微量营养素的抗氧化机制在口腔潜在恶性疾患中的研究进展

氧化应激状态被认为与口腔潜在恶性疾患(oral potentially malignant disorders,OPMD)的发病机制及恶性转化有关.抗氧化微量营养素具有预防、抑制和逆转口腔癌发生的潜力,维持抗氧化微量营养素的浓度在适当范围内对治疗相关疾病具有重要意义.本文就微量营养素的抗氧化作用机制与OPMD发生、发展及治疗相关的研究进展作一综述.     

miRNA与口腔潜在恶性病变的发生发展

口腔潜在恶性病变(OPMD)是一类具有增高癌变风险的口腔疾病的总称.OPMDs早诊、早防、早治是降低患者癌变率、提高患者总体预后的关键所在.微小RNA(miRNA)是一类小的非编码RNA,参与多条细胞通路的调控,对生物生理、发育及病理过程具有重要影响.miRNA的异常表达在口腔癌中已被广泛报道,其可在OPMDs发生发展...     

口腔潜在恶性病变的无创筛查及管理

口腔潜在恶性病变（oral potential malignant disorders, OPMDs）是一类发生在口腔黏膜、具有癌变潜能的疾病总称,对OPMDs进行有效筛查及管理对于阻断其癌变进程和提高患者生活质量均具有重要意义。现就OPMDs的无（微）创筛查技术、管理理念以及笔者课题组的临床实践体会进行总结。     

氧化应激在糖尿病相关性牙周炎发病中的作用

在糖尿病相关性牙周炎发病机制的研究中,糖尿病患者中长期慢性的高糖状态可能通过多个途径诱发氧化应激,局部产生大量的活性氧族(ROS),而ROS可改变信号传导通路引起炎症反应因子的基因和蛋白质表达异常,导致机体炎症应答大大增强,促使牙周炎症发生.本文就高血糖诱发氧化应激的可能途径、氧化应激作用机制、抗氧化物在糖尿病相关性牙...     

CD44和CD133在口腔潜在恶性病变和口腔鳞状细胞癌中的表达及其临床意义

目的 探究肿瘤干细胞标记物CD44和CD133在口腔正常黏膜、口腔潜在恶性病变（OPMD）及口腔鳞状细胞癌（OSCC）中的表达情况及相互关系,评估其作为OPMD恶性转化早期诊断指标的临床价值。方法 回顾性分析60例OPMD患者、60例OSCC患者及10例口腔黏膜正常者的临床资料,采用免疫组织化学双重染色技术检测各组病理组织中CD44与CD133的表达,分析CD44和CD133表达之间的关系及其与各临床因素之间的关系。结果 口腔正常黏膜、OPMD、OSCC三组中,CD44的阳性表达率分别为100.00%、96.67%、71.67%（P<0.05）,CD133的阳性表达率分别为0.00%、35.00%、63.33%（P<0.05）。CD44与CD133二者间的表达具有相关性（P<0.05）,且其表达又都与OSCC的临床分期和淋巴结转移相关（P<0.05）。结论 CD44和CD133作为评估OPMD恶性转化潜能的指标具有重要临床价值。     

外泌体在口腔潜在恶性疾患诊疗中的研究进展

外泌体通过介导细胞间通讯和调节免疫活性,改变受体细胞的功能和表型,其可能用于疾病的诊断、治疗和病因学研究.口腔潜在恶性疾患指口腔内具有癌变风险的所有临床表现,包括癌前病变和癌前状态.本文就近年来外泌体在口腔潜在恶性疾患诊疗中的研究进展作一综述.     

氧化应激诱发糖尿病性牙周炎作用及机制

糖尿病和牙周炎有双向关系,二者间作用机制尚不清楚。糖尿病长期高糖状态可诱发氧化应激(oxidative stress,OS)反应,产生大量活性氧族(ROS),可通过改变信号传导通路等途径引起炎症因子基因和蛋白质表达异常,导致炎症反应增强,破坏牙周组织。该文从OS诱发糖尿病性牙周炎作用、OS诱发糖尿病性牙周炎机制、抗氧化物治疗及前景等方面进行研究,为糖尿病性牙周炎治疗和研究提供依据。     

口腔黏膜潜在恶性病损甲苯胺蓝检查过程中的护理体会

甲苯胺蓝染色检查是口腔黏膜潜在恶性病损的常用检查方法之一,在染色检查过程中,通过认真完善的护理工作协助医生完成检查,对于缓解病人情绪,提高检查准确性具有重要作用。本文就本科室近三年的甲苯胺蓝口腔黏膜染色检查的临床护理体会进行总结。     

微小RNA在口腔鳞癌中的潜在作用

口腔鳞癌是口腔颌面部常见的恶性肿瘤,微小RNA在OSCC的发生发展中起重要作用。本文就微小RNA与OSCC的侵袭转移、诊治及预后进行综述。     

Malignant transformation in a cohort of patients with oral epithelial dysplasia

Oral epithelial dysplasia (OED) is often diagnosed in oral potentially malignant disorders (OPMD) and carries an increased risk of malignant transformation. Currently, the reported risk of malignant transformation for OED varies. Here we present the risk in a cohort of 150 patients with OED at a specialist centre. In this cohort 2.6%, 4.1%, and 29.2% cases of mild, moderate, and severe OED, respectively, progressed to oral squamous cell carcinoma at the dysplastic site, while a small number developed a malignant lesion elsewhere. Moreover, 17 patients experienced an increase in grade of dysplasia and two showed histological resolution of their lesions.     

Oxidative stress in oral diseases

Oxidative species, including reactive oxygen species (ROS), are components of normal cellular metabolism and are required for intracellular processes as varied as proliferation, signal transduction, and apoptosis. In the situation of chronic oxidative stress, however, ROS contribute to various pathophysiologies and are involved in multiple stages of carcinogenesis. In head and neck cancers specifically, many common risk factors contribute to carcinogenesis via ROS‐based mechanisms, including tobacco, areca quid, alcohol, and viruses. Given their widespread influence on the process of carcinogenesis, ROS and their related pathways are attractive targets for intervention. The effects of radiation therapy, a central component of treatment for nearly all head and neck cancers, can also be altered via interfering with oxidative pathways. These pathways are also relevant to the development of many benign oral diseases. In this review, we outline how ROS contribute to pathophysiology with a focus toward head and neck cancers and benign oral diseases, describing potential targets and pathways for intervention that exploit the role of oxidative species in these pathologic processes.     

氧化应激及抗氧化防御系统在慢性牙周炎中的作用

近年来研究发现,氧化应激与抗氧化防御系统的失衡在慢性牙周炎中发挥重要作用,牙周组织受到细菌刺激产生的过量活性氧可造成和加重牙周组织的损伤。本文就炎性条件下过量活性氧对牙周组织的损害,以及氧化应激与抗氧化防御系统在慢性牙周炎发生发展中的作用和机制作一综述。     

Malignant transformation of oral proliferative verrucous leukoplakia: a series of 48 patients with suggestions for management

Proliferative verrucous leukoplakia (PVL) is a rare and refractory form of oral mucosal leukoplakia of unknown origin, characterized by high rates of malignant transformation. Different diagnostic criteria, terminologies, and therapeutic approaches have been proposed since the first report in 1985. There remains no general agreement regarding the clinical and histological diagnosis, prevention, and correct management of this disease. This retrospective study investigated 48 patients affected by PVL showing at least one malignant transformation and followed up at 2-month intervals. Twenty-five were female (52.1%) and 23 (47.9%) were male; their median age was 67 years (range 40–93 years). Follow-up ranged from 18 to 240 months. Clinical examination included the use of Lugol’s solution to prevent clinical underestimation of the margins and toluidine blue for suspicious areas. Surgical excision by scalpel was the preferred treatment for suspicious lesions, with only five carcinomas surgically removed by diode laser and two by CO₂ laser. All specimens were accurately mapped after formalin fixation. Fifteen patients (31.3%; 10 female, five male) developed one oral carcinoma, while 33 (68.7%) developed two or more primary tumours (range 3–12). Only four patients (8.3%), who developed between 2 and 8 oral squamous cell carcinomas (OSCCs), died of tumour-related causes. The pre-surgical clinical workup, subsequent surgical treatment, and follow-up are key to success for patients affected by PVL with malignant transformation into stage 1 OSCC and/or verrucous carcinoma, leading to a high overall survival rate.     

The establishment of the Asia‐Pacific Oral Cancer Network—Inaugural stakeholders' Meeting

The majority of oral cancer cases occur in Asia and the incidence is expected to continue to rise. Oral cancer is amenable to early detection through visual oral examination yet in many Asian countries, the disease presents at a late stage. The barriers to early detection are similar across the Asia‐Pacific countries therefore, strategies to address these could be more effective if there were concerted efforts and joint resources amongst the countries. To facilitate better engagement and collaboration between stakeholders in oral cancer detection and management, the Asia‐Pacific Oral Cancer Network (APOCNET) was established and the inaugural meeting was held in Kuala Lumpur on the 13th to 15th of September 2019. In this meeting, we identified the challenges faced in the early detection and management of oral cancer amongst the stakeholder countries, showcased the successful oral cancer programs in the region and identified strategic areas for collaboration. For this, notable international speakers and those from local universities and the Ministry of Health Malaysia were invited to share their experiences. The lessons learned from our neighbouring countries could lead to the implementation of similar programs that could help reduce the oral cancer burden in the region.