The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Curr Oncol Rep. 2024 Sep;26(9):1047-1056. doi: 10.1007/s11912-024-01562-1. Epub 2024 Jun 12.
This review aims to provide a comprehensive overview of the current advances in managing and preventing progression of oral potentially malignant disorders (OPMDs), focusing on their histological and clinicopathological features, and management.
Recent studies, including a multicenter cross-sectional study, have identified oral leukoplakia as the most prevalent form of OPMD, comprising over half of the cases examined. Advances in histological grading, specifically the World Health Organization's three-tier system (mild, moderate, and severe dysplasia), have significantly enhanced the accuracy of risk assessment for malignant transformation. Additionally, treatments such as surgical interventions, photodynamic therapy, and chemopreventive and molecularly targeted agents are being evaluated for their safety and efficacy as well as, immune checkpoint inhibitors being evaluated as potential preventive strategies to halt the progression of OPMDs. The management of OPMDs remains challenging due to the lack of standardized screening protocols and varied clinical management approaches. Despite this, recent advancements in diagnostic grading and therapeutic interventions provide a framework for improved treatment outcomes. Continued research into the molecular and cellular mechanisms driving development and progression of OPMDs and innovative treatment trials are essential to optimize strategies that prevent malignant progression and thereby reduce the global health burden of oral cancer.
本文旨在全面综述目前在管理和预防口腔潜在恶性疾病(OPMD)进展方面的最新进展,重点关注其组织病理学和临床病理特征及管理。
最近的研究,包括一项多中心横断面研究,已确定口腔白斑病是最常见的 OPMD 形式,占所检查病例的一半以上。组织学分级的进展,特别是世界卫生组织(WHO)的三级系统(轻度、中度和重度异型增生),显著提高了恶性转化风险评估的准确性。此外,手术干预、光动力疗法以及化学预防和分子靶向药物等治疗方法正在评估其安全性和有效性,免疫检查点抑制剂也被评估为阻止 OPMD 进展的潜在预防策略。由于缺乏标准化的筛查方案和不同的临床管理方法,OPMD 的管理仍然具有挑战性。尽管如此,诊断分级和治疗干预方面的最新进展为改善治疗结果提供了框架。深入研究驱动 OPMD 发生和进展的分子和细胞机制以及创新的治疗试验对于优化预防恶性进展的策略至关重要,从而降低全球口腔癌负担。