A Clinicopathologic and Epidemiologic Study of Chronic White Lesions in the Oral Mucosa

Abstract

Invasive oral squamous cell carcinoma is often preceded by the presence of clinically identifiable premalignant changes of the oral mucosa, including white lesions. We conducted a cross-sectional, observational study to assess the clinicopathologic and epidemiologic aspects of chronic oral mucosal white lesions to determine the necessity of early biopsy in these cases. Our study population was made up of 77 patients—50 males and 27 females, aged 15 to 70 years (mean: 42.9)—who presented with white lesions persisting for at least 4 weeks. All but 3 patients underwent a biopsy; the 3 exceptions were diagnosed with smear-proven candidiasis. Patients with moderate or severe dysplasia underwent an excision biopsy. The buccal mucosa was the single most common site of white lesions, occurring in 15 patients (19.5%), although 21 patients (27.3%) exhibited a diffuse involvement of the oral mucosa. Of the 77 patients, 59 (76.6%) had concerning findings: premalignant lesions in 45 patients (58.4%) and malignant lesions in 14 (18.2%). Also, dysplasia was seen in 8 patients (10.4%), all of whom had premalignant lesions. Tobacco chewing (p = 0.008) and betel quid chewing (p = 0.029) were significantly associated with the development of premalignant and malignant lesions; a longer duration of tobacco chewing (≥10 yr) was significantly associated with a higher risk of malignant but not premalignant lesions (p = 0.031). Finally, illiteracy was a significant risk factor for premalignant and malignant lesions (p = 0.03). Our findings support the necessity of biopsy in every case. Early detection of oral carcinoma by biopsy of all oral white lesions would not only prevent patients from undergoing disfiguring surgery and chemoradiation, but it also would increase the 5-year survival rate.

Oral epithelial dysplasia and oral cancer prevalence in routine white lesion biopsies – a 6-year retrospective study

“…In the current study, the frequency of OSCC in leukoplakia was found to be even greater (11.11%), while the frequency of OSCC in the total number of white lesions subjected to histopathology was 2.84%. However, this frequency is comparatively low when compared to other study in which the dysplasia rate was 10.4%, and OSCC was found in 14,3% of all white lesions removed [16].…”

Epidemiological survey of oral lesions diagnosed at a stomatology service

“…Taking into account sites strictly affected by white lesions, the buccal mucosa was the most prevalent (45.88%), as in the studies by Simi et al and Ghosh et al, which showed this condition in about 76% and 19.5% of patients, respectively (22,23). The most frequent white lesions found in the patients in this study were Fordyce granules (35.37%), linea alba (15.85%) and frictional hyperkeratosis (9.76%), respectively, which corroborate with the prevalent lesions from the study by Kansky et al,(20).…”

Preliminary results of screening for pathological lesions in oral mucosa and incidence of oral cancer risk factors in adult population

“…Co roku wykrywane jest kilka tysięcy nowych przypadków tej choroby. Niepokojące są również doniesienia o wzroście częstości występowania zmian na błonie śluzowej i nowotworów jamy ustnej w coraz młodszej grupie wiekowej pacjentów (2,3).…”

“…Every year, several thousand new cases of this disease are detected. A significant increase in the incidence of oral mucosa lesions and oral cavity tumors in a younger age group of patients is reported (2,3).…”