复发性成釉细胞瘤的临床、影像、病理学分析

Comprehensive study on clinic presentation,radiology and pathology of recurrent ameloblastoma

目的对复发性成釉细胞瘤(RAB)的临床、影像、病理学进行综合分析,为其诊断和治疗提供依据。方法对南京大学口腔医院1996年1月—2008年3月收治的具有完整病例资料的23例RAB患者的临床资料进行总结,并进行影像学和病理学分型。结果23例RAB患者中,有20例复发1次,3例复发2次,共复发26次。23例患者中,19例首次手术治疗采用刮治术,4例首次手术治疗采用根治术;复发后4例患者采用刮治术,19例患者采用根治术。26例次RAB的影像学分型:12例次为多房型,6例次为单房型,8例次为外周型;病理分型:21例次为滤泡型,5例次为丛状型。刮治术后复发者以多房型最多(11例次),根治术后复发者以外周型最多(8例次)。结论刮治术后成釉细胞瘤复发率明显高于根治术后;滤泡型成釉细胞瘤浸润性较强,易于复发。

Objective To study the clinic presentation,radiology,pathology of recurrent ameloblastoma（RAB）.Methods All RAB cases accepted treatment in School of Stomatology of Nanjing University during 1996.1-2008.3 were retrospected.The clinic presentation,the radiological classification and pathological classification were summarized and analyzed.Results There were 23 RAB patients during 1996.1-2008.3.3 patients recurred twice,20 patients recurred once,and 26 cases were found together.19 patients were performed conservative surgery while 4 patients were per-formed radical surgery in the primary treatment;4 patients were performed conservative surgery and 19 patients were performed radical surgery in the recurrence.The radiological classification included 12 cases multicystic,6 cases uni-cystic,and 8 cases extraosseous.The pathological classification included 21 cases follicular ameloblastoma,and 5 cases plexiform ameloblastoma.The multicystic after conservative surgery（11 cases） and extraosseous ameloblastoma after radi-cal treatment（8 cases） were more than others according the radiological classification and treatment.Conclusion Con-servative surgery has apparent higher recurrences rate than radical surgery.The follicular ameloblastoma has more aggressive biological behave and is more liable to recurred.