.7%) in OSF patients were significantly higher than those (9.2, 7.3, and 5.5%, respectively) in healthy control subjects (P < 0.01, P < 0.005, and P < 0.05, respectively). Although the frequency of presence of TMA (5.5%) in OSF patients was also greater than that (2.8%) in healthy control subjects, the difference was not significant (P > 0.05). The presence of serum GPCA in OSF patients was significantly associated with daily areca quid (AQ) consumption (P < 0.05). The presence of serum ANA in OSF patients associated with daily AQ consumption was of borderline statistical significance (P = 0.066). However, no significant correlations were demonstrated between the presence of serum autoantibodies in OSF patients and other variables of oral habits, MMO, and sites of involvement. CONCLUSION: In this study, all the 109 OSF patients had AQ chewing habit and 73.4% of the OSF patients swallowed the 'juice' of AQ during the chewing process. The presence of serum GPCA and ANA in OSF patients was associated with daily consumption of AQs. AQ chewing caused mucosal microtrauma, and ulcerations facilitated the diffusion of genotoxic and cytotoxic AQ ingredients into the oral and gastric tissues. Altered autoantigens released from AQ ingredients-damaged cells may induce autoantibody production. Higher frequencies of specific HLA-DR antigens in OSF patients may also help autoantibody production. Therefore, we conclude that the high incidence of autoantibodies in OSF patients may be due to AQ chewing habit, toxic AQ ingredients, and genetic susceptibility of the OSF patients.