颌骨骨纤维异常增殖症和骨化纤维瘤的临床及病理特征分析

Analysis of clinical and pathological characteristics of fibrous dysplasia and ossifying fibroma of the jaws

目的探讨口腔颌面部骨纤维异常增殖症(fibrous dysplasia,FD)和骨化纤维瘤(ossifying fibroma,OF)的临床特征、影像学特征及病理特征,以提高临床诊断准确率。方法对我院1987—2011年间的骨纤维异常增殖症25例,骨化纤维瘤16例的临床资料、影像学资料和病理切片进行分析。结果本组病例中发病年龄两者无明显差异,FD平均22.56岁,OF平均28.25岁;前者的男女比为1∶1,后者为5∶3;发病部位两者均以上颌较多,分别为72.00%和62.50%,并且大多数都发生在磨牙区。X线片中FD病变透亮呈"毛玻璃状"边界不清,OF瘤界清楚,骨质有缺损破坏的阴影。病理组织学上FD中骨小梁呈多形态,不形成板状骨。OF的骨小梁有板状骨形成,但FD成熟型与OF在病理组织学上有相似性。结论 FD和OF是不同的独立疾病,明确其诊断,需结合临床、影像学及病理学进行综合分析。

Objective To explore the clinical,radiographic and pathological characteristics of fibrous dysplasia（FD） and ossifying fibroma（OF） for improving the diagnosis accuracy.Methods Clinical data,radiographs and pathological slices of the 25 cases of FD and 16 cases of OF who visited our hospital between 1987-2011 were analyzed.Results Onset ages of patients had no difference between two groups（mean 22.56 years in FD and 28.25 years in OF）.The former ratio of male to female was 1∶1,and the later was 5∶3.The maxilla was involved far more often than the mandible（72% and 62.5%,respectively）,most commonly in the molar region.Radiographically,OF lesion was transparent and had obscure boundary like ground-glass.FD had clear tumor boundary and there was shadow showing defects and damage in bone mass.Pathologically,trabecular bone in FD patients was polymorphic,which didn′′t form tabular bone,while trabecular bone in OF patients formed tabular bone.However,mature FD had similarity with OF pathologically.Conclusions FD and OF are different diseases.It is necessary to make a definitive diagnosis by comprehensive study of the clinical cases,X rays and pathological slices.