颌骨造釉细胞瘤的浸润方式及其意义

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。     

刮除联合冷冻治疗颌骨造釉细胞瘤20例报告

目的 探索刮除术联合液氮冷冻治疗颌骨造釉细胞瘤的临床疗效。方法 20例颌骨造釉细胞瘤患，手术刮除肿瘤后，用液氮冷冻肿瘤除后的骨壁。结果 20例颌骨造釉细胞瘤患经术后2月—6年随访观察，未见复发。结论 刮除术联合液氮冷冻治疗颌骨造釉细胞瘤为一种可选择的治疗方法。     

造釉细胞瘤复发13例

 目的 分析造釉细胞瘤复发的原因及其相关因素。方法 对1990年4月至2004年4月收治的71例造釉细胞瘤患者进行回顾性分析。结果 71例中13例复发，复发率18.31 %。术前误诊为颌骨囊肿、保守治疗、X线摄片表现为单房是与造釉细胞瘤的复发有密切关系的因素。结论 术前明确临床分类及病理分型，采用根治性手术治疗是预防复发的关键。     

胫骨造釉细胞瘤1例报告

患女,14岁,哈尼族,因左下肢胫骨肿块切除术后复发入院.患者于1996年7月无明显诱因感左下肢疼痛,活动后加重,1997年11月到当地地区医院就诊,行左胫骨下段肿块切除术,曾诊断为“骨肉瘤”,1998年7月原手术部位再次发生包块,遂来我院就诊.查体:左小腿下部皮下胫骨表面粗糙,凹凸不平,有一个1cm×2cm骨性隆起,压痛明显,表皮温度不高,无静脉曲张.左踝关节活动自如,行走步态正常.实验室检查:血常规、肝肾功能及电解质正常,血沉21mm/h、ALP140u/L、LDH105U/L.左小腿X线片示胫骨下段骨干增粗变形,其间见多个大小不等的囊性溶骨性破坏区,骨皮质膨胀变薄,边缘锐利清楚,无骨膜及应,其周围未见软组织肿块影(见图1).病理诊断为左胫骨下一步段造釉细胞瘤.手术切除胫骨瘤段9.5cm,取对侧骸骨10cm、腓骨14cm,行自体骨游离移植,以螺钉、钢丝内固定.术中切除标本病检结论仍为造釉细胞瘤(见图2).术口拆线后左下肢管形石膏固定后出院.术后3个月复查X线片示:移植骨已有中量骨痴生长,内固定牢固(见图3).     

肋骨造釉细胞瘤1例报道及文献复习

0引言长骨造釉细胞瘤是一类临床罕见、生成缓慢、低度恶性的骨肿瘤。由于其发病率极低,缺乏认识,往往会导致误诊,不能予以彻底地手术和正确的治疗。现将我院收治的1例原发性肋骨造釉细胞瘤的资料报道如下。     

颌骨造釉细胞瘤各种亚型的CT诊断

背景与目的:颌骨造釉细胞瘤根据生物学行为和组织病理学特点可分为多个亚型,其预后各不相同。本研究探讨实性或多囊型造釉细胞瘤(solidormulticysticameloblastoma,SMA)、单囊型造釉细胞瘤(unicysticameloblastoma,UA)和恶性造釉细胞瘤(malignantameloblastoma,MA)的临床和CT影像特点,以提高CT诊断的准确性。方法:收集经病理证实的SMA14例、UA6例和MA5例,对各种亚型的临床和CT表现进行回顾性分析。结果:SMA、UA和MA患者首次就诊时的中位年龄分别为33.5岁、20.5岁和56岁,在CT上的横断面最大径平均值分别为33mm,46mm和59mm。SMA病变中11例(79%)平扫时与肌肉相比呈等低混杂密度,3例(21%)呈较均匀等密度,12例(86%)边缘呈分叶状,13例(93%)骨壳被穿破,6例(43%)形成软组织肿块,但病灶的边界都清楚,10例(71%)见不全骨性分隔,9例(64%)邻近牙根被吸收,11例行增强扫描的病例中9例(82%)呈显著强化。UA病变平扫时与肌肉相比内部都呈均匀低密度,其中4例(67%)呈较规整的圆形或椭圆形,2例(33%)呈分叶状,3例(50%)局部骨皮质有缺损,但未见软组织肿块形成,1例(17%)见不全骨性分隔,2例(33%)邻近牙根有吸收,行增强扫描的3例囊壁均呈轻中度的强化。5例MA的病灶都呈分叶状,且骨皮质均被穿破并有软组织肿块形成,边界不清,其中3例(60%)平扫时与肌肉相比呈等低混杂密度,2例(40%)呈较均匀等密度,3例(60%)可见不全的骨性分隔,3例(60%)见牙根的吸收或破坏,行增强扫描的3例都呈明显强化。结论:SMA多见于中年人,在CT上多表现为强化明显的囊实性肿块,边界清楚;UA常见于年轻人,在CT上表现为囊性肿物,囊壁轻中度强化;MA多见于老年患者,在CT上常显示广泛骨破坏,软组织肿块常见,强化明显,边界不清。综合分析CT征象和临床表现有助于对造釉细胞瘤的上述亚型进行鉴别。     

长骨造釉细胞瘤的手术治疗及预后16例分析

目的分析长骨造釉细胞瘤的手术治疗效果及预后。方法回顾分析我科1999年11月至2014年3月,收治的随访5年以上的长骨造釉细胞瘤患者,分析其手术治疗方法及预后。结果 16例入选,男9例,女7例,年龄14~42岁,中位年龄21.5岁。病理诊断11例为经典型造釉细胞瘤,5例诊断为骨性纤维结构不良(osteofibrous dysplasia,OFD)样造釉细胞瘤。经典型造釉细胞瘤中9例行瘤段切除术,1例行皮质切除术,1例因术前穿刺为OFD而行刮除术。OFD样造釉细胞瘤中3例行瘤段截除术,2例行刮除术。术后随访65~184个月,中位随访109个月。局部复发4例,总复发率为25%(4/16),其中经典型造釉细胞瘤复发3例,复发率为27.3%(3/11),OFD样造釉细胞瘤复发1例,复发率为20%(1/5)。发生肺转移2例,总转移率为12.5%(2/16),均为经典型造釉细胞瘤。2例经典型造釉细胞瘤死于肺转移,OFD样造釉细胞瘤均存活,11例经典型造釉细胞瘤的5年生存率为100%,10年生存率为88.9%,15年生存率为71.1%。结论长骨造釉细胞瘤是一种罕见的原发骨肿瘤,须长期随访,经典型造釉细胞瘤表现出低度恶性特征,需要手术广泛切除,OFD样造釉细胞瘤表现出中间性肿瘤的特点,扩大刮除能得到很好的局部控制。     

左颊部恶性造釉细胞瘤一例

患者男 ,5 9岁。因右髋关节疼痛 2月余 ,于 2 0 0 1年 2月入院。患者于 1998年 10月因左颊瘘 2年余在外院行左颊瘘及部分坏死腮腺组织切除、皮瓣填塞术 ,病理诊断 :左颊部鳞癌。入院查体 :左颊部有一长约 5ｃｍ的手术疤痕。右髋关节无红、热、肿胀 ,腹股沟韧带中点内下方压痛 ,伸、屈功能正常。“4”字试验 ( ) ,轴向叩痛 ( ) ,Ｔｈｏｍａｓ征 (- )。实验室检查 :血沉 75ｍｍ/ｈ ,碱性磷酸酶 414Ｕ/Ｌ。Ｘ线片示 :右髋臼、股骨颈、股骨大粗隆及双侧耻骨见斑片状溶骨性破坏。ＥＣＴ全身骨显像示 :右枕骨、左肩峰、左肩胛骨下角、第 9～ 11胸…     

下颌骨截骨煮沸处理后再植治疗造釉细胞瘤

我科自1986年12月至1988年12月,对5例下颌骨造釉细胞瘤截骨后,用下颌骨截骨煮沸处理后再植法植骨,取得初步效果,现报道如下: 临床资料 性别与年龄:男4例,女1例。年龄最小18岁,最大38岁。 病变部位:右侧3例,左侧1例。其中1例肿瘤侵犯前联合(7+2)。位于前联合者1例(3+4)。     

造釉细胞牙瘤2例

造釉细胞牙瘤２例翟琼莉，韩振丰，战忠利，张连郁河北省保定市第三医院病理科（保定市０７１０００）造釉细胞牙瘤是一种以具有造釉细胞瘤和牙瘤的成分为特征的混合性牙源性肿瘤，临床上易误诊为恶性，国内鲜有报道，再报告２例。例１，男，６４岁。患者于２年前发现左牙...     

Huge Ameloblastoma of the Jaw (Report of three cases)

Three cases of ameloblastoma of the jaw of unusually large size are reported. Two of them were in adult Africans and one in a 10 year-old Indonesian boy.     

A 40-year Retrospective Clinicopathological Study of Ameloblastoma in Iran

Ameloblastoma is the most common epithelial odontogenic tumor. It may show locally invasive behavior resulting in recurrence and malignancy. Therefore, appropriate diagnosis of this tumor is necessary. The aim of this study was to evaluate clinicopathological characteristics of ameloblastomas in an Iranian population. We present a 40-year retrospective study of patients diagnosed from 1971 to 2010 in the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mashhad, Iran. Information gathered from patient records included age, gender, tumor location and histologic type. The frequency of odontogenic tumors among all lesions was 2.08% and ameloblastoma with 88 samples demonstrated the greatest prevalence (41.5%). Regarding gender, 60% of samples occurred in males. The mean age of studied patients was 33.02± 15.74 years with a peak of occurrence in the third decade of life. The most frequent location of tumor was the mandibles (93.2%). Eighty five (96.6%) tumors were recorded as benign and 3 (3.4%) as malignant. Of benign tumors, 62 (72.9%), 20 (23.5%) and 3 (3.6%) cases were of conventional, unicyctic and peripheral types, respectively. In contrast to most previous studies, the most common histologic subtype in the present study was plexiform. Knowledge of the incidence of ameloblastoma and its clinicopathologic features including most common location, gender and age distribution in different ethnogeographic backgrounds is necessary for accurate diagnosis and proper treatment.     

Parenchymal Mass Loss During Partial Nephrectomy: Role of Devascularized Parenchymal Mass and Excised Parenchymal Mass and Impact on Functional Preservation

This study included 93 patients with renal masses who underwent standard partial nephrectomy or tumor enucleation. After surgery, parenchymal mass loss caused by devascularization resulted in more damage to renal function than excised parenchymal mass loss. Surgeons should seek better techniques to decrease devascularization during reconstruction.IntroductionTo evaluate the importance of devascularized parenchymal mass(DPM) and excised parenchymal mass(EPM) in functional preservation after standard partial nephrectomy(SPN).Patients and MethodsForty-one patients who underwent pure tumor enucleation(TE) and 52 patients who underwent SPN with necessary data were included. As no EPM was lost in TE, the TE samples were used to estimate the degree of volume shrinkage that occurred when the measurements were performed in vivo with blood flow versus ex vivo without, and the shrinkage ratio was calculated as specimen volume divided by tumor volume in vivo. In SPN, the specimen volume comprised tumor volume plus EPM. The EPM was calculated as specimen volume divided by shrinkage ratio minus tumor volume in vivo. The DPM was defined as total ipsilateral parenchymal mass loss minus EPM. T tests, χ² test, and Mann–Whitney U tests were employed to compare clinical characteristics. Multivariate analysis was used to identify variables that correlated with glomerular filtration rate(GFR) preservation.ResultsThe mean sizes of devascularized and excised parenchymal masses were 13.6 cm³ and 5.2 cm³ (P = .01), which accounted for 7.8% and 3.4% of preoperative ipsilateral parenchymal mass (P = .03) in SPN, respectively. The shrinkage ratio was 0.71 and correlation coefficient was 0.965. After stepwise regression, DPM, and preoperative GFR were significantly associated with global GFR preservation.ConclusionThe DPM comprises most of parenchymal mass loss after SPN and plays a more important role than EPM on functional outcomes. Surgeons should pay more attention to reducing devascularization during partial nephrectomy.     

Prevalence and Epidemiological Profile of Ameloblastoma in India: A Systematic Review and Meta-Analyses

Introduction: Ameloblastoma is regarded as the second most prevalent odontogenic tumor in the light of its prevalence, clinical characteristics, greater incidence of tumor recurrence, and therapeutic challenges. The aim of this systematic review was to establish the prevalence of ameloblastoma in the Indian subcontinent and to establish a national epidemiologic profile for these lesions. Material and Methods: A systematic review was undertaken based on the PRISMA guidelines in search of epidemiologic studies concerning odontogenic tumors and ameloblastoma that are listed by PubMed, EBSCO, and Google Scholar embracing the period from January 2010 to December 2021, to evaluate the prevalence rate in India. A total of 277 publications were retrieved, of which 27 articles were selected, based on the World Health Organization classification of odontogenic tumors. Results: The affected individuals were on average in the third decade of life, with a higher male predominance. The majority of the tumors were multilocular radiolucencies in the posterior mandible, with follicular and plexiform histopathological features. The most common type of malignant lesion is ameloblastic carcinoma. Over 60% of follicular ameloblastoma recurred more frequently than the other types of ameloblastoma. The random effect model shows overall point estimate of 4.83 with 95% confidence interval (4.44 -5.26). Conclusion: The systematic study indicates a slight male predisposition to ameloblastoma, with a peak incidence in the third decade of life and the mandible as the preferred anatomical site. The solid/multicystic ameloblastoma is the most prevalent histopathologic pattern. More epidemiological research on the prevalence rate of ameloblastoma is required, particularly in India, in an effort to accurately determine the national epidemiological profile of ameloblastoma.     

原发性食管腺癌64例分析

自1995年3月～2000年2月，我院经手术及病理证实的原发性食管癌2436例，其中腺癌64例，占同期食管癌手术的2.62%，现报告如下。临床资料本组中男性49例，女性15例，男、女之比3.27∶1；年龄28岁～72岁，平均53.1岁。胸上段4例，胸中段36例，胸下段24例。术前均经食管钡透，内窥镜活检。本组行全段食管切除、颈部吻合37例，其中右胸三切口4例；主动脉弓上吻合17例；弓下吻合6例；切除率93.75%。其中根治性切除48例。术前顺铂(DDP)、5氟尿嘧啶(5鄄Fu)、平阳霉素(PYM)介入化疗1次9例。TNM分期：Ⅰ期1例，ⅡA期26例，ⅡB期14例，Ⅲ期23例。…     

成釉细胞瘤侵袭性与细胞外基质金属蛋白酶诱导因子及微血管密度的关系

背景与目的:过去的研究表明,基质金属蛋白酶MMPs与成釉细胞瘤的局部侵袭性有关,本研究通过检测和比较成釉细胞瘤与牙源性颌骨囊肿组织中的细胞外基质金属蛋白酶诱导因子(extracellular matrix metalloproteinase inducer,EMMPRIN)的表达和微血管分布情况,探讨EMMPRIN对成釉细胞瘤进展过程中血管形成的影响.方法:使用EMMPRIN多克隆抗体和CD34单克隆抗体,用SP法对41例成釉细胞瘤和40例牙源性颌骨囊肿组织进行免疫组化检测.用Weider法对CD34染色阳性的细胞簇(微血管)密度计数.结果:成釉细胞瘤和牙源性颌骨囊肿组织中EMMPRIN均为阳性表达,主要表达于基底膜附近的上皮细胞中,成釉细胞瘤EMMPRIN的强阳性表达率(85.4%)高于牙源性颌骨囊肿组织(62.5%);EMMPRIN在成釉细胞瘤的阳性表达程度与微血管密度有一定的相关性(r=0.677P<0.01).结论:EMMPRIN可能通过调控细胞外基质中的基质金属蛋白酶和微血管形成,对成釉细胞瘤进展过程产生作用.     

颌骨中心性粘液表皮样癌：附6例报告

本文报告6例少见的颌骨中心性粘液表皮样癌,上颌骨1例,下颌骨5例,其中4例发生在下颌骨角部及升支。病理为高分化型4例,低分化型2例,在死亡3例中,2例为低分化型。本病因临床及X线表现无特异性,故易误诊。应根据病理分型决定手术范围,对Ⅲ、Ⅳ期患者术后应予放疗,以防止复发。     

直肠癌前切除术中直肠冲洗64例分析

[目的]探讨直肠癌前切除术中直肠癌细胞脱落的情况和直肠冲洗的有效方法。[方法]对64例直肠癌前切除患者术中应用生理盐水经肛门反复多次冲洗直肠，冲洗总量为1500ml。按照次序将冲洗液分装3瓶，对冲洗液进行细胞学检查，并分析细胞学结果与肿瘤临床病理特征的关系。[结果]64例患者中52例第一瓶冲洗液中有癌细胞，占81.3％；14例第二瓶仍有癌细胞，占21．9％；第三瓶没有找到癌细胞。冲洗液中脱落癌细胞检出与肿瘤大小有显著相关性（P〈0．05）。[结论]直肠癌前切除术中肠腔内脱落癌细胞阳性率较高，应常规行直肠冲洗，冲洗液的总量应大于1000ml。