牙源性钙化囊肿临床与病理研究

Calcifying Odontogenic Cyst:A Clinicopathologic Study of Nineteen Cases.

目的 :本文收集 1 9例牙源性钙化囊肿 (COC)病例 ,根据其组织病理 ,X线影像 ,临床诊断以及治疗预后进行回顾 ,并复习有关文献资料进行分析研究。结果 :1 9例COC依组织病理分型可分成囊型和实体肿瘤型 ,其中囊型 1 4例 (73.7% ) ,实体肿瘤型 5例 (2 6 .1 % )。囊型COC又可分为 3个亚型 :单纯囊肿型 7例 (5 0 % ) ,囊肿伴牙瘤型4例 (2 8.6 % ) ,囊肿伴成釉细胞瘤型 3例 (1 5 .8% ) ;实体肿瘤型COC以成釉细胞纤维瘤型或者其他牙源性肿瘤间杂型为主。临床所见 ,COC分布上下颌骨无明显差异 ,上颌骨 8例 (4 2 .1 % )下颌骨 1 1例 (5 7.9% )。X线影像 ,COC绝大多数 (6 8.4 % )表现为颌骨内囊性透光阴影 ,其中伴有不等钙化斑点。手术治疗 1 9例 ,复发 3例。结论 :COC根据其囊壁上皮衬里增殖活性及生长方式决定其形态结构的多样类型 。

Objective:The data including clinical, reongegraph, histologic features and treatment of 19 cases with calcifying odontogenic cyst(COC) were reviewed and analyzised retrospectively.Results:19 cases were divided into cystic 14(73.7%) and neoplastic 5(26.3%).The cystic occurred as three variants: (1) simple unicystic 7(50%) ,(2) cyst associated with odontoma 4(28.6%),(3) ameloblastomatous 3(15.8%) and neoplasms showed ameloblasfibromatous or adenomatoid odontogenic tumor. Clinical features do not seem to be any particular predilection for either the maxilla or mandible.Radiographically,most of the lesions(68.4%) appeared as unilocular radiolucencies with variable amounts of radiopaque material.Treatment, all the cases were operated but 3(15.8%) recurred.Conclusions:The COC classification is based on the proliferative activity and growth pattern of the cyst-lining epithelium which seems very important that odontogenic epitherial with inductive factor, while it might lead to difference of the biological behavior and prognosis of COC.