34例下颌骨中心性癌临床、病理及预后分析

目的： 回顾分析下颌骨中心性癌的临床、病理以及预后特点。方法： 纳入2010—2015年于我院口腔颌面-头颈肿瘤科接受手术治疗的下颌骨中心性癌患者的基本信息、临床治疗信息、影像学信息、病理学信息、随访记录，采用SPSS17.0软件包对数据进行统计学分析。结果： 最终纳入36例患者，其中34例随访信息完整。随访患者中，男22例，女12例；年龄31~60岁23例，>60岁11例；有既往吸烟史13例，有既往酗酒史4例。瘤体最大直径中位值为4 cm，瘤体最大直径≤4 cm 21例，瘤体最大直径>4 cm 13例。病理报告提示9例存在同期淋巴结转移，所有术区切缘均为阴性。28例接受术后放疗，9例在随访期间死于肿瘤局部复发或肿瘤远处转移。结论： 手术是治疗下颌骨中心性癌的主要措施。瘤体位于下颌骨体部以外，同期肿瘤淋巴结转移的患者具有较高的术后肿瘤局部复发几率。既往酗酒史对肿瘤术后远处转移有一定促进作用，瘤体最大直径>4 cm的患者，总体预后较差。

Primary intraosseous squamous cell carcinoma of the mandible: clinical,pathological and prognosis analysis of 34 consecutive cases

PURPOSE: To analyze the clinical and pathological features as well as the prognostic factors for primary intraosseous squamous cell carcinoma of the mandible. METHODS: A retrospective study for primary intraosseous squamous cell carcinoma patients treated in our hospital from 2010 to 2015 was executed. The clinical, radiological, pathological, treatment information and follow up records were collected. Statistical analysis was performed with SPSS 17.0 software package. RESULTS: There were a total of 36 patients treated in the given time period, among them 34 were followed-up: 22 were male and 12 were female; 23 were within the age group of 31-60 years old, 11 were above 60 years old. Thirteen had smoking history, 4 had previous alcohol hobby. The median tumor size was 4 cm while 21 was < 4 cm and 13 was >4 cm. Nine had positive cervical lymph nodes in final pathological results, no positive surgical margin was found. Twenty-eight received postoperative radiotherapy, 9 died of locoregional recurrence or metastasis during follow-up. CONCLUSIONS: Surgery is the main approach for treating primary intraosseous squamous cell carcinoma of the mandible. Tumors outside the body of mandible, positive cervical lymph node were related to high rate for locoregional recurrence. Patients with previous alcohol hobby seemed to have high possibility of tumor metastasis postoperatively. Tumor size > 4 cm significantly reduces overall survival rate.