背景:增生性疣状白斑(PVL),恶性转化率为43.87%至65.8%,是恶性肿瘤倾向最高的口腔潜在恶性疾病。PVL的特征在于关于临床或组织病理学特征以及与该病症相关的预后因素的独特异质性。这项研究的目的是汇编和评估临床病理特征,恶性转化,诊断为PVL患者的相关危险因素。
方法:本研究是一项基于医院的回顾性纵向研究,对2013年至2023年诊断为PVL的36例患者进行了研究。我们对患者进行了完整的临床和组织病理学评估。
结果:该队列包括16名男性和20名女性,产生1:1.25的男女比例。随访时间8~125个月,平均47.50个月。最常见的临床类型为疣状(58.33%),牙龈是最常见的部位(44.44%)。每个病人都有2到7个病灶,平均每名患者3.36。在后续期间,12名患者(33.3%)发展为口腔癌,平均恶变时间为35.75个月。Kaplan-Meier生存分析表明,有疼痛主诉的患者,粗糙度,或者一种粗糙的感觉,患有糖尿病,细胞学异型性组织学表现出更高的恶性转化风险(p<0.05)。在这项研究中,治疗组恶变率(5/23)低于未治疗组(7/13),然而,差异无统计学意义(p=0.05)。
结论:疼痛的主要主诉,粗糙度,或者异物感,再加上组织学上的细胞学异型性表明PVL恶变风险增加.需要进一步的研究来阐明这些临床病理参数对PVL恶性进展的影响。
BACKGROUND: Proliferative verrucous leukoplakia (PVL), distinguished by its malignant transformation rate of 43.87% to 65.8%, stands as the oral potentially malignant disorder with the highest propensity for malignancy. PVL is marked by distinctive heterogeneity regarding the clinical or histopathological characteristics as well as prognostic factors pertinent to this condition. The purpose of this study is to compile and assess the clinicopathological features, malignant transformation, and associated risk factors in patients diagnosed with PVL.
METHODS: This study is a hospital-based retrospective longitudinal study of 36 patients diagnosed with PVL from 2013 to 2023. We conducted complete clinical and histopathological evaluations of the patients.
RESULTS: The cohort comprised 16 males and 20 females, yielding a male-to-female ratio of 1:1.25. The follow-up period ranged from 8 to 125 months, with an average of 47.50 months. The most common clinical type of lesion was the verrucous form (58.33%), and the gingiva was the most common site (44.44%). Each patient had between 2 to 7 lesions, averaging 3.36 per patient. During the follow-up period, twelve patients (33.3%) developed oral cancer, with an average time to malignant transformation of 35.75 months. Kaplan-Meier survival analysis indicated that patients with complaints of pain, roughness, or a rough sensation, with diabetes, and the presence of cytologic atypia histologically showed a higher risk of malignant transformation (p < 0.05). In this study, the rate of malignant transformation in the treatment group (5/23) was lower than that in the untreated group (7/13), however, no statistically significant difference (p = 0.05).
CONCLUSIONS: The main complaints of pain, roughness, or foreign body sensation, coupled with cytologic atypia histologically are indicative of an increased risk of malignant transformation in PVL. Further research is needed to elucidate the influence of these clinicopathological parameters on the malignant progression of PVL.