Clinical Investigation Of Oral Submucous Fibrosis And The Malignant Transformation Of OSF

Objective:1. To investigate the epidemiological changes of oral submucous fibrosis (OSF) and malignant transformation of OSF in Hunan.2. To investigate the risk factors of malignant transformation of oral submucous fibrosis(OSF).Method:Five hundred and eleven patients with oral submucous fibrosis treated in the Department of Stomatology ,the Second Xiangya Hospital of Central South University between Feb 2004 and Feb 2009 were investigated as sample( I), and fourty-nine oral squamous cell carcinoma (OSCC)concomitant with OSF treated in the Department of Oral and Maxillofacial Surgery , the Second Xiangya Hospital of Central South University between Feb 2006 and Feb 2009 and 10 OSF concomitant with OSCC of sample( I) (equals to 59 patiens)were investigated as sample( II). The age , sex , occupation, address, education, duration and frequency of chewing betel nut,duration and frequency of smoking, drinking, clinical features , sites of lesion , the mouth opening as well as wether concomitant with OLP or OLK and OSCC were studied in the two samples.Statistical analysis use the software package SPSS17.0, P<0.05 was considered statistically significant.Result:1. The average age of five hundred and eleven patients with oral submucous fibrosis was 36.43±0.45 years, male was prominent,the male to female ratio was 91.8:8.2. The patients distribute in every district in Hunan, the incidence was mainly seen in businessmen or staffs.The education level of the patients was mainly in junior and senior high school levels. The major of the patients were ever chewers,ever smokers or having the habit of drinking. Twenty-four patients concomitant with OLP, thirty concomitant with OLK, while ten concomitant with OSCC, the ratio was 4.7 %,5.9% and 2.0% respectively.2. The average age of fifty-nine OSF concomitant with OSCC patients was 43.98±1.21 years, male was prominent, the male to female ratio was28.5:l,the major age groups were 40～49 and 30～39, the incidence was mainly seen in businessmen and farmers, the main locations concomitant with OSCC were the tongue and the buccal mucosa, concomitant with OSCC patients were almost ever chewers,ever smokers or having the habit of drinking.3. Single sample t test demonstrated that the frequency of areca nut chewing, smoking and drinking as well as age play an important role in OSF and the malignant transformation of OSF(P<0.001).The results of Chi-square test revealed that areca nut chewing,smoking and drinking as well as age may play an important role in the malignant transformation of OSF(P<0.05).4. Univariate unconditional logistic regression analysis demonstated that areca nut chewing and duration of areca nut chewing, smoking, duration and frequency of smoking, drinking and age were statistically significantly (P<0.05).Multiple unconditional logistic regression analysis demonstrated that areca nut chewing, frequency of areca nut chewing,and duration of smoking may play an important role in the malignant transformation of OSF (P<0.05).Conclusion:1. In Hunan the male OSF patiens are more compared with female, the patients become younger, the distribution of region is likely more extensive.2. The occasion of OSF accompanied with OSCC is likely to be higher, the patients become younger ,some OSF patients accompanied with OLP or OLK. 3. Chewing areca nut, drinking and smoking may play synergic roles in the malignant transformation of OSF patients, duration and frequency of areca nut chewing and smoking, and frequency of drinking may play an important role in the malignant transformation of OSF.