摘要
着重观察研究造釉细胞瘤独特的浸润方式、浸润程度及不同组织学类型等的临床意义。方法：用ＷＨＯ（１９９２）牙源性肿瘤的组织学分型标准对５２例造釉细胞瘤重新分型、光镜下观察其浸润方式特点及程度，针对临床、发展、预后进行分析讨论。结果：见４０例（占７７％）分化良好的肿瘤细胞形成小的滤泡或上皮小岛，向肿瘤周围浸润或沿哈弗氏管蔓延，状似“生芽”，“生枝”或“生根”，此种浸润方式与恶性肿瘤的毁坏性或破坏性浸润截然不同，其周围组织不被摧毁，亦没有反应。本组有复发史的２０例病例全部见到“生芽”现象，有浸润的病例复发率为５０％（２０／４０）；未见浸润的１２例无１例复发（０／１２）；附壁性浸润（上皮岛侵入肿瘤周围纤维壁内）的２１例中５例复发，占２３．８％；侵至软组织、横纹肌或口腔粘膜下的１６例中１２例复发，占７５％；沿哈弗氏管浸润的３例全部复发，全组无１例证实有转移。结论：生芽性浸润与肿瘤及复有关，但不代表恶性；滤泡型、棘皮瘤型、基底细肥型及角化型更易浸润，易复发；姑息性手术在浸润的病例轻易复发；肿瘤细胞明显异型时浸润性强，有可能转移，应考虑恶性造釉细胞瘤。
Objective: To study the clinical significance of infiltrative mode, degree and variant histo-logical types of ameloblastoma. MethOds: Fifty - two case of ameloblastoma of jaw were reclassified accord-ing to the WHO Odontogenic Tumor Histological Classification (1992) and the infiltration features, degreeof the tumor were observed microscopically, and the clinical progression and prognosis were studied. Re-sults: 40 cases(77% ) had small follicles or islands of odontogenic epithelia formation from some well -differentiated tumor cells, and it infiltrated peripherally or along with the Haversian'stubes as 'Budding''Branching' or 'Rooting'. The invasive pattern was entirely different from the distroied infiltration of malig-nant tumors. All of 20 cases with recurrence had budding phenomenon, the recurrent rate with infiltrationwas 50% (20/40) , but no recurrence was observed in 12 cases without infiltration (0/ 12) . Five of 21patients with small islands infiltrating into the fibrotic wall of tumor recurred (23. 8% ) . Twelve of 16 cas-es with infiltration of soft tissue, muscle or oral mucosa recurred (75% ). All of 3 cases with infiltra-tion along the Haversian's tube recurred. None of this series had metastasis. Conclusion: Buddinginfiltration closely relates to the recurrence of tumor, but not malignant. The follicular, keratinized,basal cell subtypes and scanthoma of ameloblastomas, and the patients treated palliatively are easier to infil-trate and recur. The prominent heteromorphic tumor cells have strong infiltrative.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
1999年第3期207-210,共4页
Chinese Journal of Clinical Oncology
