口腔黏膜白斑癌变的相关危险因素分析  

Analysis of risk factors for carcinogenesis of oral leukoplakia

作　　者：蓝爱仙[1] 关晓兵[1] 孙正[1] 

机构地区：[1]首都医科大学口腔医学院牙周黏膜科,北京100050

出　　处：《中华口腔医学杂志》2009年第6期327-331,共5页Chinese Journal of Stomatology

摘　　要：目的通过对409例口腔黏膜白斑患者的回顾性综合分析，探讨口腔黏膜白斑癌变的相关危险因素。方法首先进行单因素检验，观察性别、年龄、病程、系统疾病、吸烟、饮酒、病变部位、临床类型、病变数量、病变范围、症状与口腔黏膜白斑组织病理的关系，筛选与口腔黏膜白斑组织病理相关的变量，进入多元Logistic回归分析模型，计算这些因素的相对危险度（OR值）及95％可信区间。结果409例口腔黏膜白斑中52例（包括9例重度异常增生）发生了癌变，癌变率为12.7％。其中，性别、年龄、临床分型、病变部位和症状被选入多元Logistic回归分析模型。多元Logistic回归分析结果表明：与单纯增生相比，发生轻中度异常增生的危险性，女性口腔黏膜白斑患者是男性的2.40倍，颗粒型口腔黏膜白斑是均质型的2.81倍，危险区是非危险区的1.98倍，伴有症状的口腔黏膜白斑是无症状的1.84倍。发生重度异常增生及癌变的危险性，女性患者是男性患者的3.11倍，颗粒型、溃疡型、疣状型口腔黏膜白斑分别是均质型的4.50、5.63、4.09倍，危险区是非危险区的2.79倍，伴有症状的口腔黏膜白斑是无症状的4.38倍。结论口腔黏膜白斑癌变与性别、年龄、临床类型、病变部位及症状等相关。Objective To investigate the risk factors for malignant transformation of oral leukoplakia. Methods A total of 409 cases with oral leukoplakia was retrospectively analyzed. Single factor test was first performed to examine the associations between oral leukoplakia＇s histopathological classification and each of risk factors including sex, age, systemic diseases, course of disease, clinical classification, site, size, numbers of lesion, alcohol and tobacco consumption, and symptom. Then the association of these selected factors with oral leukoplakia＇s histopathological classification was evaluated using multiple logistic regression analysis. Results Fifty-two cases of all 409 patients with oral leukoplakia （including 9 severe dysplasia） developed oral cancer. The ratio of malignant transformation was 12.7%. Sex, age, clinical type, site and symptom were chosen as risk factors incorporated into the multiple logistic regression models. The risk of mild-moderate dysplasia in female was 2.40 times as high as that in male. The risk of mild- moderate dysplasia of speckled leukoplakia was 2.81 times as high as that of homogeneous leukoplakia. The risk of mild-moderate dysplasia of dangerous site was 1.98 times as high as that non-dangerous site. The risk of mild-moderate dysplasia with symptom was 1.84 times as high as that without symptom. The risk of severe dysplasia and oral cancer in female was 3.11 times as high as that in male. The risk of severe dysplasia and oral cancer of speckled （ 4. 50 times ）, ulcerative （ 5.63 times ） , verrucous leukoplakia （ 4. 09 times ） were much higher than that of homogeneous leukoplakia. The risk of severe dysplasia and oral cancer in dangerous site was 2. 79 times as high as in non-dangerous site. The risk of severe dysplasia and oral cancer in leukoplakia with symptom was 4.38 times as high as without symptom.Conclusions The malignant transformation of oral leukoplakia is correlated to sex, clinical type, site and symptom.

关 键 词：白斑 口腔 口腔肿瘤 危险因素 回顾性研究 

分 类 号：R686[医药卫生—骨科学]