Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (4): 748-752. doi: 10.19723/j.issn.1671-167X.2019.04.027

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Delayed diagnosis of oral squamous cell neoplasms at different sites

Tao XU,Dian-can WANG,Xiao-feng SHAN,Zhi-gang CAI()   

  1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-08-22 Online:2019-08-18 Published:2019-09-03
  • Contact: Zhi-gang CAI E-mail:CZG4209@126.com

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Abstract:

Objective: To investigate the diagnostic delay of patients with oral squamous cell carcinoma by self-designed questionnaire to find out the significant influencing factors, so as to identify the influencing factors of the patient’s delay and the risk of oral cancer.Methods: A total of 514 patients with primary oral squamous cell carcinoma were enrolled at Peking University School and Hospital of Stomatology from January 2014 to April 2016, including 334 men and 180 women, with a male to female ratio of 1.85 :1. The youngest participant was 21 years old, with a maximum of 89 years and a median age of 57.6 years. The position of the disease according to International Classification of Diseases-10 (ICD-10) was divided into lip, buccal, gingival, retromolar, palate, floor of the mouth, tongue, and oropharynx. The age group is divided into 10 years. The level of education was divided into illiteracy, primary education level and advanced education level. Body mass index (BMI) was divided into three levels by 18 kg/m 2 and 25 kg/m 2. Visual analog scale (VAS) method was to evaluate the patient’s preoperative pain. At the same time, the patients were examined by detailed questionnaire to understand the delay factors and delay characteristics, and use SPSS 18.0 software, analysis of variance and chi-square test to explore correlation.Results: Among all patients, the proportion of patients developed in the tongue was the highest (43.3%). Delay was defined by a span of three months or longer from the onset of symptoms until treatment. The delays to diagnosis according to location were as follows (in months and in descending order): lip (6.1 months), buccal (4.1 months), floor of the mouth (3.9 months), tongue (3.6 months), oropharyngeal (2.9 months), retromolar (2.7 months), palatine (2.4 months), and gingival (2.4 months). Different sites and delayed diagnosis were statistically significant (P=0.048). There were no statistically significant differences in gender, education, pain, smoking, drinking and VAS score.Conclusion: The study has found that tumor positions and delay have a significant correlation. The position of the tumor is an obvious factor associated with the findings. The lip is the most likely to delay the diagnosis of oral positions. For the lip of the lesion, more than three months’ obvious mass is recommended for timely treatment, while at admission, physicians should take the appropriate diagnostic method as soon as possible.

Key words: Neoplasms, squamous cell, Delayed diagnosis, Mouth neoplasms

CLC Number: 

  • R739.8

Table 1

The delay characteristics of different factors of oral squamous cell carcinoma"

Items n (%) Delayed diagnosis P
No(<3 months) Yes(≥3 months)
Gender 0.759
Male 334 (65.0%) 241 (72.2%) 93 (27.8%)
Female 180 (35.0%) 127 (70.6%) 53 (29.4%)
Age 0.698
<40 years 52 (10.1%) 35(67.3%) 17(32.7%)
40-49 years 70 (13.6%) 50(71.4%) 20(28.6%)
50-59 years 147 (28.6%) 108(73.5%) 39(26.5%)
60-69 years 161 (31.3%) 110(68.3%) 51(31.7%)
70-79 years 79 (15.4%) 61(77.2%) 18(22.8%)
>79 years 5 (1.0%) 4(80.0%) 1(20.0%)
Education 0.267
Illiteracy 27 (5.3%) 23(85.2%) 4(14.8%)
Primary 309 (60.1%) 220(71.1%) 89(28.9%)
Advanced 178 (34.6%) 125(70.2%) 53(29.8%)
Smoking 0.762
Yes 273 (53.1%) 197(72.2%) 76(27.8%)
No 241 (46.9%) 171(70.9%) 70(29.1%)
Drinking 0.989
Yes 215 (41.8%) 154(71.6%) 61(28.4%)
No 299 (58.2%) 214(71.6%) 85(28.4%)
BMI 0.553
<18 kg/m2 28 (5.4%) 22(78.6%) 6(21.4%)
18-25 kg/m2 322 (62.6%) 226(70.2%) 96(29.8%)
>25 kg/m2 164 (31.9%) 120(73.2%) 44(26.8%)
VAS 0.971
0 43(8.4%) 31(72.1%) 12(27.9%)
1-3 239 (46.5%) 169(70.7%) 70(29.3%)
4-7 186 (36.2%) 134(72.1%) 52(27.9%)
7-10 46 (8.9%) 34(73.9%) 12(26.1%)
T stage 0.959
T1 98 (19.1%) 71(72.4%) 27(27.6%)
T2 192 (37.4%) 138(71.9%) 54(28.1%)
T3-4 224 (43.6%) 159(70.9%) 65(29.1%)
Position 0.048
Lip 21(4.1%) 14(66.7%) 7(33.3%)
Buccal 49(9.5%) 31(63.3%) 18(36.7%)
Gingival 111(21.6%) 92(82.9%) 19(17.1%)
Retromolar 14(2.7%) 11(78.6%) 3(21.4%)
Palatine 20(3.9%) 17(85.0%) 3(15.0%)
Floor of mouth 52(10.1%) 37(71.2%) 15(28.8%)
Tongue 223(43.4%) 150(67.3%) 73(32.7%)
Oropharyngeal 24(4.7%) 16(66.7%) 8(33.3%)

Table 2

Delayed diagnosis characteristics of different positions of oral squamous cell carcinoma"

Position n Number of delay diagnosis Time of medical history/months Time of delay diagnosis/months P
Lip 21 7(33.3%) 10.7±10.8 6.1±5.2 0.003
Buccal 49 18(36.7%) 7.1±6.5 4.1±4.6
Gingival 111 19(17.1%) 4.7±5.5 2.3±3.6
Retromolar 14 3(21.4%) 4.5±3.9 2.7±4.0
Palatine 20 3(15.0%) 3.7±3.2 2.4±3.3
Floor of mouth 52 15(28.8%) 6.2±6.5 3.9±5.9
Tongue 223 73(23.7%) 6.5±6.4 3.6±4.7
Oropharyngeal 24 8(33.3%) 5.3±5.0 2.9±3.2
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