Fogorvosi szemle, 2007 (100. évfolyam, 1-6. szám)
2007-10-01 / 5. szám
253 FOGORVOSI SZEMLE ■ 100. évf. 5. sz. 2007. DM2, both the chronic inflammatory processes (gingivitis, periodontitis) and the atrophic epithelial lesions (cheilitis, glossitis) may be possible precursors of the malignant transformation. Epidemiological correlations of glucose metabolism disorders and oral tumor risk Our working group examined the correlations between DM and oral premalignancies and tumors in a clinical study. The first part of the study was a stomato-oncological screening on 200 diabetic patients in the Medical Departments of the Semmelweis University Budapest; the control group included 280 adult dentistry outpatients. Both inpatients and outpatients were involved: 82 patients had DM1, and 118 had DM2. A total of 131 were women, and 69 were men. The average age was 45.8 years. The mean age of the patients was 36.3 years in the DM1 group, and 55.3 years in the DM2 group. The control group comprised 280 adult, otherwise healthy dentistry outpatients (109 men, 171 women). Their mean age was 47.2 years. Two physicians performed the examinations, and the data were recorded on a specially prepared questionnaire. Besides the relevant personal data, the recorded information of laboratory values related to previous treatment of DM, possible complications, as well as smoking habits were also recorded. This was followed by a clinical examination, including a thorough examination of the oral cavity and bimanual palpation of the cervical region. Details were recorded, mucosal lesions, precanceroses, and tissue The second part of the study was retrospective DM screening of 610 inpatients with histologically confirmed squamous cell OC in the Department of Oral and Maxillofacial Surgery of Semmelweis University. The control group comprised 574 complaint- and tumor-free adults. Ratio of smokers and fasting blood glucose levels were determined in both groups, and the tumor location was registered in the cancer patients. Fasting blood glucose levels were determined repeatedly within 4 days. The level was regarded as elevated only if it was repeatedly elevated. Based on the findings, the patients were classified into three groups: Group 1: patients with a normal fasting blood glucose level (<6.0 mmol/l); group 2: patients with an elevated fasting blood glucose (EFG) level (6.0-6.9 mmol/l); and group 3: patients with DM (>6.9 mmol/l). Smoking habits in both cancer and control groups, as well as tumor locations in the OC group were registered. Stomato-oncological screening of DM patients The results are presented in Table I. The lesions found were classified in three groups. Type 1: inflammatory lesions, such as cheilitis and glossitis; type 2: benign tissue accumulations; and type 3: precancerous lesions, such as leukoplakia and erythroplakia. Malignant lesions were found neither among these 200 diabetes patients nor in the control group. Oral cavity lesions were found in 51.5% of the DM patients. In both types of DM, inflammations were the most frequent, followed by benign tumors, and then by precancerous lesions. In the control group, the frequency of all lesions was significantly lower (p<0.01). The proportions of inflammatory lesions, benign lesions, and precancerous lesions were higher among Table I: Distribution of oral lesions by type and sex in the groups of the type 1 and type 2 DM patients Number of cases Control group Type 1 DM group Type 2 DM group Men Women Total % Men Women Total % Men Women Total % All 280 82 118 Cheilitis, glossitis 11 15 26 9.2 6 15 21 25.6 12 25 37 31.3 Benign tumor 8 10 18 6.4 2 7 9 10.9 6 14 20 16.3 Leukoplakia/ erythroplakia 4 5 9 3.2 2 1 3 3.6 4 9 13 11 Total 23 30 53 18.8 10 23 33 40.2 48 48 70 59.2 accumulations considered clinically to be benign or malignant. The examiners were not aware of the patients’ diabetic state. patients with DM2 than among those with DM1 (Table I). The 11% incidence of leukoplakia in the DM2 group was noteworthy. The proportions of active smokers and of those who had given up smoking in this group
