Cytologic and DNA-cytometric follow-up of oral leukoplakia after CO2- and Er:YAG-laser assisted ablation: a pilot study.
OBJECTIVE
The aim of the present pilot study was to determine therapeutic responses to Er:YAG- and CO(2)-laser ablation in patients with oral leukoplakia as evaluated by means of exfoliative cytology (EC) and DNA-image-cytometry (DNA-I).


METHODS
Ten patients exhibiting a total of 16 lesions affecting a variety of intraoral sites were randomly treated with either (1) an Er:YAG laser (300 mJ/pulse, 10 Hz, defocused mode) (ERL), or (2) an CO(2) laser (4-6 W, 20-50 Hz, focused mode) (CO). Brush (B) and incisional (I) biopsies were obtained from the respective lesions immediately before treatment (B, I) as well as 24-96 weeks postoperatively (B). In cases, in which EC revealed suspicious cells, nuclear DNA-contents were measured using a TV image analysis system.


RESULTS
Both treatment approaches resulted in a complete (C) or partial (P) remission of all investigated lesions. In particular, ERL exhibited C(3), P(5), and CO C(5), P(3). However, in the CO group, two of eight lesions showed a recurrence 32-48 weeks following treatment. Among all investigated lesions, both histological and EC/DNA-I diagnosis revealed no sign of malignancy or dysplasia before or following laser assisted ablation.


CONCLUSIONS
Within the limits of the present study, it may be concluded that both treatment approaches seem to have limitations to achieve predictable eradication of oral leukoplakia.
Schwarz
Frank
F
Department of Oral Surgery, Heinrich Heine University, Westdeutsche Kieferklinik, R-40225 Düsseldorf, Germany. info@frank-schwartz.de
Maraki
Dimitra
D
Yalcinkaya
Sebnem
S
Bieling
Katrin
K
Böcking
Alfred
A
Becker
Jürgen
J
D000328:Adult; D000368:Aged; D003584:Cytological Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D019044:Image Cytometry / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D007972:Leukoplakia, Oral / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome