前体病变,过度诊断和口腔癌:一个批判性回顾
Nicola Cirillo1,2,3
1Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3053, Australia.
Cancers
|April 27, 2024
概括
专注于口腔潜在恶性疾病 (OPMDs) 可能无法有效降低口腔癌死亡率,因为大多数OPMDs的恶性转变率很低. 针对性监测对于只有高风险病变至关重要.
科学领域:
- 口腔病理学 口腔病理学
- 在瘤学瘤学.
- 牙科医学 牙科医学
背景情况:
- 口腔潜在恶性疾病 (OPMDs) 被强调用于早期口腔癌检测.
- 然而,唇部和口腔癌的死亡率已经停滞了30年.
- 只有很小一部分口腔癌是由OPMD引起的,大多数OPMD的年转化率为<1%.
研究的目的:
- 审查口腔癌的流行病学.
- 探索OPMD的局限性,专注于减少口腔癌发病率和死亡率.
- 通过挑战"可能"的癌症标签,反对OPMD的过度诊断.
主要方法:
- 现有文献的叙述性审查.
- 对OPMD转变率和口腔癌流行病学的分析.
- 对诊断和监测策略的讨论.
主要成果:
- 大多数OPMD患者具有低恶性转变潜力 (每年<1%).
- 一小部分口腔癌的前身是OPMDs.
- 在OPMD内部的异质性需要风险分层的方法.
结论:
- 仅仅关注OPMD可能不足以降低口腔癌死亡率.
- 密切监测和治疗应保留给高风险的OPMDs (例如,增殖性白血病,红血病,严重发育不良).
- 大多数OPMD的"可能"癌症标签可能构成过度诊断.
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