Abstract：
The aim of this study was to identify the risk factors associated with developing oral squamous cell carcinoma (OSCC) from surgically excised oral leukoplakia (OL) in patients with previous oral cavity cancer. Clinicopathological data of 84 patients who were treated for OL between July 2002 and July 2020 and who had previously received treatment for OSCC were reviewed retrospectively. The follow-up time ranged from 0.69 to 17.99 years (mean 6.78 ± 4.25 years). The overall cumulative malignant transformation rate was 25% and the annual transformation rate was 5.73%. Kaplan-Meier survival analysis and the log-rank test showed that Candida infection (P = 0.010) was a risk factor associated with malignant transformation. In the multivariate Cox regression analysis, tongue and floor of the mouth as the location of the leukoplakia (P = 0.039), multifocal lesions of OL (P = 0.047), and Candida infection (P = 0.018) were the three independent prognostic factors related to the development of OSCC from the treated OL. A cautious approach to OL of the tongue with Candida infection or multifocal disease in this group of patients would be appropriate.
摘要：
这项研究的目的是确定与先前口腔癌患者手术切除的口腔白斑（OL）发展为口腔鳞状细胞癌（OSCC）相关的危险因素。回顾性分析了2002年7月至2020年7月接受OL治疗且先前接受OSCC治疗的84例患者的临床病理数据。随访时间0.69~17.99年,平均6.78±4.25年。总体累积恶性转化率为25％，年转化率为5.73％。Kaplan-Meier生存分析和log-rank检验显示念珠菌感染(P=0.010)是恶性转化的危险因素。在多元Cox回归分析中，舌和口底是白斑的位置（P=0.039），OL的多灶性病变（P=0.047），和念珠菌感染（P=0.018）是与治疗后的OL发展为OSCC相关的三个独立预后因素。在这组患者中，对患有念珠菌感染或多灶性疾病的舌头的OL采取谨慎的方法是适当的。
