Abstract
ABSTRACTObjective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects.Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05).Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each).Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.
Highlights
Oral leukoplakia is a predominantly white lesion that may be of smooth, rough or warty texture.[3]. Oral erythroplakia, in turn, refers to a red macular or plaque-like lesion.[8]. Actinic cheilitis affects the lower lip in 95% of cases and appears as dryness, erosion and loss of definition in the lip contour.[9]. Oral lichen planus is of unknown etiology, in which an immune response attacks the lining epithelium
A retrospective cross-sectional study, with a population comprised of all charts of patients with suspected potentially malignant oral lesions (PMOL), and with a sample comprised of cases with clinical diagnosis of oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, atypical ulcerated lesion and oral lichen planus, treated at the Oral Diagnosis Center, at the Universidade Federal do Rio Grande do Norte, Natal (RN), between May 2012 and July 2013
This study features a higher amount of actinic cheilitis cases, which is explained by the setting where the research was conducted
Summary
Epidermoid carcinoma is the most common diagnosis - an invasive neoplasm of the squamous epithelium with varying degrees of differentiation, and propensity to early and extensive lymphatic metastases.[11] Treatment usually consists of surgery and radiation therapy, but significant rates of local relapse are not infrequent.[12] Several studies addressed investigations of malignant transformations of PMOL.[1,13] Given their risk of undergoing malignant transformation, studies are required to assess the prevalence of these lesions in the population, in addition to demonstrate indicators to help health professionals recognize them
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