口腔颌面部恶性肿瘤的淋巴结转移

颈淋巴清扫术是治疗口腔颌面部恶性肿瘤的重要手段。但是,由于口腔颌面部恶性肿瘤的颈淋巴结转移的早期诊断问题目前仍未解决,以至选择性淋巴清扫术的误选率仍较高。因此,努力提高诊断颈淋巴结转移的准确率仍然是摆在我们面前的重要课题。关于口腔磷癌淋巴结转移的预测问题,Shear于1976年就提出了“转移机率”预测法,并根据转移机率再决定是否应作预防性清扫术。本文就我科25年     

PET/CT在诊断口腔颌面部肿瘤颈淋巴结转移中的价值

目的:通过与MRI检查比较,评价PET/CT(integrated PET-CT system)在诊断口腔颌面部肿瘤颈部淋巴结转移中的临床价值.方法:前瞻性分析2008-2011年47例口腔颌面部肿瘤患者,于术前2周内分别进行PET/CT、MRI检查.分别获取PET/CT影像和MRI影像.以病理结果为金标准,分析2种方法判断颈部淋巴结转移的敏感度、特异度及准确率方面的差异.采用SPSS13.0软件包对数据进行x2检验.结果:PET/CT、MRI判定颈淋巴结转移的敏感度分别为89.5％和73.7％(P＜0.05);特异度分别为89.3％和78.6％(P＞0.05);准确率分别为89.4％和76.6％(P＜0.05).结论:PET/CT在口腔颌面部肿瘤颈部淋巴结转移判定中的敏感度及准确率均优于MRI,差异具有统计学意义;PET/CT在口腔颌面部肿瘤颈淋巴结转移判定中作为一种辅助诊断方法,具有重要的临床价值.     

老年人口腔鳞癌颈淋巴结转移CT诊断标准的病理学再评价

目的：虽然CT和MRI对口腔颌面部鳞癌颈淋巴结转移的诊断具有很大的帮助，但评价颈部淋巴结病变的方法仍有缺陷。本文对颈淋巴结转移的影像学诊断标准进行再评价。方法：运用显微病理方法检查了口腔颌面部鳞癌病人42例，颈淋巴结清扫术的1722个淋巴结的形态学特征。结果：37％恶性转移淋巴结的直径小于10mm，而淋巴结结外膨隆在很小的淋巴结也可发现。结论：目前，评价颈淋巴结状态的影像学标准主要建立在淋巴结的大小上，本文结果提示，现有的影像学诊断标准，对判断颈淋巴结转移存在局限性，本文旨在对改善口腔颌面部鳞癌颈淋巴结转移诊断的新方法进行讨论。     

口腔颌面部转移瘤

目的 总结口腔颌面部转移瘤的发病率及原发灶和转移灶情况。方法 回顾总结华西医科大学口腔颌面外科46年间收治的14例口腔颌面部转移瘤病例。结果 口腔颌面部转移瘤占所有该部恶性肿瘤（6813例）的2.05‰。转移灶多数位于颌面骨（9/14）。原发部位有肺、肝脏和上消化道、前列腺等，病理类型以上皮性肿瘤为主（12/14），尤以腺癌多见（7/12）。结论 口腔颌面部转移瘤的发病率和原发灶的构成与具高转移向恶性肿瘤的发病率和构成比有关。转移灶部位以颌骨多见。     

肝癌翼腭窝转移1例

大约50％～64％肝癌有肝外转移，但口腔颌面部转移少见，肝癌口腔颌面部转移常多见于下颌骨，翼腭窝转移极其少见。现将诊治的1例肝癌翼腭窝转移报告如下：     

31例上颈部淋巴结结核的临床分析

３１例上颈部淋巴结结核的临床分析张丽瑾，朱虹青指导王善昌口腔颌面部淋巴结结核多见于颈部淋巴结群及颌下淋巴结群，患者多无结核病史。我科从１９７５年～１９９１年期间共收治３１例，现就其临床特点、诊断、鉴别诊断和治疗等方面讨论如下。１临床资料１．１一般资料...     

老年人口腔颌面部肿瘤的临床分析

目的:分析老年颌面部肿瘤患者的临床资料, 为老年人口腔颌面部肿瘤的诊治提供借鉴.方法:对近10年来口腔颌面外科老年住院肿瘤患者1254例的诊治情况进行分析.结果:老年颌面部肿瘤患者中男∶女=1.55∶1,其中恶性肿瘤占59.81%,男∶女=1.65∶1;良性肿瘤男:女=1.29∶1.结论:老年人口腔颌面部肿瘤在发病情况及治疗方法的选择上有其特殊性.     

肺癌口腔颌面部转移的临床分析

目的：探讨肺癌在口腔颌面部转移的临床特点与鉴别。方法：对6例的临床资料进行肺癌口腔颌面部转移患者分析。结果：本组6例中5例首诊于口腔科门诊，转移部位以牙龈最多，病理类型以未分化癌最多，3例同时伴有其它部位和脏器的转移，获得随访的5例中有4例于2-3个月后死亡。结论：肺癌转移至口腔颌面部的表现形式复杂，预后差，早期发现对治疗和预后有重要意义。     

口腔颌面部肿瘤

吉西他滨对舌鳞癌细胞增殖和端粒酶活性的影响；口腔鳞状细胞癌ERK蛋白表达与临床分期、淋巴结转移的关系；口腔癌前病变细胞凋亡的原位观察与分析；^90锶、^90镱敷贴治疗颌面部血管瘤及脉管畸形疗效观察；平阳霉素白蛋白微球的制备及其体外释药的实验研究；……[编者按]     

口腔颌面部鳞癌组织中p16基因变异的初步研究

目的 检测口腔颌面部鳞癌中p16基因的缺失和突变，以了解p16基因在口腔颌面部恶性肿瘤发生发展过程中的作用。方法 应用聚合酶链反应－单链构象多态性分析（PCR－SSCP）技术，检测33例原发性口腔颌面部鳞癌的石蜡标本，将p16基因的变异频率与口腔颌面部鳞癌的临床分期，组织学分级及淋巴结转移进行统计学分析。结果 p16基因的缺失率为21％，点突变率为6％，变异频率为27％。临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期每两期之间无显著性差异（P＞0．05）；而临床Ⅰ、Ⅱ期和Ⅲ、Ⅳ期之间有显著性差异（P＜0．05）。组织学分级和有，无淋巴结转移之间p16基因变异无显著性差异（P＞0．05）。结论 p16基因的缺失和突变是口腔颌面部鳞癌中常见的分子事件，它的失活在口腔颌面部鳞癌的发生发展中起着重要作用，说明其变异与肿瘤的临床分期密切相关，随着肿瘤临床进程的发展，其变异频率增高。研究未发现其变异与肿瘤组织学分级和淋巴结转移之间存在相关关系。     

Mood and malignancy: head and neck cancer and depression

Head and neck cancer patients have been reported to show high rates of depression. However, it is important to differentiate between depressive symptoms and a depressive disorder. This review critically examines the relationship between head and neck cancer and depression. There appears to be little evidence for depression leading to an increased risk of developing cancer and although depressive symptoms in head and neck cancer patients are common, very few studies have investigated depressive disorders. The studies that investigated the incidence of a comorbid depressive disorder report a prevalence very close to that of the general population, implying that major depression is not a normal response to cancer. Finally, the evidence suggests that comorbidity of depression with cancer has a negative impact on morbidity and mortality. Both psychosocial and biological factors could account for this. Dysregulation of the stress hormone axis and increased inflammation are common in depressive disorders and have been suggested as underlying pathological mechanisms and are both markers of poor prognosis in cancer. This evidence suggests that a relatively small number of patients develop a depressive disorder following a diagnosis of cancer, but for those that do it may have a substantial impact on their prognosis.     

低氧和自噬与肿瘤的发生发展

自噬作为真核生物的一种应激调控机制,既可以促进肿瘤的发生发展,又可以抑制肿瘤的增殖。在肿瘤局部低氧的微环境下,低氧诱导因子-1α、哺乳动物雷帕霉素靶蛋白信号转导通路抑制、内质网应激均可促进自噬的发生。在肿瘤快速地发生发展过程中,肿瘤的糖代谢功能增强、活性氧族增多、窖蛋白1下调以及上皮间质转化的激活均诱导了自噬的发生并促进肿瘤的局部浸润、侵袭转移和耐药,因此,抑制自噬可能为肿瘤治疗提供一种新的策略。     

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--education and experience

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.     

Open bite and and therapeutic strategy

Anterior open bites can be divided into two categories: skeletal and dento-alveolar. The etiology, basically affecting dento-alveolar structures, is functional or mechanical such as the rotation of the first higher molars, the exaggerated curve of Spee and the incisor supraclusion and the simple orthodontic treatment can bring a therapeutic success but functional rehabilitation remains the guaranty of such a stability of our treatment. The purpose of this work is to make a teaching article which puts the point on the interest of the elements of the diagnosis and the orthodontic treatment indicated in certain clinical situations of anterior open-bite; this by detailing biomechanics of correction of this anomaly requiring various therapeutic strategies. Functional rehabilitation remains always the guaranty of such a therapeutic stability. For the teaching aspect, we want to attach stereotypic forms and also to present clinical cases treated in the service of consultation and dental treatment in order to answer such a request.