口腔扁平苔藓癌变研究新进展

口腔扁平苔藓 (orallichenplanus ,OLP)是口腔黏膜常见慢性炎症性疾病 ,具有癌变倾向。其癌变潜能一直存在争议。本文简要综述近三年OLP癌变的流行病学、分子机理、治疗等研究的新进展。     

口腔扁平苔藓癌变生物标记物的研究进展

口腔扁平苔藓(OLP)是一种口腔黏膜慢性炎性疾病,临床上表现为白色纹状或斑块状,主要位于颊黏膜和舌[1]。WTO已把OLP定为口腔黏膜潜在恶性疾患[2]。最近的一项Meta分析显示约1.1%的OLP会发生癌变,其中吸烟者,酗酒者及感染丙型肝炎病毒的人群癌变率较高[3]。大量研究表明糜烂型OLP最易癌变,而舌是最常癌变的部位。组织学上判断OLP癌变的标准是根据是否具有上皮异常增生,但这一标准具有一定的主观性,本文就将OLP癌变预测标记物做一综述,为临床癌变预防和早期诊断提供一定的理论依据和指导。     

口腔扁平苔藓的治疗循证医学分析

口腔扁平苔藓(OLP)是口腔黏膜病中常见病。目前OLP归于慢性、浅表性、非感染性炎症范畴。OLP是否属于癌前病变，文献报道不一，目前尚无定论，但倾向有癌变的可能。OLP病因复杂，目前尚不清楚，因而OLP的治疗也是多种多样。     

口腔扁平苔藓癌前状态及癌变研究

口腔扁平苔藓(OLP)癌前性质引起广泛关注,WHO已将其列入癌前状态。本文就OLP癌前状态及癌变相关研究及可能的分子病理机制、治疗等作一简要综述。     

口腔扁平苔藓癌变的临床研究(附9例报告)

目的：探讨口腔扁平苔藓（OLP）癌变发生特点及规律。方法：对668例OLP病例进行近19年的临床观察及随诊资料统计,并且所有病例均得到组织病理学证实。结果：共发现9例OLP癌变病例,癌变率为1.35%,女性明显多于男性。3例发生在口腔黏膜3个危险区。2例在外界刺激下发生癌变。糜烂型、斑块网纹型病损均可发生癌变。病程15个月至10年不等。结论：OLP癌变患者女性多于男性,口腔黏膜3个危险区好发,外界刺激可诱发癌变,OLP癌变与病损类型无明显关系,癌变病程长。     

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。     

口腔黏膜扁平苔藓癌变的诊断与综合治疗

目的:探讨口腔黏膜扁平苔藓(OLP)癌变的诊断和以手术为主的综合治疗的效果。方法:对1998—2007年间收治的经临床初诊并经病理学证实的64例OLP癌变患者,从临床角度进行回顾性分析。为便于观察,均选择位于颊黏膜的患者,在PVP诱导化疗21d后选择根治性手术。结果:术后1、3年的生存率分别为87.50%和75.00%,局部复发11例(17.18%)。结论:探讨OLP癌变的诊断标准,解决了Krutchkoff等提出的不同意OLP癌变的3点质疑;OLP癌变治疗的重点在于综合治疗。     

氧化应激对潜在口腔恶性疾病作用的研究进展

潜在口腔恶性疾病(oral potentially malignant disorders,OPMD)是一类具有癌变潜能的口腔疾病,其发病机制尚未明确.研究表明,口腔扁平苔藓(oral lichen planus,OLP)、口腔白斑、口腔黏膜下纤维性变(oral submu-cous fibrosis,OSF)患者体内...     

生物标记物在OLP癌变中的研究进展

口腔扁平苔藓(OLP)是一种具有恶性转变风险的慢性口腔黏膜病,临床上判断癌变可能性的主要依据是通过病理切片来观察组织学形态,但存在主观性较强的技术瓶颈。近年来,生物标记物的发展有助于更加客观地判断OLP患者所处的疾病阶段,并预测癌变的潜在危险性,但是如何提高生物标记物的特异性和可靠性是该领域研究的难点之一。本文就近5年来生物标记物在OLP癌变中的研究进展做一综述。     

口腔扁平苔藓、白斑及鳞癌棘细胞形态计量学分析

目的:从形态计量学角度探讨口腔扁平苔藓(OLP)癌变的可能性,并为口腔黏膜良恶性病变的鉴别诊断提供客观参考资料。方法:采用多功能图象分析系统对取自口腔黏膜的正常、口腔扁平苔藓(OLP)、伴轻、中度上皮异常增生白斑(LK)、鳞癌(SCC)的上皮棘层细胞及胞核进行形态计量学研究分析,选择表示细胞及细胞核大小和形状的二维参数9个,体视学参数10个,并比较这些参数在各组间的变化趋势及差异。结果:无论从二维或三维的各项形态学指标,OLP的测量值都处于正常与LK和鳞癌之间,与正常组相比,各参数值多无显著性差异,而与鳞癌组差异显著。结论:OLP是一种介于正常与轻、中度上皮异常增生之间的病变,具有一定的癌变倾向,但癌变潜能低于癌前白斑。二维定量和三维定量结合可更全面地反映口腔黏膜癌变过程中细胞及细胞核的量变质变过程;核质比值、细胞核体积密度可作为鉴别良恶性病变的参考指标。     

血管生成与口腔扁平苔藓关系的研究进展

［摘要］ 口腔扁平苔藓是一种常见口腔黏膜慢性炎性疾病,但关于口腔扁平苔藓的病因机制仍不明确。已知血管生成参与到很多免疫介导的慢性炎症疾病中。近年来已有很多研究关注血管生成在口腔扁平苔藓发生发展中的作用,因此本文就血管生成在口腔扁平苔藓发生发展及其癌变和治疗中的作用进行综述。     

Oral lichen planus: controversies surrounding malignant transformation

Studies of the malignant potential of oral lichen planus (OLP) have been hampered by inconsistencies in the diagnostic criteria used for OLP, the criteria adopted to identify a true case of malignant transformation in OLP, the risk factors for malignant transformation and the optimum management of patients to ensure the early diagnosis of transformation. Consensus remains elusive, and leading workers in this field have recently published conflicting reports on the malignant potential of OLP and on the important question of the advisability of excluding patients with epithelial dysplasia or a tobacco habit from studies on this issue. The present review outlines these debates and proposes a possible a molecular basis for the malignant transformation in this disease.     

Oral lichen planus and malignant transformation: a retrospective follow-up study of clinical and histopathologic data.

OBJECTIVE: Patients in the stomatology service of the Department of Oral Surgery and Stomatology who were clinically and histopathologically diagnosed with oral lichen planus (OLP) in the years 1995 to 2001 were examined for a possible malignant transformation of a previously biopsied OLP site. METHOD AND MATERIALS: For the 145 patients included, the recordings were searched for initial localization and type of OLP lesion, potential noxious agents, distribution between symptomatic and asymptomatic OLP types, and for a malignant transformation of a known OLP site during the follow-up period up to December 2003. RESULTS: The group comprised 47 men and 98 women with a mean age of 56.3 years. Of the 497 lesions, almost half were classified as reticular or papular, predominantly located on the buccal mucosa, gingiva, and borders of the tongue. Four patients did not adhere to their scheduled control visits and were dropped from the study. During the follow-up period 4 patients developed malignant transformation of OLP. In 3 of these cases, dysplasia was present at the initial diagnosis of OLP. This results in a malignant transformation rate of 2.84% among the remaining 141 patients; if the 3 patients with initial dysplasia are excluded, the rate drops to 0.71%. CONCLUSIONS: Until further knowledge is derived from large prospective studies, the data supporting or negating a potential malignant character of OLP lesions remains inconclusive. Special emphasis has to be directed toward unified inclusion and exclusion criteria regarding clinical and histologic findings and identifiable risk factors to allow the comparison of different studies.     

In situ carcinoma developed over oral lichen planus: a case report with analysis of BUB3, p16, p53, Ki67 and SOX4 expression

Oral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.     

Oral lichen planus: progress in understanding its malignant potential and the implications for clinical management

Oral lichen planus (OLP) is an inflammatory lesion that has malignant potential, but few cases of OLP progress to malignancy. A diagnosis of OLP should be confirmed on the basis of historical, clinical, and histologic data. The presence of dysplasia in an OLP-like lesion increases the risk of malignant transformation, mandating management and close follow-up. A molecular assessment of OLP may provide the best evidence of malignant risk and will likely become available for clinical use. In addition, exfoliated cells may be examined for loss of heterozygosity and may become a valuable clinical tool for patient follow-up. The treatment of OLP should include elimination of tissue irritants and recurring exposure to oral carcinogens. If OLP is symptomatic, appropriate treatment with immunosuppressive medications, particularly corticosteroids, should be undertaken. For lesions with dysplastic changes, management may include attention directed to the inflammatory change and follow-up biopsies to assess residual histologic changes that may represent dysplasia. Dysplastic OLP may be best treated as other oral dysplastic conditions; thus, regular, more frequent follow-up is required.     

CD133在口腔扁平苔藓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CD133在口腔正常黏膜、口腔扁平苔藓（OLP）及口腔鳞状细胞癌（OSCC）中的表达情况及临床意义,评估其作为OLP恶性转化的早期诊断指标、OSCC治疗干预靶标的临床价值,为进一步研究口腔黏膜癌变机制提供基础。 方法回顾性分析10例正常口腔黏膜、60例OLP、60例OSCC患者的临床资料,运用免疫组织化学技术检测各组病理组织中CD133表达情况,采用Mann-Whiney秩和检验比较各组间CD133表达差异,卡方检验统计分析CD133与各临床因素的关系。采用免疫组织化学技术和免疫印迹技术检测人口腔癌前病变细胞株（DOK）和人OSCC细胞株（CAL-27）中CD133的表达情况,t检验比较CD133在DOK与CAL-27细胞株中含量差异。 结果口腔正常黏膜、OLP、OSCC三组中,CD133的阳性率为0（0/10）、31.67%（19/60）、63.33%（38/60）,表达逐渐增强。CD133在口腔正常黏膜与OLP表达强度差异有统计学意义（Z=-2.046,P= 0.041）。CD133在OLP与OSCC表达强度差异具有统计学意义（Z=-3.777,P<0.001）。CD133在DOK中弱阳性表达,在CAL-27中阳性表达,DOK与CAL-27中CD133含量差异有统计学意义（t=-5.029,P= 0.001）CD133与OSCC的临床分期和淋巴结转移有关。 结论CD133作为评估OLP恶性转化潜能的指标及OSCC早期治疗干预靶标可能具有重要临床价值。     

Oral lichen planus: Malignant potential and diagnosis

Oral lichen planus (OLP) is one of the most common diseases of the oral mucosa. Clinically, it has specific and clearly identifiable features; bilateral symmetric presentation showing a lace-like network of fine white lines (known as Wickham's striae) is an essential element of OLP even if the lesion exhibits a mainly atrophic and erosive pattern. There are various lesions that resemble OLP clinically and histologically. These lesions are widely referred to as lichenoid reactions or lichenoid lesions (OLLs). OLLs include contact hypersensitivity to dental materials, drug-induced lichenoid lesions, lichenoid reactions in chronic graft-versus-host disease, and other lesions that resemble OLP. The risk of malignant transformation of OLP is the subject of ongoing debate in the literature. Some authors have suggested that only OLLs, but not OLP, are of a premalignant nature and thus, should be categorized as “other dysplastic conditions.” Contrary to this suggestion, many cases of oral squamous cell carcinoma (OSCC) developing in patients with OLP presenting with no epithelial dysplasia have been reported. In addition, it has been reported that multiple events including multifocal dysplasia and/or OSCC subsequently occurred in some patients with OLP, suggesting possible field cancerization in OLP. In this paper, differential diagnosis between OLP and OLLs and their malignant potential are reviewed.     

Urine metabolic profiling for the pathogenesis research of erosive oral lichen planus

ObjectiveOral lichen planus (OLP) is a relatively common chronic immune-pathological and inflammatory disease and potentially oral precancerous lesion. Erosive OLP patients show the higher rate of malignant transformation than patients with non-erosive OLP. Identifying the potential biomarkers related to erosive OLP may help to understand the pathogenesis of the diseases.MethodsMetabolic profiles were compared in control and patient subjects with erosive OLP by using ultra-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UPLC-QTOF-MS) coupled with pattern recognition methods An integrative analysis was used to identify the perturbed metabolic pathways and pathological processes that may be associated with the disease.ResultsIn total, 12 modulated metabolites were identified and considered as the potential biomarkers of erosive OLP. Multiple metabolic pathways and pathological processes were involved in erosive OLP.ConclusionThe dysregulations of these metabolites could be used to explain the pathogenesis of the disease, which could also be the potential therapeutic targets for the disease.