口腔黏膜下纤维性变并存白斑74例的临床病理分析

目的：???观察口腔黏膜下纤维性变（OSF）并存白斑（OLK）患者的临床表现以及病理特征,探讨其上皮异常增生程度与纤维性变严重程度的相关性。方法整理74例OSF并存OLK患者的临床病理资料并进行分析。结果74例OSF并存OLK患者多见于中青年男性,均有咀嚼槟榔史,以20~49岁年龄段发病率较高,临床上同时具有OSF、OLK的临床症状和体征。病理表现为上皮细胞间隙增宽;基底膜增厚、不规则;胶原纤维水肿,变性。结论 OSF并存OLK患者的上皮异常增生程度与纤维性变严重程度无显著相关性;OSF并存OLK并非两种疾病的单纯叠加,而具有其特征性的表现。     

免疫组织化学法在口腔黏膜白色病变病理诊断中的意义研究

目的：研究免疫球蛋白（Ig）和补体（C）在口腔扁平苔藓（OLP）、盘状红斑狼疮（DLE）和慢性增殖型念珠菌病（CHC）中的表达,以期找出对口腔黏膜白色病变有辅助检查意义的更简便、有效的方法。方法：运用免疫组织化学非生物素二步法对OLP、DLE和CHC进行检测,并将结果进行统计学分析。结果：免疫组织化学染色显示免疫复合物在三组基底膜区和结缔组织中单核细胞的阳性表达率有统计学差异（P〈0.05）。DLE组的基底膜区有免疫复合物的多元沉积。结论：运用免疫组织化学非生物素二步法检测Ig和C在口腔黏膜白色病变中的表达对其鉴别诊断有一定的辅助意义。     

应用沙利度胺治疗口腔黏膜病的进展

沙利度胺 (又称反应停 ,酞咪哌啶酮 ,thalidomide)是谷氨酸衍生物。 195 3年首先合成 ,最初被引入临床是作为一种镇静剂和止痛剂。 196 1年因其严重的致畸作用 (胎儿海豹样畸形或无肢畸形 )而被禁用。 2 0世纪 90年代 ,研究者们逐渐发现 ,沙利度胺具有抗炎、免疫抑制及血管生成抑制等作用而再度应用于临床 ,并且在多发性骨髓瘤、白血病、肾细胞癌及移植物抗宿主反应等疾病的治疗中呈现出很好的疗效。随着研究的不断深入 ,沙利度胺逐渐被引入一些口腔黏膜疾病的治疗中 ,现综述如下。一、沙利度胺在口腔黏膜疾病中的应用1.复发性口腔溃疡 (rec…     

天疱疮与良性粘膜类天疱疮中郎格罕细胞的免疫组织化学观察

本文采用抗T_6抗体及S—100蛋白免疫组织化学方法,对20例口腔粘膜病的病损组织中的郎格罕细胞进行了观察,初步探讨了其在疱性病损发病中的作用。观察结果表明,天疱疮与良性粘膜类天疱疮上皮组织中的郎格罕细胞均比对比观察组中的扁平苔藓与慢性盘状红斑狠疮明显减少,甚至缺如。本研究提示了郎格罕细胞数量降低,与疱性疾患中的上皮内疱形成或上皮下疱形成、存在有内在的联系。     

口腔黏膜多发性癌前病损1例

口腔黏膜癌前病损如口腔白斑、口腔扁平苔藓、口腔红斑、口腔黏膜下纤维性变等同时发生称为多发性口腔癌前病损。临床上较为少见。现就中南大学湘雅医院收治的1例报告如下:患者,男,58岁,因口腔黏膜不能进食刺激性食物8年,舌头白色斑块1年余,于2005年8月26日就诊。患者8年前进辛辣食物时口腔黏膜出现疼痛不适,遂自行避免进食该类食物,但未就诊及进行相应治疗,1年前发现右舌背出现一白色斑块,无明显疼痛不适。患者曾咀嚼槟榔10年,已停食槟榔1年;吸烟30余年。体检:张口度3.0 cm,右侧舌背黏膜可见一白色斑块样损害,约2 cm×1.5 cm大小,表面粗糙,…     

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数据库的初步建立及临床应用

目的    设计一个用于口腔黏膜下纤维性变（OSF）患者临床资料收集、查询的数据库,介绍其临床应用。 方法    首先建立数据库的最初模型,然后由程序员利用 Visual Studio 2013和Microsoft SQL server 2005等专业工具进行计算机编程支持,构建OSF患者临床资料数据库。将2014年6月至2015年12月就诊于中南大学湘雅二医院口腔医疗中心及长沙市口腔医院门诊的154例OSF患者的临床资料输入数据库,进行使用性测试。 结果    成功建立了OSF患者临床资料数据库,该数据库具有数据录入简单快捷、数据查询方便、数据统计实用并有针对性、数据维护安全可靠的特点,可对病案实行信息化管理。结论    建立OSF患者临床资料数据库,为OSF患者的临床资料信息化管理提供了一种有用的工具。     

口腔黏膜病

银杏叶提取物对大鼠复发性口疮模型外周血T淋巴细胞的影响；金因肽治疗糜烂型扁平苔藓疗效观察；干燥综合征患者唾液pH值、电解质测定的诊断意义初步探讨；口腔扁平苔藓、白斑及鳞癌棘细胞形态计量学分析；口腔黏膜下纤维性变中u—PA和PAI-1的表达及意义；口腔干燥症患者唾液分泌与相关因素分析；萎缩性舌炎病因探讨及治疗。[编者按]     

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。     

康宁克通-A磷酸氯喹治疗口腔慢性盘状红斑狼疮的临床观察

自1995年起应用长效皮质类固醇康宁克通-A混悬液病损粘膜下注射,同时口服磷酸氯喹治疗口腔慢性盘状红斑狼疮(Discoid Lupus Erythematosus,DLE),取得较好效果。     

Impact of oral potentially malignant disorders on quality of life

Background

Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients.

Methods

Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF‐12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF‐12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS).

Results

A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, “physical impairment and functional limitations” than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased.

Conclusions

OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.     

Molecular genetics of premalignant oral lesions

Oral squamous cell carcinoma (OSCC) is characterized by cellular and subcellular alterations that are associated with a progression towards dedifferentiation and growth. There are several histologically distinct lesions of the oral cavity which have malignant potential. These are leukoplakia, erythroplakia, lichen planus, and submucous fibrosis. These are characterized by a spectrum of chromosomal, genetic, and molecular alterations that they share with each other as well as with the malignant lesions that develop from them. In this review we summarize the investigation of the molecular genetics of each of these lesions and relate them to the alterations, which have been demonstrated in OSCC, to define their location on the continuum of changes, which lead to malignant transformation.     

口腔癌前病变细胞凋亡的原位观察与分析

目的　探讨口腔白斑、扁平苔藓的癌变机制。方法　通过原位末端转移酶标记法 ,观察分析 10例正常口腔黏膜上皮 ,18例扁平苔藓 ,2 3例白斑 ,2 2例鳞癌上皮组织凋亡状况。结果　除单纯上皮增生 ,非糜烂型扁平苔藓外 ,上皮 (轻、中、重 )异常增生 ,鳞癌及糜烂型扁平苔藓的凋亡指数均高于正常 ,差异有显著性。从上皮异常增生到鳞癌凋亡指数逐渐增高 ,糜烂型扁平苔藓的凋亡指数低于鳞癌 ,差异有显著性。结论　细胞凋亡参与白斑癌变的过程 ,在病变不同阶段作用不同。扁平苔藓的发病机制可能与细胞免疫诱导角朊细胞凋亡亢进有关     

Immunohistochemical study of oral keratoses including lichen planus

Biopsies of non-ulcerated oral mucosa from 13 patients with oral lichen planus and 12 patients with leukoplakia were immunohistochemically stained using monoclonal antibodies to pan T, pan B, T helper and T suppressor/cytotoxic cells and the stained lymphocytes enumerated using an image analyser. The results show the preponderance of T cells infiltrating both oral lichen planus and leukoplakia. The T helper: T suppressor/cytotoxic cell ratio was the same (1:2) for both oral lichen planus and leukoplakia. A similar proportion of T suppressor/cytotoxic cells was found infiltrating the epithelium. These data indicate that T cell subset analysis is of no value in distinguishing oral lichen planus from other oral keratoses.     

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.