早期口腔癌检查及诊断方法的研究进展

Advances in detection and diagnosis of early oral cancers

过去几十年,口腔癌的治疗方法取得了很大进步,但中晚期口腔癌的预后并未得到明显改善,早期诊断、早期治疗仍然是提高治愈率的关键措施。早期确诊的主要方法是切取活检,但该方法有创,且异常增生与早期口腔癌的区分过于依赖病理医师的临床经验。为诊断口腔异常增生和早期口腔癌,迫切需要可在门诊条件下操作简便、实用且无创的诊断工具。目前发展迅速的早期口腔癌检测方法包括光学系统检查、活组织染色、唾液检测、刷取活检、DNA分析等。本文对这些方法诊断口腔鳞癌及癌前病损的价值进行回顾与评价。

The therapeutic modalities have accomplished important advances in last several decades, while the prognosis of oral cancers remains unchanged. Since oral cancers have a much better prognosis in early stage than in advanced stage, the detection and diagnosis of early oral cancers is the key in the overall control of oral cancers. The essential method in identification of early cancers is still scalpel biopsy. However, this method is invasive and restricted to highly suspicious lesions. Furthermore, scalpel biopsy depends heavily on the experiences of pathologists in the differential diagnosis of dysplasia and early oral cancers. There is urgent need to devise easy, practical, and non-invasive methods for the detection and diagnosis of early oral cancers that can be performed easily in out-patient set-up. This paper reviewed the current methods, including light-based oral cancer screening system, vital staining, saliva testing, brush biopsy, DNA diploidy analysis, et al, and evaluated them in the detection and diagnosis of early oral cancers and precancerous lesions.