MacDonald-Jankowski D S, Yeung R, Lee K M, Li T K
Division of Oral and Maxillofacial Radiology, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Canada.
Dentomaxillofac Radiol. 2004 Mar;33(2):71-82. doi: 10.1259/dmfr/23357977.
The aim of Part 1 of this study was to determine the clinical presentation of central ameloblastomas in the Hong Kong Chinese and to compare them with other reported series by a systematic review (SR).
The study had two elements, that of a complete series of all ameloblastomas presenting at a major Chinese maxillofacial surgical unit as well as a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for ameloblastoma cases. The relevant literature was identified by electronic databases, review of citation lists and hand searching of key journals. The principal selection criterion was that the study should represent a complete collection of cases.
Fifty-three published series of cases were included in the SR. They generally reported little more than sex, mean age and range, and affected jaw. Only 16 studies considered recurrence. Sixty-one cases of ameloblastoma were identified in the present study. There were 30 males and 31 females, contrary to the predilection for males in other reports. Eighty-four percent of cases were found in the mandible, agreeing with the SR. The mean age at first presentation was 30.5 years, lower than that of the SR; only a Korean report and a small Bangladeshi report showed younger presentation. The present report had the shortest period between first becoming aware of the lesion and seeking treatment; this period was significantly shorter for younger patients. Although the present study was in agreement with the SR with regard to swelling, this study reported a significantly higher proportion of patients presenting with pain.
Although the presentation of ameloblastoma within this Chinese community was broadly similar to that observed in other populations, it differed in a number of important respects. It had a younger age at first presentation than many other communities, including other Orientals; it was associated with a shorter period between first becoming aware of the lesion and seeking treatment, particularly in the young; and it was more frequently associated with pain than in the SR.
本研究第一部分的目的是确定香港华人中枢性成釉细胞瘤的临床表现,并通过系统评价(SR)将其与其他已报道的系列病例进行比较。
本研究有两个部分,一是对一家主要的华人颌面外科单位所诊治的所有成釉细胞瘤病例进行完整系列研究,二是进行系统评价。回顾了香港大学口腔颌面外科1989年至2000年间的病历以查找成釉细胞瘤病例。通过电子数据库、参考文献列表回顾以及重点期刊的手工检索来确定相关文献。主要的入选标准是该研究应代表完整的病例收集。
系统评价纳入了53个已发表的病例系列。这些系列通常仅报告了性别、平均年龄和年龄范围以及受累颌骨。只有16项研究考虑了复发情况。本研究共确定了61例成釉细胞瘤病例。其中男性30例,女性31例,这与其他报道中男性更易患病的情况相反。84%的病例发生在下颌骨,与系统评价结果一致。首次就诊时的平均年龄为30.5岁,低于系统评价中的年龄;只有一份韩国报告和一份小型孟加拉国报告显示就诊年龄更小。本报告中从首次发现病变到寻求治疗的时间最短;年轻患者的这段时间明显更短。尽管本研究在肿胀方面与系统评价结果一致,但本研究报告有疼痛症状的患者比例显著更高。
尽管该华人社区中成釉细胞瘤的表现与其他人群中观察到的大致相似,但在一些重要方面存在差异。其首次就诊年龄比许多其他社区,包括其他东方人群体更年轻;从首次发现病变到寻求治疗的时间更短,尤其是在年轻人中;并且与系统评价相比,与疼痛相关的情况更频繁。