Risco e prevalência de câncer oral em pacientes com diferentes tipos de lúpus eritematoso: uma revisão sistemática e metanálise
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2024-02-02
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Universidade Federal de Goiás
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Lupus erythematosus (LE) is an autoimmune disease that can manifest itself
systemically and/or cutaneous, with several clinical presentations, some of which are:
systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE). The
SLE and DLE forms are those that commonly present the highest risk of malignancy,
including oral cancer, thus justifying the review of this entity in the latest update of the
group potentially malignant oral disorders (DOPMs). More than 40% of patients with
SLE present oral manifestations, including: oral ulcers, lichenoid lesions, leukoplasia
lesions, plaques, petechiae, elevated keratotic plaques, purpura and erythematous
areas. The literature presents several controversies regarding the relationship
between LE and oral cancer, which is why several epidemiological studies have been
carried out. With the aim of evaluating the risk and prevalence of oral cancer in
patients with SLE or DLE, a systematic review of the literature with meta-analysis
was carried out. This review followed the recommendations of PRISMA (Preferred
Reporting Items for Systematic Review and Meta-analyses), initially, searches were
carried out in the following databases: PubMed, Scopus, EMBASE, LILACS, Web of
Science, Scopus and Livivo and, Google Scholar and ProQuest, without restrictions
on language or publication date. The reading of the studies was conducted in two
phases, independently, in which three reviewers, first, evaluated the titles and
abstracts of 3580 studies and, subsequently, carried out the complete reading of 28
works to include the studies according to the criteria pre-defined eligibility criteria. At
the end of phases one and two, eight studies were included for data extraction and
qualitative analysis, two of which were cross-sectional studies and six were cohorts.
The risk of bias was carried out using the JBI critical assessment tool (Joanna Briggs
Institute) for analytical cross-sectional studies and cohort studies. The analytical
cross-sectional studies were analyzed separately from the cohorts, and,
coincidentally, participants in the cross-sectional studies had DLE, and those in the
SLE cohorts. Through quantitative data analysis, the pooled prevalence of oral
cancer in patients with DLE was 10% (95% CI; 0.03-0.13; I 2 = 59%; p = 0.12). The
pooled risk indicated a significantly increased risk of oral cancer in patients with SLE
(RR = 2.69; 95% CI, 1.75-4.16; I 2 = 0%; P = 0.78) compared to general population.
The present review shows that patients with SLE/DLE have an increased risk of
developing oral cancer, and that the oral manifestations of these entities are
multiform. Individuals with SLE/DLE should be closely monitored to monitor the oral
manifestations of SLE/DLE, and for early detection and treatment of oral cancer
when appropriate.
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RODRIGUES, L. R. S. Risco e prevalência de câncer oral em pacientes com diferentes tipos de lúpus eritematoso: uma revisão sistemática e metanálise. 2024. 87 f. Dissertação (Mestrado em Odontologia) - Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia, 2024.