牙源性粘液瘤的临床、X线和病理学研究  

AND PATHOLOGICAL STUDY

作　　者：田卫东[1] 王虎[1] 陈列[1] 陈伟辉[1] 

机构地区：[1]华西医科大学口腔医学院

出　　处：《口腔颌面外科杂志》1999年第2期127-132,共6页Journal of Oral and Maxillofacial Surgery

摘　　要：研究目的：对４１例牙源性粘液瘤（ＯＭ）的临床资料、Ｘ线表现和病理特征进行研究分析，并提出ＯＭ的Ｘ线特征分型，以期为临床提供帮助。研究方法：对１９６４－１９９８年间４１例经病理确诊的ＯＭ的临床表现、影像学特征、组织病理改变和治疗情况进行分析总结。结果：男性较女性多见（６０．９８％），好发年龄１２－４０岁，发病部位以下颌骨较多见（５８．５４％），上颌骨多累及上颌窦（５８．８３％），患者多以无痛性包块就诊（８２．９５％）。ＯＭ的Ｘ线表现较复杂，下颌骨可表现为“火焰状”、牙槽突型、单囊型和骨质破坏型等改变，发生于上颌骨的ＯＭ由于上颌窦的存在，表现非常复杂。病理学研究发现，肿瘤组织中星形和梭形细胞散布于粘液样基质中，首次发现存在类“浆细胞”，部分肿瘤组织发现上皮条索。结论：在临床治疗中，应将ＯＭ视为低度恶性的临界瘤，彻底切除肿瘤的同时，应注意形态与功能兼顾的原则，并尽可能保留下牙槽神经，以提高患者的生活质量。Objective This study evaluated the clinical data, radiological and pathological features of 41 odontogenic myxomas (OM) and defined the types of radiological presentation of the OM. Method 41 cases between 1964 and 1998 with the diagnosed pathologically as OM were analysed in terms of clinic data, radiographic images, histopathology and treatment. Results The mean age of the patients varied from 12 to 40 years, with a distinct predominance in males (60.98%) and a predilection for the mandibel (58.54%). The maxillary antrums were of ten involved (58.83%).The usual clinical presentation was a painless swelling. Few cases also visited the doctors by toothache, gingival fistula, unhealing of the toothextract wound and nosebleed. OM showed variable radiographic features. In the mandible, the lesions have four different pictures, including flame shape type unicystic type and osteolytic type. In the maxilla, where the tumor can spread to the maxillary antrum, it produces more complex presentation. Microscopic examination showed that stetellate and spindle cells were suspended on an abundant mucoid background. The plasmacytoid cells have been found for the first time. Two cases contained the odontogenic epithelial strands. Conclusion In clinical, OM should be treated as a lowgrade malignant border line tumor. In addition to the completely removal of the tumor, both outlook and function must be considered at the same time, besides the preserve of the inferior alveolar nerve. So the livingquality of the patient will be improved.

关 键 词：牙源性粘液瘤 诊断 治疗 病理学 

分 类 号：R739.82[医药卫生—肿瘤]