局限性青少年海绵状牙龈增生的系统综述

Systematic review of localized juvenile spongiotic gingivitis hyperplasia

目的 系统性分析局限性青少年海绵状牙龈增生(localized juvenile spongiotic gingivitis hyperplasia, LJSGH)的患病情况和治疗方法。方法 通过万方数据库、中国知网、PubMed、迈特思创和泉方学术等数据库检索2007年1月至2021年5月LSJGH相关文献,经筛选后对最终纳入的文献进行系统综述。结果 纳入文献共20篇,报道LJSGH患者221例,其中男127例,女94例,平均年龄15.2岁。所有病例均未报道明确病因和发病机制。病理表现以显著的细胞间水肿(海绵状结构)和整个病损上皮的细胞角蛋白(CK)19呈强阳性为主要特征。171例患者病损仅位于上颌,前牙区LJSGH较后牙区或同时累及前后牙区LJSGH更为常见。受累牙龈常呈鲜红色隆起,界限清楚,表面呈乳头状、颗粒状或天鹅绒状。治疗方法以手术为主,复发率为13.8%;少数病例采用光动力疗法、冷冻治疗或药物治疗。结论 LJSGH多发生于儿童和青少年,也可见于成年人,虽病因和发病机制尚未明确,但独特的病理特征及免疫组织化学染色在临床中具有诊断价值,在临床诊疗中应注意鉴别诊断。

Objective To systematically analyze the prevalence and treatment of localized juvenile spongiotic gingivitis hyperplasia(LJSGH). Methods Related literature from January 2007 to May 2021 was retrieved from Wanfang Database, CNKI, PubMed, Metstr and Qf Academic databases, and included literature was systematically reviewed after screening. Results A total of 20 pieces of literature were included, and 221 cases of LJSGH were reported, including 127 males and 94 females. The mean age was 15.2.The etiology and pathogenesis of all cases have not been reported. Microscopically, significant intercellular edema(spongiotic structure) and strong positive cytokeratin(CK) 19 across epithelium of the lesion were main characteristics.171 patients only had lesions in the maxilla, and LJSGH was more common in the anterior teeth than in the posterior teeth or in both the anterior and posterior teeth. The affected gingival was usually bright red with clear boundary and papillary, granular or velvety surface. The main treatment was surgery, and the recurrence rate was 13.8%. A few cases were treated with photodynamic therapy, cryotherapy or drug therapy. Conclusion LJSGH occurs mostly in children and juvenile, but also in adults. Although the etiology and pathogenesis are not clear, its unique pathological features and immunohistochemical staining have clinical values in diagnosis, and differential diagnoses should be paid attention to in clinical diagnosis and treatment.