几种牙源性肿瘤及其相关病损的临床与病理研究现状

颌骨是人类骨骼中最好发上皮性囊肿和肿瘤的部位,这是由于牙和牙发育与颌骨关系密切,颌骨内的成牙组织常可作为囊肿和肿瘤的组织来源.这类多发于颌骨内的牙源性病损好发于年轻人,可造成颌骨及邻近软组织的破坏,导致口腔颌面部外形改变;某些侵袭性病损具有较高的复发倾向,可对患者的生存质量及心理健康造成严重影响.由于其发生与颌骨和牙的发育关系密切,故在发病过程、临床病理表现以及生物学行为等方面均具特殊性,是口腔颌面部特有的一类肿瘤.

Clinical and pathological aspects of some odontogenic tumors and related lesions

The jaw bones are the most common sites for epithelial cysts and tumors in the human skeleton due to their close relationship to the tooth and odontogenesis. Most of these cysts and tumors have in common an origin from the tissues of tooth formation and constitute a very diverse group of lesions that reflects the complex development of the dental structures. This group of odontogenic lesions occurs predominantly in the jaws, with a predilection for young people. Some aggressive lesions have attracted much attention as they often produce marked facial deformity and tend to recur after insufficient surgery. The most widely quoted classification of odontogenic tumors is that proposed in the WHO booklet published in 1992. There are, however, a number of controversial issues that need to be addressed with respect to clinicopathological subtypings, terminology, and diagnosis which all have direct bearings on therapeutic and/or prognostic implications. In the light of recent publication of the WHO new classification and a series of related studies undertaken by the author's group, this paper is to put together an overview on some of these important aspects related to unicystic ameloblastoma, clear cell odontogenic tumor, calcifying odontogenic cyst, odontogenic keratocyst, ameloblastic fibroma and its related lesions. Consequent upon a better understanding of the nature of these tumors and their variants, the various treatment protocols currently recommended by different surgeons will be better rationalized.