口腔扁平苔藓癌变

病例报告例1 喻某某,女,39岁,门诊号24295,住院号18912,因左舌缘溃疡伴白色损害于1979年来我院粘膜病专科门诊就诊。在就诊前2月参加普查时发现舌左缘中份有一小“溃疡”,疼痛明显,进食刺激性食物时疼痛加剧,周围有白色损害。患者认为“溃疡”与月经周期有关。尤其在行经前半月溃疡扩大,疼痛加重。就诊时查:舌左舌缘后份有—1×2cm大小的白色损害区,呈条纹状,粗糙,粘膜充血明显,局部糜烂,压痛,但质软,无硬结,舌质红、舌苔白,脉弦细数。临床诊断:口腔     

口腔扁平苔藓癌变的临床研究

口腔扁平苔藓（ＯＬＰ）的癌变问题一直争论很大。作者从１９８５年来对收治的５９６例ＯＬＰ患者进行了为期１０年的追踪随访观察,平均随访时间为７年,这些ＯＬＰ患者均在病理上有“符合扁平苔藓”的诊断,且均有２－３次活检,至少每年随访一次。在这１０年中,发现ＯＬＰ癌变的病例７例,从这７例ＯＬＰ癌变的病例分析中发现,癌变与不适当的治疗和对外界致癌因素敏感有关。     

口腔扁平苔藓癌变临床病理分析

口腔扁平苔藓 (ＯｒａｌＬｉｃｈｅｎＰｌａｎｕｓ ;ＯＬＰ)是最常见的口腔粘膜病之一 ,ＯＬＰ是否癌变直接关系到临床治疗方法和患者的预后。自 190 5年Ｂｅｔｔｍａｎ首次报道ＯＬＰ癌变以来 ,国内外学者对之进行了广泛的调查与研究。现将我们 1977～ 1998年间收治的 4例ＯＬＰ发生恶变的病例报告如下。一、材料和方法4例患者均为ＯＬＰ病例 ,2例发展为不典型增生 ,2例恶变为鳞癌 ,癌前后均经病理学证实。 4例患者中男性 1例 ,女性 3例 ,年龄 33岁～ 5 6岁 ,平均 46 .0岁。典型病例 :女 ,33岁。右颊部、右下唇糜烂 8年。 1977年 3月就诊 ,…     

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。     

口腔扁平苔藓癌变的探讨（附2例报告）

口腔扁平苔藓癌变的探讨（附２例报告）中国医科大学附属口腔医院彭春岩，王兆元，王惠琼口腔扁平苔蓟（ＯＬＰ）是否是癌前病变，这个问题一直有争论。自１９０５年Ｂｅｔｔｍａｎ首次报道了ＯＬＰ癌变以来，英文文献上陆续见不少报道，但日文文献上关于ＯＬＰ癌变的报道...     

口腔扁平苔藓癌变的研究进展

口腔扁平苔藓是常见的口腔黏膜慢性炎症性疾病,WHO将其列入潜在性癌前病损的范畴.本文就近年来口腔扁平苔藓癌变研究现状,癌变预测标记物及防治做一综述.     

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。     

64例老年口腔扁平苔藓的临床分析

口腔扁平苔藓（oral lichen planus OLP）是一种伴有慢性浅表性炎症的黏膜角化异常性疾病,发病率约为0.51%,是口腔黏膜病中常见的疾病之一[1]。临床上具有起病症状不明显、病期较长、迁延反复、左右对称等特点。作者对我院口腔科1999-2009年间接诊的64例60岁以上的老年口腔扁平苔藓患者病历资料进行了统计分析。     

口腔扁平苔藓相关microRNAs的研究进展

口腔扁平苔藓(oral lichen planus,OLP)是一种常见的病因不明的慢性炎症性疾病,细胞介导的局部免疫应答紊乱在其中发挥着重要作用。目前发现microRNAs(miRNAs)在炎性反应、自身免疫性疾病的发生发展中起到重要作用,已有大量研究报道显示miRNAs可能与OLP相关。文献复习结果表明,miRNA?19a高表达和miRNA?122、miRNA?199、miRNA?138、miRNA?635、miRNA?578低表达可能通过调控白介素、干扰素、肿瘤坏死因子等细胞因子而与OLP的发生相关;miRNA?125a低表达和miRNA?132、miRNA?146a、miRNA?155高表达可能通过影响CD4^+T细胞在Th1/Th2亚群上的分化过程而与OLP的严重程度相关;miRNA?26a、miRNA?29a、miRNA?31高表达和miRNA?27b、miRNA?200a、miRNA?137低表达可能通过具有功能关系的相关基因组、转录因子和miRNA协同调控网络等与OLP癌变风险相关。目前研究仍存在不足之处,许多利用基因芯片筛选差异表达miRNA的研究并没有根据OLP类型或癌变风险进一步的分组探究。     

The management of oral lichen planus

OBJECTIVE: To review the current literature regarding the medical treatment of oral lichen planus (OLP).DATA SOURCES: PubMed on-line Medline data searches were carried out for the years 1966-1998 to identify reports on therapy of OLP.METHODS OF STUDY SELECTION: Single case reports or open trials were included if they covered new therapeutic approaches or suggested significant modifications of known treatment modalities. Review papers were limited to those dealing with the topic.DATA EXTRACTION AND SYNTHESIS: Every paper was critically examined. Because of the great heterogeneity of the response criteria, many data could not be directly compared. Stronger weight was given to therapies that have proven to be effective under placebo-controlled research protocols. Attention was also drawn to potential and effective adverse effects of every drug used.CONCLUSIONS: Among the various medications advocated for the treatment of OLP, several lack conclusive findings from adequately controlled trials. Mainly high-potency topical corticosteroids in an adhesive medium appear at present the safest and most efficacious. Adjuvant agents as antimycotics may be useful in topical steroid treatment. Systemic corticosteroids may be occasionally indicated for severe recalcitrant erosive OLP or for diffuse mucocutaneous involvement. Topical cyclosporine should be considered in steroid-unresponsive cases considering that its efficacy in OLP could be related to a systemic effect and its high cost. Classical PUVA therapy seems to have too many side effects; topical application of psoralen is promising but still experimental. Topically and systemically delivered retinoids combined with topical corticosteroids could improve the efficacy of these agents whereas complete remission is difficult to achieve with retinoids alone and they frequently cause adverse effects. Finally, there are only few data concerning the long-term effect of the medical treatments upon the course of OLP and we do not know if therapy influences the malignant evolution of OLP.     

The characteristics of oral lichen planus

Lichen is a chronic, mucocutan disease with unknown origin. Oral lesions are usually bilateral, the most frequent location of the reticular form is the posterior part of the buccal mucosa. It undergo only rarely spontaneous remission, and it has a potential to turn into malignant tumor. It is hypothesized that due to an antigen-specific mechanism, auto-cytotoxic T-cells infiltrates the affected region. T-lymphocytes induces apoptosis in the keratinocytes of the basal epithelium. Since etiology is unknown, there is no cure for lichen. The symptomatic treatment has been focused on reducing the subjective discomfort and to maintain or improve the quality of life. The main course of therapy are topical retinoids, locally given steroids, but immunosuppressive therapies have been also tried. Data about exact etiology, diagnostical criteria and effective treatment are still limited. Therefore, besides the early detection of the disease, symptomatic treatment, and the close observation of dysplastic lesions is recommended.     

102例口腔扁平苔藓临床治疗回顾性分析

目的探讨口腔扁平苔藓的临床特点和治疗方法。方法回顾性分析102例口腔扁平苔藓患者的临床特点、治疗方法及疗效。结果本研究中患者以女性多见,占55.0%;病损部位以颊黏膜多见,占82.4%;多部位病损患者占73.5%。采用局部和全身联合用药方式,充血糜烂型和溃疡型患者口服硫酸羟氯喹片、白芍总苷胶囊,病损区域基底部行醋酸曲安奈德注射液封闭治疗。反复出现糜烂或溃疡且曲安奈德局部封闭无效者给予他克莫司软膏病损处外用。单纯网纹型患者口服白芍总苷胶囊,局部外用维甲酸软膏。所有患者均给予碳酸氢钠溶液含漱和西吡氯铵含片含服。3个月总有效率为79.4%,6个月为86.3%,1年为88.2%。结论根据口腔扁平苔藓的临床特点采用局部和全身联合用药疗法效果较理想。     

口腔扁平苔藓的免疫疗法现况与展望

口腔扁平苔藓是发生在口腔黏膜上常见的自身免疫性疾病,病因不明,尚无特效疗法,临床上主要以免疫疗法为主,本文就此现况进行综述,为临床工作提供参考。     

Apoptosis in oral lichen planus

Apoptotic cell death may be a contributory cause of basal cell destruction in oral lichen planus (OLP). Therefore. the purpose of this study was to investigate the rate of apoptosis in OLP and the expression of two proteins (FasR and FasL) regulating this process. Biopsies from 18 patients with histologically diagnosed OLP were investigated, with comparison to normal oral mucosa of healthy persons. For visualisation of DNA fragmentation, the TUNEL method was used. In order to characterise the infiltrating cell population (CD3. CD4, CD8) and expression of FasR and FasL, we used an immunohistochemical technique. The results showed that T cells dominated in the subepithelial cell infiltrate. Within the epithelium the apoptotic cells were confined to the basal cell layer, and more apoptotic cells were seen in areas with basal cell degeneration and atrophic epithelium. There was a prominent expression of FasR/FasL in OLP. with a rather uniform distribution throughout the inflammatory cell infiltrate. In the epithelium, the FasR/FasL expression was more abundant in the basal cell area compared to the suprabasal cell layer. In conclusion, apoptosis within the epithelium is significantly increased in situ in OLP compared to normal oral mucosa, and seems to be related to the epithelial thickness.     

Macrophages in oral lichen planus

The presence and distribution of macrophages within 15 non-ulcerated lesions of oral lichen planus was investigated using an immunoperoxidase technique for the detection of the macrophage markers lysozyme and α₁ antitrypsin. All specimens contained mononuclear lysozyme and α₁ antitrypsin positive cells which were concentrated in a band immediately beneath the epithelium and often associated with areas of damaged basal cells. Cell counts revealed that 11% of the positive cells were in the epithelium and 89% in the lamina propria. Approximately 61% of all positive cells were found within a 125 μm wide zone centred on the basement membrane. These results suggest that in oral lichen planus macrophages are in close proximity to the epithelial basal cells, where cell damage occurs, and play a role in the pathogenesis of his condition.