不同因素对成釉细胞瘤治疗预后的影响  

Effect of different factors on prognosis of ameloblastoma

作　　者：王攀攀 魏凯通 马雅晴 赵军方[1] 孙明磊[1] 孙强[1] Wang Panpan;Wei Kaitong;Ma Yaqing;Zhao Junfang;Sun Minglei;Sun Qiang(Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,郑州450052

出　　处：《中华实验外科杂志》2023年第10期2065-2068,共4页Chinese Journal of Experimental Surgery

基　　金：河南省自然科学基金面上项目(212300410391);河南省医学适宜技术推广项目(SYJS2022113);河南省科技厅重点研发与推广专项(科技攻关)项目(212102310592);河南省医学科技攻关计划联合共建项目(LHGJ20200270);河南省医学科技攻关(省部共建重点)项目(SBGJ202002071);河南省中青年卫生健康科技创新人才(杰青)项目(YXKC2020030)。

摘　　要：目的探讨不同因素对成釉细胞瘤治疗效果的影响。方法分析郑州大学第一附属医院2012年至2019年口腔颌面外科收治的288例成釉细胞瘤病历资料,对其发病年龄、部位、组织结构、手术方式以及复发情况,采用卡方检验对研究数据进行统计学分析。对31例成釉细胞瘤组织标本进行聚合酶链反应(PCR)及鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)基因测序并用卡方检验及Fisher精确检验进行统计学分析。结果在手术治疗的288例成釉细胞瘤病例中,58例开窗减压后刮治(磨除骨壁),复发36例(62.1%),71例采用刮治术(术中磨除骨壁),复发29例(40.8%),101例采取单纯摘除术,复发84例(83.2%),58例截骨术,复发10例(17.2%)。在31例成釉细胞瘤样本中检测BRAF-V600E突变率64.5%,其中性别、年龄、部位和肿瘤结构分别经组内卡方检验比较,与BRAF-V600E的阳性率差异无统计学意义(P>0.05),BRAF-V600E的阳性率与成釉细胞瘤复发呈正相关(χ^(2)=8.952,P<0.01),且经单侧Fisher精确检验,P<0.01,可认为复发病例的BRAF-V600E突变率高于无复发病例。结论不同手术方式对成釉细胞瘤疗效差异明显,BRAF-V600E突变与成釉细胞瘤的复发密切相关。Objective To investigate the effect of different factors on the therapeutic effect of ameloblastoma.Methods The medical records of 288 cases of ameloblastoma admitted to the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University from 2012 to 2019 were analyzed,and the age of onset,location,histological structure,surgical methods,and recurrence were statistically analyzed using the chi-square test.Polymerase chain reaction(PCR)and v-raf murine sarcoma viral oncogene homolog B1(BRAF)gene sequencing were performed in 31 ameloblastoma tissue samples and statistically analyzed with chi-square test and Fisher exact test.Results Among 288 cases of ameloblastoma treated surgically,58 cases were treated with curettage after fenestration decompression(abrasion of bone wall),36 cases(62.1%)recurred,71 cases were treated with curettage(abrasion of bone wall during operation),29 cases(40.8%)recurred,101 cases were treated with simple enucleation,84 cases(83.2%)recurred,58 cases were treated with osteotomy,and 10 cases(17.2%)recurred.The mutation rate of BRAF-V600E was detected in 64.5%of 31 ameloblastoma samples,in which gender,age,location,and tumor structure were compared by intraclass chi-square test,respectively,and there was no statistically significant difference with the positive rate of BRAF-V600E(P>0.05),and the positive rate of BRAF-V600E was positively correlated with ameloblastoma recurrence(χ^(2)=8.952,P<0.01),and by unilateral Fisher’s exact test,P<0.01,it could be considered that the mutation rate of BRAF-V600E was higher in recurrent cases than in non-recurrent cases.Conclusion Different surgical methods have significant differences in the curative effect of ameloblastoma,and BRAF-V600E mutation is closely related to the recurrence of ameloblastoma.

关 键 词：成釉细胞瘤 手术方式 鼠类肉瘤滤过性毒菌致癌同源体B1-V600E 复发 

分 类 号：R730.5[医药卫生—肿瘤]