成釉细胞瘤细胞计量病理学的研究

目的　用计量病理学方法探讨成釉细胞瘤上皮细胞的增殖特性。方法　利用多功能图像分析系统对 2 6例成釉细胞瘤的上皮细胞进行计量形态学和DNA含量分析 ,并用角化囊肿、根尖囊肿、含牙囊肿各 10例进行对比。结果　上皮细胞核DNA含量及形态参数比较显示 ;成釉细胞瘤明显大于含牙囊肿 (P <0 .0 5 ) ,与角化囊肿和根尖囊肿相近 ;滤泡型大于丛状型 (P <0 .0 5 ) ;外周细胞明显高于中央细胞 (P <0 .0 5 )。结论　成釉细胞瘤上皮细胞增殖活跃 ,其增殖特性符合临界性肿瘤的生物学特点     

牙源性角化囊肿细胞增殖抗原和表皮生长因子受体表达

目的　探讨牙源性角化囊肿衬里上皮细胞的增殖特点。方法　采用免疫组化染色方法 ,对牙源性角化囊肿、成釉细胞瘤、含牙囊肿、正常口腔粘膜上皮中细胞增殖抗原 Ki- 6 7和表皮生长因子受体 (EGFR)的表达进行分析比较。结果　牙源性角化囊肿中 Ki- 6 7表达较含牙囊肿高 ,与正常口腔上皮相似 ;复发的与未复发的牙源性角化囊肿 Ki- 6 7指数无显著性差异。牙源性角化囊肿中 EGFR表达呈阳性。结论　牙源性角化囊肿上皮增殖活跃 ,上皮增殖生长可能与表皮生长因子家族有关。     

牙源性角化囊肿上皮细胞增殖动力学初步研究

目的探讨角化囊肿上皮细胞增殖特性,进一步了解角化囊肿的生物学行为,为临床治疗和预防复发提供一定的依据。方法采用增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ,ＰＣＮＡ）免疫组化法和细胞核ＤＮＡ含量分析,对牙源性角化囊肿、根尖囊肿、含牙囊肿和造釉细胞瘤上皮细胞进行对比研究。结果角化囊肿上皮细胞增殖活跃,与造釉细胞瘤相似。提示角化囊肿生物学特性为上皮细胞主动生长,而非被动性膨胀生长。结论角化囊肿可视为具有侵袭性生长的良性肿瘤,提出命名为“牙源性角化囊性瘤”更能反应其生物学特性     

成釉细胞瘤和角化囊肿细胞生长特点的研究

目的观察、比较成釉细胞瘤和角化囊肿细胞的生长特点,探讨角化囊肿复发的原因。方法原代体外培养成釉细胞瘤细胞、牙源性角化囊肿、根端囊肿及口腔粘膜的上皮细胞和成纤维细胞,倒置光相差显微镜观察。结果成釉细胞瘤上皮细胞生长较快,细胞生长晕周围不规则,大细胞生长晕周围有许多卫星样小生长晕,成纤维细胞呈网格状。角化囊肿与其他囊肿和正常粘膜的上皮细胞相同,生长缓慢,细胞生长晕周围规则,由呈漩涡状生长的成纤维细胞围绕。结论成釉细胞瘤细胞生长活跃,而角化囊肿细胞的生长特点与其他囊肿和粘膜相似,提示成釉细胞瘤细胞的浸润性生长特点,推测角化囊肿复发的主要因素不是因为其具有肿瘤的生长特点。     

牙源性囊肿上皮增殖活性的研究

目的：研究牙源性角化囊肿,含牙囊肿,根尖囊肿3种主要的牙源性囊肿衬里上皮的细胞增殖活性,方法：应用Ki-67单克隆抗体免疫组化LSAB法对30例牙源性囊肿进行免疫组化染色,结果通过计算机图像分析,计算单位面积衬里上皮内（mm2)阳性细胞数,进行统计学分析,结果：牙源性角化囊肿衬里上皮有较多的Ki-67阳性细胞,明显高于含牙囊肿和根尖囊肿;正常口腔粘膜未见Ki-67阳性表达,结论：Ki-67在不同的牙源性囊肿中表达的差异显示了它们具有不同的增殖和分化过程。     

Bcl—xL、Livin在牙源性角化囊性瘤组织中的表达及意义

目的：检测Bcl-xL、Livin在牙源性角化囊性瘤囊壁上皮细胞中的表达,初步探讨凋亡抑制蛋白在牙源性角化囊性瘤发生发展中的意义。方法：免疫组化法检测32例牙源性角化囊性瘤,30例单囊型成釉细胞瘤及30例含牙囊肿手术切除标本中Bcl-xL、Livin蛋白的表达。结果：Bcl-xL在牙源性角化囊性瘤、单囊型成釉细胞瘤及含牙囊肿中的阳性表达率分别为84．38％、90．00％、36．67％,Bcl-xL在牙源性角化囊性瘤中的阳性表达率高于含牙囊肿。 Livin在牙源性角化囊性瘤、单囊型成釉细胞瘤及含牙囊肿囊壁中阳性表达率分别为59．38％、66．67％、20．00％,Livin在牙源性角化囊性瘤中的阳性表达率高于含牙囊肿（P＜0．05）,牙源性角化囊性瘤中Bcl-xL与Livin的表达呈正相关（r＝0．483,P＜0．05）。结论：Bcl-xL、Livin在牙源性角化囊性瘤的发生发展中可能起一定作用,并且二者可能具有协同效应。     

牙源性囊肿抗增殖细胞核抗原抗体细胞动态分析

作者应用抗增殖细胞核抗原(PCNA)抗体免疫组织化学方法,研究囊肿壁内衬表皮细胞动态。以牙源性囊肿手术摘除的囊肿壁内衬表皮完整者作为标本。其中根端囊肿和含牙囊肿各20例,始基囊肿及牙源性角化囊肿25例,钙化性囊肿1例。造釉细胞瘤15例和正常牙龈5例作对照。 结果:囊肿内衬上皮及结缔组织的细胞核PCNA略呈阳性,尤其在囊肿衬里上皮的基底细胞及其上的2～3层细胞多见。根端囊肿表现在组织学上炎症反应     

364例牙源性颌骨囊肿治疗与预后的探讨

本文报告牙源性囊肿３６４例，根尖囊肿，始基囊肿，含牙囊肿和角化囊肿分别占３９．６％，２２．８％，２８．８％和８．８％。全部病例行囊肿摘除骨腔刮治术。手术并发症主要为感染（占７７．１％）。囊肿复发率为５．５％，造釉细胞瘤变率为２．５％。本资料，始基囊肿和角化囊肿复发率／瘤变率近似，又明显高于含牙囊肿（Ｐ＜０．０５）。认为前两者组织学术源相同。提出根尖囊肿，含牙囊肿甚至始基囊肿囊肿区完好牙应予保留。除角化囊肿外，囊肿区保留牙与感染复发无明显关系。对术后感染，囊肿复发与瘤变防治问题作了讨论。     

牙源性囊肿和成釉细胞瘤体外骨吸收的实验研究

目的定量分析牙源性角化囊肿和成釉细胞瘤的体外骨吸收效应,探讨其颌骨吸收机制。方法收集25例牙源性囊肿[牙源性角化囊肿(OKC)14例、牙源性角化囊肿伴感染6例、含牙囊肿(DC)5例]和7例成釉细胞瘤的新鲜组织块行体外培养(24h),取其上清液与SD大鼠(新生5天)颅盖骨培养体系继续培养48h,以原子分光光度计法检测培养体系上清液中的Ca2+含量,从而判断不同牙源性病损在体外导致骨吸收作用的差异。同时采用放射免疫技术检测牙源性病损体外培养上清液中的骨吸收相关因子:白细胞介素6(IL6)、肿瘤坏死因子α(TNFα)、前列腺素E2(PGE2)、骨钙素(BGP)和降钙素(CT)等的含量。结果各组牙源性囊肿和肿瘤引起大鼠颅盖骨培养Ca2+析出的浓度显著高于空白组(P<0.01);OKC伴感染组Ca2+浓度显著高于OKC组和成釉细胞瘤组(P<0.05)。各组牙源性囊肿和成釉细胞瘤培养上清液中IL6、TNFα、PGE2和CT含量显著高于空白对照组(P<0.05);OKC组和OKC伴感染组IL6含量显著高于成釉细胞瘤组(P<0.05);OKC伴感染组CT含量显著高于OKC组和含牙囊肿组(P<0.05)。这些因子和Ca2+含量的相关性分析结果显示,IL6与钙值之间呈显著性正相关(P<0.01)。结论颌骨牙源性病损在体外可促进骨吸收,此作用可能与其产生的某些细胞因子有关。     

牙源性囊肿和肿瘤中核仁组织导体区的定量研究

本文采用 AgNOR 技术对多种牙源性囊肿和肿瘤中的核仁组织导体区作了定量分析和观察,结果表明:牙源性恶性肿瘤和具有侵袭性行为的病损(如牙源性角化囊肿和造釉细胞瘤)中的 AgNORs 计数显著高于其它良性病变(含牙囊肿、根尖囊肿和牙源性腺样瘤),各病变组的 AgNORs 计数均值基本上与病变的生物学行为相平行,即计数值越大,病变的生物学行为越差。提示 AgNOR 技术可望作为牙源性囊肿和肿瘤鉴别诊断和预后判断的重要辅助手段。     

Interleukin-1alpha-dependent regulation of matrix metalloproteinase-9(MMP-9) secretion and activation in the epithelial cells of odontogenic jaw cysts

Interleukin-1alpha (IL-1alpha) and matrix metalloproteinase-9 (MMP-9) are thought to be involved in odontogenic cyst expansion. In this study, we investigated the effects of IL-1alpha on the secretion and activation of MMP-9 in odontogenic jaw cysts. An active form of MMP-9 was present in odontogenic keratocyst (6 of 8 cases) fluids more frequently than dentigerous cyst (3 of 10 cases) and radicular cyst (3 of 10 cases) fluids, although proMMP-9 was present in all cyst fluids. Odontogenic keratocyst fragments in explant culture secreted a larger amount of IL-1alpha than dentigerous cyst and radicular cyst fragments in explant culture, and spontaneously secreted both proMMP-9 and an active form of MMP-9. The fragments of dentigerous cysts and radicular cysts secreted a small amount of proMMP-9, but no active form of MMP-9. Exogenously added recombinant human IL-1alpha (rhlL-1alpha) increased the secretion and activation of proMMP-9 in the fragments of dentigerous cysts and radicular cysts. The epithelial cells isolated from odontogenic keratocysts secreted IL-1alpha and proMMP-9 without stimulation. Under the cultivation on a fibronectin-coated dish, rhIL-1alpha increased the secretion of proMMP-9 from the epithelial cells in a dose-dependent manner. Moreover, rhIL-1alpha induced the secretion of proMMP-3 and plasminogen activator urokinase (u-PA) from the epithelial cells, and converted the secreted proMMP-3 to the active form in the presence of plasminogen. The secreted proMMP-9 was also activated in the presence of rhIL-1alpha and plasminogen. Hence, our results suggest that IL-1alpha may up-regulate not only proMMP-9 secretion but also proMMP-9 activation by inducing proMMP-3 and u-PA production in the cyst epithelial cells by autocrine/paracrine regulatory mechanisms.     

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目的探讨开窗减压术治疗颌骨巨大囊性病变的临床应用价值。方法对2009年5月至2010年11月南方医科大学附属南海医院口腔科收治的8例颌骨囊性病变患者(包括1例根尖囊肿,1例含牙囊肿、5例角化囊肿、1例囊性成釉细胞瘤),经口内进行开窗减压,术后定期复诊,3个月复查曲面断层摄影,1年进行三维CT重建,测量术后囊腔缩小情况。结果 8例患者,最长的已观察18个月,最短的观察3个月,2例患者(包括1例根尖囊肿、1例成釉细胞瘤)囊腔完全消失,6例患者囊腔越来越缩小。结论开窗减压术是一种简便、经济、效果良好的治疗颌骨囊性病变的方法。     

Lectin histochemistry of cystic jaw lesions: an aid for differential diagnosis between cystic ameloblastoma and odontogenic cysts

The binding sites for Ulex europaeus agglutinin I (UEA-I), Bandeirea simplicifolia agglutinin I (BSA-I), and peanut agglutinin (PNA) were comparatively examined in the surgical materials from 41 cases of cystic and solid ameloblastomas and 42 cases of non-neoplastic odontogenic cysts including dentigerous cyst, odontogenic keratocyst, and radicular cyst. In non-neoplastic cysts, most of epithelial lining layers gave positive binding with UEA-I and BSA-I. However, no positive reactions were obtained for these two lectins in the epithelial components of ameloblastoma, except for limited UEA-I binding to markedly keratinized tumor cells in four cases. PNA binding was irregular and did not make any clear distinction between ameloblastomas and cysts. The results suggest that the lectin staining for UEA-I and BSA-I is a useful histologic aid for differential diagnosis between cystic ameloblastoma and non-neoplastic jaw cysts.     

A comparative stereologic and ultrastructural study of blood vessels in odontogenic keratocysts and dentigerous cysts

Blood vessels were investigated both stereologically and ultrastructurally in keratocyst and dentigerous cyst. The volume and surface densities of blood vessels in 15 keratocysts and dentigerous cysts were analyzed stereologically. No significant differences were found between them using these parameters, suggesting that their overall vascularity may be similar. However, the ultrastructural study showed marked differences between blood vessels in these two types of cysts. It was observed that fenestrated capillaries were found only in keratocysts. In addition, degeneration of endothelial lining associated with thrombosis was also a prominent feature of this cyst. While ruptured endothelium, narrow lumen and Weibel-Palade bodies were characteristic of vessels in dentigerous cyst. The presence of fenestrated capillaries in keratocyst and not in dentigerous cyst might indicate a rapid transfer of fluid to meet the demand of the relatively active proliferating epithelium, which may be promoted by growth factors released from platelets in those thrombosed vessels.     

Survivin、bcl-2、caspase-3在牙源性角化囊肿中的表达及意义

目的检测凋亡相关蛋白survivin、bcl-2、caspase-3在角化囊肿中的表达,探讨其在角化囊肿发生发展中的意义。方法免疫组织化学方法检测20例角化囊肿(10例原发和10例复发)、10例含牙囊肿和10例根端囊肿中survivin、bcl-2、cas-pase-3的表达。结果Survivin、bcl-2、caspase-3阳性染色分别见于13(65%)、13(65%)、9(45%)例角化囊肿。Survivin、bcl-2在角化囊肿上皮基底层细胞中阳性表达,阳性率显著高于含牙囊肿和根端囊肿;caspase-3在角化囊肿上皮表层细胞表达。Survivin的表达与bcl-2正相关,与caspase-3无明显相关性。结论Survivin、bcl-2、caspase-3在角化囊肿形成和发展中起一定作用。