口腔扁平苔藓的临床特征、治疗和恶性肿瘤发生率:一项欧洲多中心研究。

IF 2.2 3区 医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-01-06 DOI:10.1016/j.jormas.2025.102218
Paolo Boffano, Francesca Neirotti, Valeria Nikolovska, Matteo Brucoli, Muhammad Ruslin, Petia Pechalova, Nikolai Pavlov, Angel Sapundzhiev, Petar Uchikov, Juan Carlos de Vicente Rodríguez, Tania Rodríguez Santamarta, Christophe Meyer, Aurelien Louvrier, Alexandre Michel-Guillaneux, Eugenie Bertin, Thomas Starch-Jensen, Ivana Gusic, Branislav V Bajkin, Rosa Maria López-Pintor, José González-Serrano, Sophie Dugast, Helios Bertin, Pierre Corre, Ágnes Bán, József Szalma, Jaana Rautava, Johanna Snäll
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引用次数: 0

摘要

口腔扁平苔藓(OLP)是一种慢性炎症性粘膜皮肤病,包括一系列口腔临床表现,从轻度无痛的白色病变到疼痛性糜烂和溃疡。这项欧洲多中心研究的目的是描述OLP病变的一般特征,临床和组织病理学诊断,以及不同欧洲口腔医学和颌面外科中心的OLP管理,以尽量减少选择偏差,并提供有关欧洲OLP治疗的当前趋势的信息。材料和方法:对OLP患者的资料和组织病理学记录进行回顾性修订,仅纳入符合美国口腔颌面病理学会2016年立场文件诊断标准的患者。记录每位患者的以下数据:性别、年龄、性欲习惯、OLP的危险因素(心理压力、药物、全身性疾病)、OLP病变部位、临床表现、临床表现模式、症状、治疗、可能的临床改善和恶性转化。结果:565例OLP患者(女性422例,男性143例)符合纳入标准。研究人群诊断时的平均年龄为60.11岁。262例(46.4%)患者仅发现OLP的一个部位,其中186例仅在颊黏膜被诊断出OLP。最常见的临床表现为网状。在评估所接受的治疗时,294名患者以观望的方式进行随访。最常见的治疗方案是局部使用皮质类固醇(123例)。局部使用皮质类固醇(P < .0005)或类维生素A (P < .000005)与症状改善之间存在显著的统计学关联。565例OLP患者中有9例(1.6%)在随访期间观察到与OLP病变相关的鳞状细胞癌。结论:网状和混合型临床表现是OLP最常见的亚型。局部使用皮质类固醇和类维生素a治疗OLP似乎可以很好地改善症状和体征。由于OLP的慢性性质和可能的恶性转化,临床长期随访是至关重要的。
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Clinical characteristics, management, and malignancy rate of oral lichen planus: A European multicenter study.

Introduction: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous condition that includes a spectrum of oral clinical manifestations ranging from mild painless white lesions to painful erosions and ulcers. The purpose of this European multicenter study is to describe the general characteristics of OLP lesions, the clinical and histopathological diagnosis, and the management of OLP at different European Oral Medicine and Maxillofacial Surgery centers, in order to minimize selections biases and provide information about the current trends in the treatment of OLP across Europe.

Materials and methods: Data and histopathological records of patients with OLP were retrospectively revised and only those patients that fulfilled the diagnostic criteria from the 2016 position paper by American Academy of Oral and Maxillofacial Pathology were included. The following data were recorded for each patient: gender, age, voluptuary habits, risk factors for OLP (psychological stress, medications, systemic diseases), location of OLP lesions, clinical presentation, patterns of clinical expression, symptoms, treatment, possible clinical improvement, and malignant transformation.

Results: A total of 565 OLP patients (422 females, 143 males) fulfilled the inclusion criteria. The mean age of the study population at diagnosis was 60.11 years. In 262 patients (46.4 %), just a site of OLP was identified: in 186 of these "one-site" patients, OLP was diagnosed just in buccal mucosa. The most frequently observed clinical pattern was reticular. When evaluating the treatment received, 294 patients were kept in follow up with a Wait-and-see approach. The most frequent treatment regimen was the use of topical corticosteroids (123 patients). A significant statistical association was found between the prescription of topical corticosteroids (P < .0005) or retinoids (P < .000005) and symptoms improvement. Squamous cell carcinoma associated with OLP lesions was observed during the follow-up in 9 OLP patients out of 565 (1.6 %).

Conclusions: Reticular and mixed clinical patterns are the most frequent subtypes of OLP. The use of topical corticosteroids and retinoids for the management of OLP seems to allow good improvement results of symptoms and signs. A clinical long-term follow-up is fundamental due to the chronic nature of OLP and possible malignant transformation.

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来源期刊
CiteScore
2.20
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305
期刊介绍: J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.
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