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Objectives: This study aimed to examine the association between hyperglycemia and the malignant transformation of oral leukoplakia (OLK). Patients and Methods: This retrospective case–control study involved 133 patients with the malignant transformation of OLK into oral squamous cell carcinoma (case group) and 266 patients with untransformed OLK (control group). The clinical history and follow‐up data included age, gender, lesion size and location, and fasting plasma glucose. Logistic regression analysis, Kaplan–Meier survival analysis, and univariate and multivariate Cox regression analyses were used to assess the effects of risk factors on the malignant transformation of OLK. Results: Hyperglycemia (adjusted hazard ratio [AHR] = 4.7, p =.001), non‐homogenous OLK (AHR = 3.0, p <.001), location of the lesion on the ventral surface of the tongue or floor of the mouth (AHR = 3.6, p <.001), and epithelial dysplasia (AHR = 2.8, p =.005) had significant effects on the malignant transformation of OLK. Conclusion: Hyperglycemia, non‐homogenous OLK, location of the lesion on the ventral surface of the tongue or floor of the mouth, and epithelial dysplasia might be associated with malignant transformation of OLK. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to systematically review the efficacy of direct optical fluorescence imaging as an adjunct to comprehensive oral examination in the clinical evaluation, risk assessment and surgical management of oral cancer and potentially malignant disorders. Methods: Studies adopting autofluorescence devices, evaluating the efficacy of comprehensive oral examination and optical fluorescence imaging in detection, visualisation or management of oral squamous cell carcinoma or oral potentially malignant disorders, as well as discriminating oral epithelial dysplasia from other mucosal lesions, were included in the literature search across bibliographic databases until October 2018. Results: Twenty‐seven studies were found to be eligible for inclusion in qualitative analysis. Of these, only six studies demonstrated a low risk of bias across all domains of the methodological assessment tool (QUADAS‐2). Optical fluorescence imaging demonstrated positive results, with higher sensitivity scores, increased lesion detection and visualisation than comprehensive oral examination alone in the clinical evaluation of oral squamous cell carcinoma and oral potentially malignant disorders. Conclusions: This review provides promising evidence for the utilisation of optical fluorescence imaging as an adjunct to comprehensive oral examination in varying clinical settings. It is important that devices utilising optical fluorescence imaging are viewed strictly as clinical adjuncts and not specifically as diagnostic devices. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of more open access to health services by Thailand's universal health coverage (UHC) on diagnostic delay of oral squamous cell carcinomas (OSCC) by comparing results with our previous study prior to the UHC. Reasons for delay in attending healthcare professional (HCP) consultation were also investigated. Methods: A structure questionnaire was employed to interview 154 OSCC consecutive patients. Variables were included for Cox proportional regression models to conclude the hazard ratio of each delay. Results: Regarding patient delay, those who had more than 12‐year education showed less delay (HR 0.46, 95% CI: 0.21–1.01) while longer delay was found in farmers (HR 1.49, 95% CI: 1.05–2.11). Compared with the previous study, there was no association between herbal medication and patient delay, herbal medication and total delay, nor religion and total delay. Professional delay showed no association with any variable. Only half of the patients received initial proper HCP management in both studies. Patient delay was mostly (89.9%) due to unawareness of the lesion severity. Conclusions: Open access to the healthcare system had an influence on diagnostic delay. Public education and precise clinical acumen by HCPs in OSCC diagnosis are needed for early detection. [ABSTRACT FROM AUTHOR]