Oral epithelial dysplasia (OED) in oral potentially malignant disorders (OPMDs) increases the risk of malignant transformation. However, the management of OED is not well defined. Photodynamic therapy (PDT) is a hypotoxic, highly selective and minimally-invasive operation which reduces morbidity and disfigurement greatly. Additionally, laser ablation guaranteed a better penetration for topical application of 5-aminolaevulinic acid (ALA)-PDT. Herein, we present a case of a large lesion of oral leukoplakia (OLK) in left tongue dorsum and lateral margin, pathologically manifested as severe epithelial dysplasia (SED). We firstly discussed the feasibility of Er: YAG laser assisted PDT for the treatment of SED in OPMDs. The patient achieved complete remission at 1 year follow-up. Downregulated number of p53 and Ki67 positive cells were observed in the tissues after Er: YAG laser assisted PDT. In addition, increased CD8+ positive cells infiltrated around the tissues and increased natural killer (NK) cells level were detected in the peripheral blood. In summary, Erbium:yttrium-aluminum-garnet (Er:YAG) laser assisted PDT is an effective and promising treatment for the management of SED in OPMDs with innate and adaptive immune responses.
Keywords: Immune repsonse; Laser assisted; NK cells; Oral epithelium dysplasia; Oral potentially malignant disorders; Photobiomodulation therapy; Photodynamic therapy.
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