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Oral submucous fibrosis transforming into squamous cell carcinoma: a prospective study over 31 years in mainland China

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Abstract

Objective

Oral submucous fibrosis (OSF) is an oral mucous disease caused by betel quid chewing. It is controversial whether OSF can transform into oral squamous cell carcinoma (OSCC).

Materials and methods

In this prospective study, a group of 567 patients with OSF were enrolled from 1986 to 2017 and followed-up until 2019. The cancerous information was collected and analyzed.

Results

OSF transformed into OSCC in 32 cases (32/567, 5.6%). The patient’s age ranged from 20 to 69 years, and the average age was 52 years. The time taken for transformation ranged from 2 to 24 years, the average being 8.6 years. The cancerous transformation occurred in 18 patients (56%) from years 2 to 9, in 13 patients (41%) from years 10–19 and in 1 patient (3%) from 24 years. We analyzed the betel quid chewing habits and found all 32 patients with OSCC-chewed betel quid. Betel quid chewing was most prevalent in patients aged 40–69 years. Sixteen patients had chewed betel quid for 10–19 years (16/32, 50%) and 19 patients (60%) chewed 10–19 slices each day. The OSCC was located in the left or right buccal regions in 23 patients (23/32; 72%) and in the left or right lingual regions in 4 patients (4/32; 12%). Well, moderately and poorly differentiated squamous cell carcinoma was present in 23 patients (23/32; 72%), 4 patients (3/32; 9%), and 5 patients (5/32; 16%), respectively.

Conclusion

Our findings supported that OSF is a real oral premalignant disorder.

Clinical relevance

The long duration of the transformation from the OSF to OSCC suggests more frequent examinations and corresponding treatments are necessary for OSF patients.

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Acknowledgments

The authors thank the staff of the Oral and Maxillofacial Surgery of Xiangya Hospital, Central South University.

Funding

This project was supported by the National Natural Science Foundation of P. R. China (No. 81260166, No. 30572044).

Author information

Author notes

  1. Xinchun Jian and Yu Jian are Co-first authors.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China

    Xinchun Jian, Xiaoshan Wu, Feng Guo, Xing Gao, Canhua Jiang & Ning Li

  2. Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China

    Yu Jian

  3. Department of Oral and Maxillofacial Surgery, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, 410078, People’s Republic of China

    Yanjia Hu

  4. Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hainan, 410008, People’s Republic of China

    Yingfang Wu

  5. Department of Oral and Maxillofacial Surgery, People’s Hospital of Haikou City, Central South University, Haikou, Hainan, 507208, People’s Republic of China

    Deyu Liu

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  1. Xinchun Jian
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  2. Yu Jian
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  9. Yingfang Wu
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  10. Deyu Liu
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Corresponding author

Correspondence to Xinchun Jian.

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The authors declare no potential conflicts of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Ethical Committee of Xiangya Hospital, Central South University.

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Informed consent was obtained from all individual participants enrolled in this study.

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Jian, X., Jian, Y., Wu, X. et al. Oral submucous fibrosis transforming into squamous cell carcinoma: a prospective study over 31 years in mainland China. Clin Oral Invest 25, 2249–2256 (2021). https://doi.org/10.1007/s00784-020-03541-9

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  • DOI: https://doi.org/10.1007/s00784-020-03541-9

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