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[Oral precancerous conditions--an overview]
1Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Charité, Medizinische Fakultät, Humboldt-Universität Berlin, Augustenburger Platz 1, 13353, Berlin. peter-a.reichart@charite.de
Mund-, Kiefer- Und Gesichtschirurgie : MKG
|September 10, 2003
Summary
Precancerous conditions significantly increase cancer risk. Oral submucous fibrosis (OSF) and oral lichen planus (OLP) are key oral precancerous states, with OSF showing higher malignant transformation rates.
Area of Science:
- Oncology
- Oral Medicine
- Dermatology
Context:
- Precancerous conditions represent a heightened risk for developing cancer.
- Several oral and perioral conditions, including sideropenic dysphagia, oral lichen planus (OLP), oral submucous fibrosis (OSF), syphilis, discoid lupus erythematosus, xeroderma pigmentosum, and epidermolysis bullosa, are recognized as precancerous.
- Malignant transformation data for some of these conditions remain limited.
Purpose:
- To review and define precancerous conditions in the oral and perioral region.
- To discuss the significance and malignant transformation potential of specific oral precancerous conditions, particularly OLP and OSF.
- To highlight the diagnostic challenges and epidemiological relevance of these conditions.
Summary:
- Oral lichen planus (OLP) has a controversial premalignant status, with reported transformation rates from 0% to 5.6%. Recent research suggests oral lichenoid reactions (OLR) may have a higher potential for malignant transformation than classic OLP, though differentiation is challenging clinically and histopathologically.
- Oral submucous fibrosis (OSF), primarily linked to betel quid chewing and prevalent in South/Southeast Asia, is the second most significant oral precancerous condition, with a transformation rate as high as 7.6%.
- Carcinomas associated with syphilis in the tongue and oral cavity are of historical importance, though serological evidence persisted into the 1990s.
Impact:
- This review emphasizes the critical need for early detection and management of oral precancerous conditions to mitigate cancer risk.
- Understanding the varying transformation rates and diagnostic complexities of conditions like OLP, OLR, and OSF is crucial for clinical practice and patient outcomes.
- Highlights the significant public health impact of OSF in endemic regions, underscoring the need for targeted prevention and intervention strategies.