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Abstract：
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term \"potentially malignant disorders of the oral mucosa\" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with \"oral lichenoid lesions\" and among those diagnosed with oral manifestations of \'chronic graft-versus-host disease\'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
摘要：
口腔潜在恶性疾病（OPMD）与唇癌或口腔癌的发生风险增加有关。本文介绍了OPMD的命名和分类的最新报告，主要基于他们的临床特征，在世界卫生组织（WHO）英国口腔癌合作中心举办的研讨会上，专家组进行了讨论。2005年在伦敦举行的第一次研讨会考虑了广泛的“口腔粘膜潜在恶性疾病”（PMD）（现在称为口腔潜在恶性疾病：OPMD），包括白斑，红斑,增生疣状白斑，口腔扁平苔藓,口腔粘膜下纤维化，反向吸烟者的腭病变，红斑狼疮,大疱性表皮松解症,和先天性角化障碍.在此期间发布的任何新证据都被认为对2007年分类进行了重大修改。在当前更新中，保留了大多数实体，但对其定义进行了较小的更改。有足够的证据表明，诊断为“口腔苔藓样病变”的患者和诊断为“慢性移植物抗宿主病”的口腔表现的患者患口腔癌的风险增加。这些已被添加到OPMD列表中。有,到目前为止,关于慢性增生性念珠菌病和口腔外生性疣状增生的恶性潜力的证据不足，无法将这些疾病视为OPMD。此外，由于缺乏关于大疱性表皮松解症OPMD的明确证据,这被移至证据有限的类别.我们建议建立一个全球研究联盟，以根据此处提出的分类和命名法进一步研究OPMD的自然历史。这将需要具有统一诊断标准的多中心纵向研究，以改善OPMD患者的识别和癌症风险分层，将它们与基于证据的干预措施联系起来，目的是促进唇癌和口腔癌的预防和管理。
