100例成釉细胞瘤临床病理分析

Comparative study on clinical pathological type,modes of operation and prognosis of 100 cases of ameloblastoma

目的:对比研究成釉细胞瘤不同临床病理类型、治疗方法与复发的关系。方法:对100例成釉细胞瘤患者的临床病理分型、治疗方法及术后复发情况进行回顾性研究。确切概率法(SAS9.13软件包)检验各相关因素与复发之间的关系。结果:发病年龄与临床分型有一定关系,单囊型成釉细胞瘤主要见于青少年。100例成釉细胞瘤患者中,单囊型术后复发率7.69%(3/39)、外周型复发率为40.00%(2/5)、一般型复发率为57.14%(32/56),三者间有显著性差异(P<0.05)。减压术治疗29例,术后8例复发;刮治术治疗38例,24例复发;颌骨方块切除11例,3例复发;根治性切除22例,术后2例复发。不同术式术后复发率有显著性差异(P<0.05)。结论:不同临床类型、不同术式治疗的成釉细胞瘤术后复发率显著不同,设计手术方案时,应综合考虑患者的年龄、临床分型、发病部位等因素,选择相应的适应证。不当的手术方案设计也是引起复发的重要因素。

PURPOSE： To investigate the relationship between clinical pathological type, modes of operation and prognosis of ameloblastoma. METHODS： One hundred cases of ameloblastoma were retrospectively analyzed based on their clinical pathological types, modes of operation and prognosis. Chi-square test was used for statistical analysis（SAS 9.13 software package）. RESULTS： Unicystic type often occurred in teenagers. Among 100 cases, the recurrence of unicystic type was 7.69%（3/39）, compared with peripheral type of 40.00%（2/5） and common type of 57.14%（32/56）（P〈0.05）. Among 29 cases treated with decompression, 8 cases had recurrence, 24 had recurrence treated curettage, 3 cases had recurrence treated with partial resection, and 2 cases had recurrence treated with radical resection. Significant difference was found among three modes of operation（P〈0.05）. CONCLUSION： Prognosis of ameloblastoma varies among age, clinic pathological type and modes of operation. Modes of operation should be chosen based on the age and clinic pathological type.