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目的 明确不同程度的上皮增生与癌变的关系、癌变的组织学表现以及癌变前的上皮增生程度、组织学特点与白斑癌变临床表现的关系.方法 回顾性研究1832例口腔黏膜白斑的组织切片,分析口腔黏膜白斑癌变的临床病理学特点并进行统计学分析,对各种率的比较采用卡方检验,对不同上皮增生程度癌变时间的差异进行秩和检验,检验水准为双侧α=0.05.结果 1832例白斑中有85例(4.6％)癌变；异常增生白斑和中、重度异常增生白斑的癌变率[分别为12.9％ (55/428)20.6％ (22/107)、19％( 12/63)]显著高于单纯增生白斑的癌变率[2.1％ (30/1404)](P值均小于0.005).85例癌变白斑中,29例单纯增生者中有10例为非均质型(34％),50例异常增生白斑中35例为非均质型(70％),二者差异有统计学意义(P ＜0.005)；959例男性白斑中26例(2.7％)癌变,873例女性白斑中59例(6.8％)癌变,男、女癌变率差异有统计学意义(P＜O.005).结论 上皮单纯增生白斑也可癌变,上皮异常增生白斑的癌变危险性高于上皮单纯增生；女性白斑患者的癌变率高于男性；癌变的非均质型白斑伴上皮异常增生者多于伴单纯增生者.

Objective To investigate the histological features of oral leukoplakia which underwent malignant transformation and its correlation with the clinical manifestation.Methods A total of 1832 cases of oral leukoplakia were reviewed and the clinicopathological characteristics of malignant transformation were analyzed.Results Malignant transformation occurred in 85 cases(4.6％ ) of the 1832 cases.Thirty cases (2.1％ ) of 1404 cases with simple epithelial hyperplasia had malignant transformation. Fifty-five cases ( 12.9％ ) in 428 cases with epithelial dysplasia were transformed to malignancy,especially in the cases with moderate or severe dysplasia,in which the ratio of malignant transformation was higher than in the cases with simple epithelial hyperplasia( P ＜ 0.005 ).Clinical parameters associated with an increased risk of malignant transformation were female gender and epithelial dysplasia was more often seen in non-homogenous leukoplakias than in homogenous ( P ＜ O.005 ).Conclusions Non-dysplastic leukoplakia may become malignant. Epithelial dysplasia was associated with an iacreased risk of malignant transformation.Leukoplakia in female may be at a higher risk for malignant transformation.