中国口腔白斑恶变率的Meta分析

Malignant Transformation Rate in Chinese Patients with Oral Leukoplakia:a Meta-analysis

背景口腔癌具有较高的发病率,大多数口腔癌是由口腔潜在恶性疾患造成,口腔白斑是常见的口腔潜在恶性病变。口腔白斑恶变不仅会影响患者的身心健康,而且会给患者家庭和社会带来沉重的经济负担。由于受到样本量、地区差异等因素的限制,我国口腔白斑患者恶变的流行病学特征结果不一。目的系统评价中国人群口腔白斑的恶变率。方法计算机检索中国知网、中国生物医学文献数据库、维普中文科技期刊全文数据库、万方数据知识服务平台、PubMed、Web of Science、Embase、Cochrane Library,获取有关中国人群口腔白斑恶变率的队列研究,检索时限均为建库至2022年2月,由2名研究员独立筛选文献,对纳入的研究进行质量评价与数据提取,采用Stata 15.0软件进行统计学分析。结果最终纳入30篇队列研究,包括109047例患者。Meta分析结果显示,我国口腔白斑患者恶变率为9.0%〔95%CI(7.0%,11.3%)〕。亚组分析结果显示,男性患者口腔白斑恶变率为7.6%〔95%CI(5.1%,10.6%)〕,女性患者口腔白斑恶变率为13.2%〔95%CI(9.5%,17.4%)〕;<60岁患者口腔白斑恶变率为12.3%〔95%CI(9.2%,15.7%)〕,≥60岁患者口腔白斑恶变率为17.9%〔95%CI(13.8%,22.5%)〕;舌部口腔白斑患者的恶变率为16.2%〔95%CI(11.0%,22.2%)〕,其他部位口腔白斑患者的恶变率为6.1%〔95%CI(3.2%,9.6%)〕。结论当前证据表明,中国人群口腔白斑的恶变率较高,女性、年龄≥60岁、舌部口腔白斑恶变率较高。

Background Oral cancer is highly prevalent,which is often caused by oral potentially malignant disorders,and oral leukoplakia is the most common.The malignant transformation of oral leukoplakia not only affects the physical and mental health of patients,but also imposesa heavy economic burden on the patient's families and society.Due to limited sample size,regional differences and other factors,the epidemiological characteristics of malignant transformation in Chinese patients with oral leukoplakia in China are various.Objective To perform a systematic review of the malignant transformation rate of oral leukoplakia in Chinese patients.Methods Databases of CNKI,SinoMed,CQVIP,Wanfang Data,PubMed,Web of Science,Embase and Cochrane Library were searched to identify cohort studies about malignant transformation rate of oral leukoplakia in Chinese patients included from inception to February 2022.Two researchers separately screened the cohort studies,evaluated the qualities and extracted data.Meta-analysis was conducted using Stata 15.0.Results Thirty cohort studies including 109047 patients were finally included.Meta-analysis revealed that the malignant transformation rate of oral leukoplakia in Chinese patients was 9.0%〔95%CI(7.0%,11.3%)〕.The results of subgroup analysis revealed that the malignant transformation rate was 7.6%in male patients〔95%CI(5.1%,10.6%)〕,and was 13.2%in female patients〔95%CI(9.5%,17.4%)〕.The malignant transformation rate of oral leukoplakia in patients aged<60 years was 12.3%〔95%CI(9.2%,15.7%)〕,and was 17.9%in those aged≥60 years〔95%CI(13.8%,22.5%)〕.The malignant transformation rate of tongue leukoplakia was 16.2%〔95%CI(11.0%,22.2%)〕,and that of leukoplakia of other parts of the oral cavity was 6.1%〔95%CI(3.2%,9.6%)〕.Conclusion Current evidence shows that the malignant transformation rate of oral leukoplakia in Chinese patients is relatively high,female,age≥60 years,tongue oral leukoplakia malignant rate is higher.