颌骨肉瘤95例临床病理分析

Sarcoma of the jaw bones: a clinico-pathological study of 95 consecutive patients

目的:回顾分析95例颌骨肉瘤的临床资料。方法:按照WHO骨肿瘤最新分类,对95例颌骨肉瘤的性别、年龄、病程、部位、临床表现、病理分型、X线表现进行统计学分析。结果:颌骨肉瘤患者中,男性多于女性,男女比例为2.06∶1;好发年龄为20～49岁,占发病总数的58.95%;病程最短1周,最长5.5a,平均5.2个月;下颌骨较上颌骨多见;临床症状多有肿块(82.10%),伴疼痛、麻木及牙松动移位等;病理类型以骨肉瘤(31.58%)最多,其他依次为恶性纤维组织细胞瘤(22.11%)、软骨肉瘤(15.79%)、恶性淋巴瘤(11.58%)、横纹肌肉瘤(6.32%)、纤维肉瘤(5.26%)、浆细胞肉瘤(5.26%)和尤文肉瘤(2.11%)。68.42%表现为骨质破坏,6.32%表现为骨质硬化,25.26%表现为骨质破坏伴骨质硬化。结论:颌骨肉瘤以20～49岁男性多见,与身体其他部位肉瘤的发病特点相似;骨肉瘤最为常见;根治性手术是治疗该类疾病的主要手段。

PURPOSE： To study the clinico-pathological characteristics of sarcoma of the jaw bones.METHODS： The clinico-pathological data of 95 patients were retrospectively reviewed.The patients’ records were reviewed for gender,age,duration,location,clinical symptoms,pathological diagnosis and X-ray characteristics.RESULTS： Among 95 case of sarcomas of the jaw bones,males were more than females （M：F=2.06：1）;there was an age prediction for 20-49 years （represented 58.95% of the total cases）;clinical symptoms were usually presented from 1 week to 5.5 years before diagnosis（mean duration,5.2months）;the location of the tumor in mandible was more than in maxilla;the complaints of 82.10% were swelling with pain or numbness or dislocation of teeth;the most common pathological type was osteosarcoma （represented 31.58% of the total cases）,followed by malignant fibrous histiocytoma of bone,chondrosarcoma,fibrosarcoma,plasma cell sarcoma,Ewing’s sarcoma.The features of X-ray showed destruction of bone （68.42%）,neoplastic osteogenesis（6.32%）,or both（25.26%）.CONCLUSIONS： There was a prediction of sarcoma of jaw for males between 2049 years old,which is similar to that of body and extremities.Osteosarcoma was the most common pathological type.Radical surgery was the main therapeutical modality.