颌骨骨肉瘤临床与病理研究

Clinical and Pathological Study of Osteosarcoma of the Jaws

目的:总结颌骨骨肉瘤临床、病理特点。方法:对32例颌骨骨肉瘤的临床表现、X线影象及病理特征等进行回顾性分析。结果:32例中男14例,女18例,平均年龄36.9岁;病变位于下颌骨20例,上颌骨12例;临床多以颜面部肿胀伴皮肤麻木和牙痛就诊,X线主要表现为境界不清的骨破坏区;镜下均可见到肿瘤性成骨,并可分为骨母细胞型(13例)、软骨母细胞型(11例)和纤维母细胞型(8例)3种类型。获得随访15例,其中死亡2例,均为骨母细胞型骨肉瘤患者,分别发生于上颌窦和下颌骨升支。结论:肿瘤性成骨是病理诊断重要依据;颌骨骨肉瘤发病年龄较晚,其预后较好,但发生于上颌窦、下颌升支的骨母细胞型骨肉瘤预后相对较差。

Objective： To study the clinic and pathology of osteosarcoma（OS） of the jaws. Methods： The data in cluding clinical, X--ray, histologic features of 32 cases of OS of the jaws were analysed retrospectively. Results： Among the 32 cases of OS, 14 were male and 18 were female, with the mean age 36.9. The location of the lesion was limited in this study： 20 of cases were in the mandible, while 12 were in the maxilla. The majority of cases had presented facial swelling with numbness as well as toothache. OS had been described classically as an extensive de structive of bone and produced irregular, diffuse radiolucency. Usually OS was noted on a histologic feature as tu- morous osteoplastic and it＇s divided into three types： osteoblastic osteogenic sarcoma（13cases）, chondroblastic os teogenic sarcoma（llcases） and fibroblastic type osteogenic sarcoma（8cases）. Follow--up, among the 15 cases, two patients were died which were osteoblastic osteogenic sarcoma located in maxillary sinus and rambs of mandibular. Conclusion： OS is characterized by the tumorous osteoplastic histologically. The age of patients from OS in jaws was elder than that of the OS in other parts of the body, and its prognosis was relatively good ,but lesions in maxillary sinus, mandibular ramus of osteoblastic osteogenic sarcoma may have worse prognosis.