摘要
目的探讨造釉细胞瘤的不同组织学类型及表现，以及不同浸润程度，不同手术方式与复发的关系。方法按１９９２年ＷＨＯ有关牙源性肿瘤的组织学分型标准，对５２例造釉细胞瘤重新分类，并对其临床及病理表现进行回顾性研究。结果分滤泡型，丛状型，棘皮瘤样型，基底细胞型，颗粒细胞型，促结缔组织增生型，角化型，有骨形成型８种组织学类型。手术后复发数依次为５／１１例，０／５例，７／１５例，５／８例，０／３例，０／３例，２／３例，１／４例。肿瘤侵犯周围纤维壁的２１例中５例复发，浸润达纤维壁外软组织的１６例中１２例复发，行肿瘤摘除术或颌骨部分截除术后的复发率分别为５６５％（１３／２３例），２４１％（７／２９例）。３例肿瘤分化差细胞有异型，手术后均多次复发。结论滤泡型、棘皮瘤型、基底细胞型及角化型易复发；浸润软组织时易复发；行肿瘤摘除或剥除手术较颌骨部分截除手术复发率高；细胞异型时尤易复发。
Objective To observe the relationship between the histologic types, tumor invasion, operation mode and recurrence of ameloblastoma. Methods Using WHO classification (1992) for histological typing of odontogenic tumors, 52 cases of ameloblastoma were studied clinicopathologically. Results The 8 pathological types are: follicle formation type, plexiform type, acanthoma type, basal cell type, granular cell type, desmoplastic ameloblastoma, keratoameloblastoma and ameloblastoma accompanied by bone formation. Recurrence in the 8 above types following surgery were 5/11, 0/5, 7/15, 5/8, 0/3, 0/3, 2/3 and 1/4 respectively. Five cases recurred in 21 patients with tumor cells infiltrating into the connective tissue surrounding the tumors. 12 cases recurred in 16 patients with tumor cells infiltrating thru the capsule into surrounding soft tissue. The recurrence rate in patients who had their tumor enucleated or curetted was 56.5% (13/23). The recurrence rate in the tumors resected together with involved bone segment was 24.1% (7/29). Multiple recurrences occurred in 3 cases whose tumors were not well differenciated and had atypical cells. Conclusions Recurrence was more often seen in the follicular, acanthoma, basaloid, and keratoid types of ameloblastoma. When these tumors invade adjacent soft tissues, the recurrence rate is also higher. Recurrence is linked to conservative surgery and to tumors with low differentiation.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
1999年第2期109-111,共3页
Chinese Journal of Pathology
