79例头颈部牙源性黏液瘤临床、病理及预后分析

Head and neck odontogenic myxoma: clinical, pathological and prognosis analysis of 79 consecutive cases

目的:研究头颈部牙源性黏液瘤的临床、病理及预后特点。方法:回顾2001—2017年于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科接受手术治疗的头颈部黏液瘤患者的临床、病理及预后信息,采用SPSS 17.0软件包对数据进行统计学分析。结果:纳入患者79例,其中可随访71例。可随访患者中,男30例,女41例。年龄≤30岁27例,31~60岁39例。12例有吸烟史,3例有酗酒史。12例接受过手术治疗;42例发生于下颌骨,26例发生于上颌骨及颅底。肿瘤最大直径中位值为3.5 cm,36例肿瘤最大直径≤3.5 cm。60例接受肿瘤根治性切除,11例接受局部刮治术。52例瘤体组织以纤维成分为主,19例以黏液成分为主;随访期间4例出现局部复发。接受局部刮治术的患者,术后复发率(36.36%)显著高于接受肿瘤根治性切除的患者(P=0.001)。结论:头颈部牙源性黏液瘤是一种较为罕见的良性肿瘤,具备局部侵袭性,下颌骨发病较常见,患者年龄以31~60岁为主。相对于局部刮治术,根治性切除可有效抑制肿瘤术后复发。

PURPOSE:To analyze the clinical pathological and prognosis factors of head and neck odontogenic myxoma.METHODS:A retrospective study was adapted for patients who received surgery in the Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People's Hospital from 2001-2017.Clinical,pathological and prognosis data were collected and analyzed with SPSS 17.0 software package.RESULTS:Seventy-nine patients were finally selected,71 could be followed up.Among 71 patients,30 were male;27 were≤30 years,39 were within 31-60 years.Twelve had smoking history,3 had alcoholism history.Forty-two had tumor in mandible,26 had tumor in the maxilla and skull base.The median of the largest diameter tumor was 3.5 cm,36 were≤3.5 cm.Sixty received block resection,11 underwent curettage.Fifty-two were rich in fibrous content while 19 were rich in mucus content.Four had local recurrence within follow-up period.Patients receiving curettage had higher rate of local recurrence(36.36%)compared while those with block resection(P=0.001).CONCLUSIONS:Head and neck odontogenic myxoma was a kind of benign tumor with local recurrence,mostly located in the mandible and high incidence in patients within 31-60 years old.Block resection can provide good control of local recurrence compared with curettage.