补血活血法对口腔扁平苔藓患者TNF-a、IL-1、IL-6水平的调节作用

目的：探讨补血活血中药对口腔扁平苔藓（OLP）患者TNF－a、IL－1、IL－6水平调节作用，为临床用药提供依据。方法：50例OLP患者随机分为二组，分别给予补血活血中药和雷公藤总甙片进行治疗，采用双抗体夹心法检测了治疗前后TNF－a、IL－1、IL－6水平的变化。结果：治疗两个月后补血活血中药对口腔扁平苔藓（OLP）患者的粘膜斑纹改善方面和TNF－a、IL－1、IL－6水平调节作用明显优于雷公藤总甙片；还显示患者粘膜充血及白色斑纹程度越重，TNF－α、IL－1、IL－6的水平就越高。结论：口腔扁平苔藓患者因病情不同免疫平衡失调的严重程度也不同；补血活血中药是治疗OLP有效的并具有调节免疫功能的药物，值得临床推广应用。     

口腔白斑和口腔鳞状细胞癌患者血清前列腺素E2和干扰素-α的意义

目的：血清前列腺素E2（FGE2）、干扰素－α（IFN－α）的检测对诊断口腔早期癌的临床意义。方法：60例可疑病人及30名正常人空腹血的实验室前列腺素E2、干扰素－α测试。结果：口腔鳞状细胞癌前列腺素E2恙白斑、正常人有显著差别，而白斑与正常人前列腺素E2水平无显著差别；口腔鳞状细胞癌、白斑的干扰素－α水平与正常人有显著差别；口腔鳞状细胞癌与白斑干扰素－α水平无显著差别。结论：血清前列腺素E2、干扰素－α的检测作为一种辅助诊断对诊断口腔早期癌是有意义的。     

牙周炎患者GCF及血清中IL-6测定及其与牙周炎的关系

目的：研究龈沟液（GCF）中白细胞介素－6（IL－6）的来源及其与牙周炎的关系。方法：采用双抗夹心酶联免疫吸附法（ELISA）测定了72例成人牙周炎，13例牙龈炎，18例健康对照组GCF IL－6含量，及17例牙周炎患者，7例健康人血清IL－6水平。结果：牙周炎患者GCF IL－6水平显著高于健康人，牙周炎患者GCF IL－6II与牙周炎患者血清中IL－6含量有显著性差异，牙龈炎患者血清IL－6含量比正常对照组含量高，牙周炎患者GCF IL－6含量与牙龈炎患者有显著性差异，重度牙周炎患者GCF中IL－6含量高于轻度牙周炎患者，牙周炎患者GCF中IL－6含量与出血指数（BI）、牙周袋深度（PD）、附着丧失（AL）有正相关关系。结论：龈沟液中IL－6主要来源于局部牙龈组织，IL－6在牙周炎的发生，发展过程中起一定作用。     

糜烂型OLP患者唾液Th1、Th2、Th17相关细胞因子及β防御素的表达

目的：检测Th1、Th2、Th17相关细胞因子和HBD－2,－3在糜烂型口腔扁平苔藓（EOLP）患者唾液中的表达,探讨其在EOLP发生发展中的作用。方法：分别纳入EOLP患者30例及按年龄和性别匹配的健康者20例作为实验组和对照组,采用流式微球技术（Cytometric Bead Array,CBA）检测唾液中IL－1β、TNF－α、IL－6、IL－17、IFN－γ、IL－4、IL－10的表达水平,并采用酶联免疫吸附测试法（ELISA）检测唾液中HBD－2和HBD－3。结果：EOLP患者唾液中IL－1β、IL－6、HBD－2、HBD－3水平显著高于对照组（P＜0．05）,TNF－α、IL－17、IFN－γ、IL－4、IL－10与对照组比较差异无显著性（P＞0．05）。患者唾液HBD－2的表达与IFN－γ呈正相关、与IL－17呈负相关,HBD－3的表达与IL－17和IL－10均呈负相关。结论：唾液中IL－1β、IL－6、HBD－2和HBD－3的高表达可能与EOLP的发生发展密切相关。     

牙种植体龈沟液中IL-1β、IL-6、TNF-α的检测分析

目的：研究口腔种植体周围龈沟液（PICF）中IL－1β、IL-6、TNF-α的表达特点。方法：34位接受种植义齿治疗的患者作为受试者，检测种植体数目为43枚，其中种植体龈组织有炎症表现的31枚作为实验组，龈组织健康的12枚作为对照组。用whatman 1#滤纸条吸取种植体龈沟液（PICF）。采用ELISA法检测PICF中的细胞因子（IL－1β、IL-6、TNF-α）的种类及含量。结果：种植体龈组织健康的PICF中未检测到IL－1β和IL－6，但有少量的TNF－α。种植体龈组织有炎症表现的PICF样本中可检测到IL－1β、IL-6的存在，TNF-α的含量有显著增加。结论：IL－1β、IL-6、TNF-α参与了种植体组织炎症的免疫调节，并且有可能作为评价种植体组织健康程度的指标。     

Evaluation on Malignant Transformation of Oral Lichen Planus

目的：口腔扁平苔藓（oral lichen planus,OLP)是否属于癌前病变，至今仍存在较大的争论。本文的目的在于评估OLP的癌变性质。方法：报告1995－2002年之间9例OLP的癌变病例。结果：5例OLP患者同时或继发为口腔鳞状细胞癌，1例为疣状癌，3例为上皮异常增生。其中7例发生在原OLP存在的部位，1例发生在其它部位，1例在同一部位同时存在OLP和鳞状细胞癌。OLP的癌变常发生在糜烂型和萎缩型，发生于颊粘膜，舌或牙龈。根据所制定的OLP的诊断及癌变标准，4例OLP患者发生了癌变。结论：OLP具有一定的癌变潜力，对OLP患者应每年随访2－4次，尤其是对发生在颊粘膜，舌或牙龈的糜烂型和萎缩型的患者。     

补血活血法对口腔扁平苔藓患者ＴＮＦ—α、ＩＬ—８及sIL—2R水平的调节作用

目的：探讨补血活血中药对口腔扁平苔藓（ＯＬＰ）患者ＴＮＦ－α、IL０８及sＩＬ－２Ｒ水平调节作用,为临床用药提供依据。方法：４０例ＯＬＰ患者随机分为两组,分别给予补血活血中药和雷公藤总甙片进行治疗,采用双抗体夹心法检测治疗前后ＩＮＦ－α、ＩＬ－Ｉ及sIL-2R水平的变化,结果：治疗２个月后补血活血中药对口腔扁平苔藓（ＯＬＰ）患者的粘膜斑纹改善方面和ＴＮＦ－α、ＩＬ－８及sIL-2R水平调节作用明显优于雷公藤总甙片,还显示患者粘膜充血及白色斑纹程度越重,ＴＮＦ－α、ＩＬ－Ｉ及sIL-2R的水平就越高。结论：口腔扁平苔藓患者因病情不同免疫平衡失调的严重程度也不同,补血活血中药是治疗ＯＬＰ有效的并具有调节免疫功能的药物,值得临床推广应用。     

妊娠中期孕妇血清IL－1与牙周病的关系

目的：研究妊娠中期孕妇血清白细胞介素－1（IL－1）与牙周炎的关系。方法：选择60例中期妊娠妇女为研究对象,其中牙周炎30例,健康对照者30例。分别检查菌斑指数（PLI）、探诊深度（PD）、临床附着丧失（CAL）和出血指数（BI）;同时抽取空腹静脉血5mL,以ELISA法测定血清IL－1水平。结果：牙周炎组和对照组之间,PLI、PD、CAL、BI和血清IL－1均有统计学差异（P％0．05）;IL－1与牙周临床指数PLI、PD、CAL、BI间相关系数为0．692、0．556、0．342、0．683。结论：血清IL－1与PLI、PD、CAL、BI之间呈正相关关系,提示妊娠中期血清IL－1水平与牙周炎存在关联。     

口腔颌面部肿瘤患者血清可溶性白细胞介素─2受体水平的研究

作者用双抗体夹心法酶联免疫吸附试验（ＥＬＩＳＡ法）检测了４６例颌面部肿瘤患者血清可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）水平、并与２５例正常健康人进行对照比较。结果显示：口腔颌面部恶性肿瘤患者血清ＳＩＬ－２Ｒ水平显著高于颌面部良性肿瘤患者血清ＳＩＬ－２Ｒ水平（Ｐ＜０．０ｌ）及正常健康人血清ＳＩＬ－２Ｒ水平（Ｐ＜０．０ｌ），而颌面部良性肿瘤患者血清ＳＩＬ－２Ｒ水平与正常健康人血清ＳＩＬ－２Ｒ水平之间无显著性差异（Ｐ＞０．０５）。本研究表明、血清ＳＩＬ－２Ｒ有可能作为颌面部恶性肿瘤的诊断、疗效考核及预后判断的一个辅助监测指标。     

PCNA、p53和hTERT在口腔黏膜癌前病变和鳞癌中的表达及意义

目的：探讨PCNA、p53蛋白和hTERT在口腔黏膜癌前病变和鳞癌组织中的表达及临床意义。方法：采用原位杂交和免疫组化技术检测口腔黏膜单纯增生(HP)9例,轻度异常增生(LD)11例,中度异常增生(MD)10例,重度异常增生(原位癌CIS)9例,鳞癌(SCC)11例中p53蛋白、PCNA和hTERTmRNA的表达。结果：PCNA、p53和hTERT在口腔黏膜癌前病变和鳞癌中均有表达的异常。结论：hTERT、PCNA和p53与口腔黏膜癌前病变癌变的发生发展有关,它们的异常表达有助于口腔黏膜癌前病变和鳞癌的早期诊断,为研究癌前病变癌变的发生提供了一定的理论依据。     

Immunology of premalignant and malignant conditions of the oral cavity. II. Circulating immune complexes

Prabha B, Pillai MR, Abraham T. Immunology of premalignant and malignant conditions of the oral cavity. II. Circulating immune complexes. J Oral Pathol 1987: 16: 389–391.
Quantitation of circulating immune complexes (CIC) levels was established in patients with oral cancer and oral precancerous lesions. The levels were compared with that in normal controls and chronic chewers of betal quid with no signs of any disease. Both patients with oral cancer and oral precancerous lesions had elevated CIC when compared to both the control groups. The most interesting observations were (a) the CIC levels in the chewing controls were significantly raised when compared to normal controls; and (b) the CIC levels in the patients with premalignant lesions were elevated almost to the same levels as in the oral cancer patients.     

Patients’ awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit

The present study analyzed history of smoking and willingness to quit smoking in patients referred for diagnosis and treatment of different oral mucosal lesions. Prior to the initial clinical examination, patients filled in a standardized questionnaire regarding their current and former smoking habits and willingness to quit. Definitive diagnoses were classified into three groups (benign/reactive lesions, premalignant lesions and conditions, and malignant diseases) and correlated with the self-reported data in the questionnaires. Of the 980 patients included, 514 (52%) described themselves as never smokers, 202 (21%) as former smokers, and 264 (27%) as current smokers. In the group of current smokers, 23% thought their premalignant lesions/conditions were related to their smoking habit, but only 15% of the patients with malignant mucosal diseases saw that correlation. Only 14% of the smokers wanted to commence smoking cessation within the next 30 days. Patients with malignant diseases (31%) showed greater willingness to quit than patients diagnosed with benign/reactive lesions (11%). Future clinical studies should attempt (1) to enhance patients’ awareness of the negative impact of smoking on the oral mucosa and (2) to increase willingness to quit in smokers referred to a dental/oral medicine setting.     

金黄地鼠颊囊癌变过程中COX-2,VEGF表达及相互关系的研究

目的 :环氧合酶 - 2 (cyclooxygenase- 2 ,COX - 2 )是催化前列腺素生物合成的限速酶 ,和许多肿瘤的形成与生长关系密切。本研究旨在探讨DMBA诱导金黄地鼠颊囊癌变过程中COX - 2的表达情况及其与血管内皮生长因子 (vascularendothelialgrowthfactor,VEGF)的关系。方法 :6周龄叙利亚品系金黄地鼠 6 0只 ,建立颊囊癌变的动物模型。然后用免疫组化的方法检测了COX - 2和VEGF的表达情况 ,并探讨COX - 2与VEGF关系。结果 :COX - 2在癌前病变、原位癌中高表达 ,与正常组织相比 ,其表达有显著差异 (P <0 .0 5 )。COX - 2不仅在癌细胞中表达 ,而且在癌组织及附近组织血管内皮细胞中表达。VEGF表达强度随着正常粘膜至鳞癌的发展逐渐增强。结论 :COX - 2在口腔鳞癌的发生、发展中起重要作用 ,与VEGF表达显著相关     

P73蛋白在金黄地鼠颊囊癌变过程中的表达及意义

目的 检测p73基因在口腔癌前病变和鳞状细胞癌发生发展中的表达，为明确p73在口腔癌前病变和鳞状细胞癌中的诊断和治疗价值提供理论依据。方法 采用免疫组化SABC法研究p73在60只地鼠颊囊黏膜癌前病变和鳞状细胞癌中的表达。结果 p73在口腔癌前病变和鳞状细胞癌中表达逐渐增加，证实p73参与了黏膜癌前病变和鳞状细胞癌的发生与发展，有可能用于肿瘤的基因治疗。结论 结果对口腔黏膜癌前病变和鳞状细胞癌的早期诊断、鉴别诊断、基因治疗提供了理论依据。     

Dental practitioner’s knowledge,opinions and methods of management of oral premalignancy and malignancy

Objectives

The present study outlines the results of a pilot study to determine the knowledge and awareness of a cohort of dentists in United Arab Emirates (UAE) regarding aetiology, clinical features and appropriate early management of oral premalignant and malignant lesions.

Materials and methods

A self-administered questionnaire was constructed and posted to 300 UAE Dental Practitoners (DPs), selected randomly from the register of Emirates Dental Association. The present report details the responses of this cohort.

Results

182 questionnaires were completed and returned (response rate 60.6%). One hundred and twenty-seven (69.8%) of the responding dentists were male and the median age of the DPs was 40 years (range 24–75 years). The majority (84%) practised or had practised in or around Dubai and Sharjah, 75% had graduated from a dental school after 1980. Eighty-two respondents (45.0%) had attended specific courses on premalignant or malignant oral lesions. During their undergraduate training 70% of DPs had witnessed more than 10 patients with oral SCC. Only 60.4% of respondents indicated that the tobacco and alcohol use were the principle causes of oral SCC while 19.7% suggested that HIV disease was a risk factor for oral SCC. 29% of DPs routinely recorded the tobacco or alcohol use of their patients and only 3.8% offered advice to patients regarding modification of these habits. Eight-three percent of the respondents suggested that clinical screening was an effective means of reducing the frequency of premalignant and malignant oral lesions.

Conclusions

In view of the gradual rise in oral malignancy worldwide there is an increased need for DPs to be able to recognize the signs and symptoms of oral malignancy and premalignancy, provide appropriate preventive advice and be aware of the appropriate early management of patients with such oral lesions.     

PCNA,p53在口腔粘膜癌前病变及鳞癌中表达的免疫组化研究

应用免疫组化方法对３９例口腔粘膜癌前病变和癌中的增殖细胞核抗原，突变型ｐ５３的表达进行检测。结果表明：从ＬＰ，ＬＫ到ＩＳＣ，其ＰＣＮＡ和Ｐ５３的阳性表达均呈递增趋势。提示ＰＣＮＡ，Ｐ５３表达程度与细胞增殖程度和分化程度关系密切。     

Immunology of premalignant and malignant conditions of the oral cavity. II. Circulating immune complexes

Quantitation of circulating immune complexes (CIC) levels was established in patients with oral cancer and oral precancerous lesions. The levels were compared with that in normal controls and chronic chewers of betel quid with no signs of any disease. Both patients with oral cancer and oral precancerous lesions had elevated CIC when compared to both the control groups. The most interesting observations were (a) the CIC levels in the chewing controls were significantly raised when compared to normal controls; and (b) the CIC levels in the patients with premalignant lesions were elevated almost to the same levels as in the oral cancer patients.     

Oral verrucous hyperplasia: histologic classification, prognosis, and clinical implications

Background:  Oral verrucous hyperplasia (OVH) is a premalignant lesion that may transform into an oral cancer.
Methods:  Sixty consecutive OVH cases were collected from 2003 to 2004. Clinicopathological features and the 5-year malignant transformation rate of these 60 OVH lesions were evaluated and analyzed.
Results:  We found that 84% of OVH lesions occurred in patients between 40 and 69 years of age. The most common site for OVH lesions was the buccal mucosa (48%), followed by the tongue (20%), palate (18%), gingiva (7%), and labial mucosa (7%). Approximately 91% of OVH patients were areca quid chewers and 89% were smokers. When 60 OVH lesions were classified into 30 plaque-typed and 30 mass-typed OVH lesions, the mass-typed OVH lesions had a higher malignant transformation rate of 17% (5/30) than the plaque-typed OVH lesions (3%, 1/30) during a mean follow-up period of 59 ± 7 months. The mean time for malignant transformation was 22 ± 11 months. Of the 6 OVH lesions with malignant transformation, 2 underwent total surgical excision and 4 did not receive any form of therapy.
Conclusions:  We conclude that OVH lesions occur more commonly on the buccal mucosa and are highly associated with the areca quid chewing and cigarette smoking habits. The overall 5-year malignant transformation rate of 60 OVH lesions was 10%. The mass-typed OVH lesions had a higher malignant transformation rate than the plaque-typed OVH lesions and thus should receive an immediate treatment, such as total surgical excision or photodynamic therapy, after the histopathologic diagnosis.     

Papillomaviruses: the current status in relation to oral disease

Human papillomaviruses of different types are associated with a variety of benign oral lesions and may be associated with some premalignant and malignant oral lesions. However, since it is now clear that a variant of human papillomavirus 16 is harbored by normal oral mucosa, as well as by premalignant and malignant lesions, such associations may not necessarily always be causal. The rapid progress of recent research in this field is reviewed, with particular reference to oral disease, and the current status is discussed.     

Oral Cancer: A Prosthodontic Diagnosis

The prosthodontic literature is replete with articles addressing the reconstruction, psychological adaption, prosthesis success, quality of life, need for careful follow-up, and many other issues related to the patient who has undergone surgery, radiation, and/or chemotherapy for oral malignant neoplasms. However, in the prosthodontic professional literature, there is a paucity of information related to the early diagnosis and referral of lesions that may represent premalignant or malignant neoplasia. This article will describe the rationale, epidemiology, and appearance of oral premalignant and malignant mucosal lesions as well as the state-of-the-art diagnostic tools currently available to prosthodontists to ensure that their patients are diagnosed at the earliest possible time.