Oral squamous cell carcinoma (OSCC) may be associated with precursor lesions known as oral potentially malignant disorders (OPMD). Few studies have reported on how OPMD diagnosis affects early detection and outcome of OSCC. We reviewed a large series of OSCC to determine the proportion that was associated with preceding OPMD and to compare the outcome of OSCC with or without precursor. Cases of oral–oropharyngeal carcinoma diagnosed between 2005 and 2015 were retrieved from the Ontario Cancer Registry (OCR) and matched to records of OPMD between 2001 and 2015 in two large oral pathology diagnostic services and the pathology databases of two hospitals with oral pathology services, to identify cases with precursor. Of 10,987 cancer cases, 378 (3.44%) had a preceding OPMD. Patients living in Central Ontario were more likely to have OPMD diagnosed before carcinoma than those in North Ontario (4.73% vs. 1.63%, P = 0.05). 329 of 5,257 cases of oral cancer were linked to a precursor, compared with 24 of 4,174 cases of oropharyngeal cancer (6.26% vs. 0.57%, P < 0.0001). Oral cancers with precursor were predominantly diagnosed at stage I (49.30%), compared with those without precursor, where stage IV disease predominated (41.28%). Sixty-nine of 309 (22.33%) patients with precursor-associated oral cancer have died of disease, compared with 1,551 of 4,656 (33.31%) patients without a precursor ( P = 0.02). We conclude that patients with OSCC associated with a precursor had significantly lower odds of dying from disease. The beneficial effect of precursor lesion diagnosis on outcome is related to a higher proportion of stage I disease. Prevention Relevance: OSCC causes significant morbidity and mortality, especially if diagnosed at late stages. Precursor lesions to OSCC can be recognized by clinical examination. Our study shows that early diagnosis of OSCC at the precursor stage can improve the outcome of oral cancer.

中文翻译：

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与前体病变相关的口腔鳞状细胞癌

口腔鳞状细胞癌 (OSCC) 可能与称为口腔潜在恶性疾病 (OPMD) 的前驱病变有关。很少有研究报道 OPMD 诊断如何影响 OSCC 的早期发现和结果。我们审查了大量的 OSCC 以确定与先前 OPMD 相关的比例，并比较有或没有前体的 OSCC 的结果。从安大略癌症登记处 (OCR) 检索到 2005 年至 2015 年间诊断出的口咽癌病例，并与 2001 年至 2015 年间在两个大型口腔病理学诊断服务和两家提供口腔病理学服务的医院的病理学数据库中的 OPMD 记录相匹配，识别有前兆的病例。在 10,987 例癌症病例中，378 例 (3.44%) 曾有过 OPMD。居住在安大略省中部的患者比安大略省北部的患者更可能在癌症之前诊断出 OPMD（4.73% 对 1.63%，P = 0.05）。5,257 例口腔癌中有 329 例与前兆有关，而 4,174 例口咽癌中有 24 例（6.26% 对 0.57%，P < 0.0001）。有前驱的口腔癌主要在 I 期诊断（49.30%），而无前驱的口腔癌以 IV 期为主（41.28%）。309 名前驱相关口腔癌患者中有 69 名（22.33%）死于疾病，而无前驱相关口腔癌的 4,656 名患者中有 1,551 名（33.31%）死于疾病（P = 0.02）。我们得出结论，与前体相关的 OSCC 患者死于疾病的几率显着降低。前体病变诊断对结果的有益影响与较高比例的 I 期疾病有关。预防相关性：OSCC 会导致显着的发病率和死亡率，尤其是在晚期诊断时。OSCC 的前体病变可以通过临床检查来识别。我们的研究表明，在前兆阶段早期诊断 OSCC 可以改善口腔癌的预后。