Nakayama Eiji, Sugiura Kazutaka, Kobayashi Ieyoshi, Oobu Kazunari, Ishibashi Hiroaki, Kanda Shigenobu
Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Oral Maxillofac Surg. 2005 Mar;63(3):311-8. doi: 10.1016/j.joms.2004.04.033.
The study goal was to clarify the association between computed tomography (CT) findings, histologic features, and outcome of osteosarcoma of the jaw (OSJ).
The CT findings and histologic features of 10 patients with OSJ were retrospectively analyzed. The patients were histopathologically diagnosed to have OSJ. The points analyzed on the CT included the patterns of osteogenesis and any signs of bone destruction. The histologic types were classified according to the 1993 World Health Organization histologic classification of bone tumors. Furthermore, the histologic subtype was classified into the following 3 types: osteoblastic, chondroblastic, and fibroblastic. The grade of the tumor tissue was classified from I to IV. These were compared with the affected jaw site and the outcome of the patients with OSJ.
All tumors were classified into the conventional central osteosarcoma histologically. Eight cases were osteoblastic, and 2 cases were chondroblastic. Grade I or II (4 of 5 patients are alive without disease) dominated in the maxilla, but in contrast, grade III or IV (4 of 5 patients are dead of disease or alive with disease) dominated in the mandible. A significant association was seen between the osteogenesis found on the CT images and the outcome, between the grade and the outcome, and between the outcome and the affected jaw site ( P = .02), respectively, in OSJ in this study. However, no significant association was observed between the CT findings and the histologic features in OSJ in this series.
The osteogenesis on the CT, grade, and affected jaw site were considered to be prognostic factors in OSJ in this limited series.
本研究的目标是阐明计算机断层扫描(CT)表现、组织学特征与颌骨骨肉瘤(OSJ)预后之间的关联。
回顾性分析10例OSJ患者的CT表现和组织学特征。这些患者经组织病理学诊断为OSJ。CT上分析的要点包括成骨模式和任何骨破坏迹象。组织学类型根据1993年世界卫生组织骨肿瘤组织学分类进行分类。此外,组织学亚型分为以下3种类型:成骨细胞型、软骨细胞型和成纤维细胞型。肿瘤组织的分级从I级到IV级。将这些与受影响的颌骨部位及OSJ患者的预后进行比较。
所有肿瘤在组织学上均被分类为传统的中央型骨肉瘤。8例为成骨细胞型,2例为软骨细胞型。I级或II级(5例患者中有4例无病存活)在上颌骨中占主导,但相比之下,III级或IV级(5例患者中有4例死于疾病或带病存活)在下颌骨中占主导。在本研究的OSJ中,分别在CT图像上发现的成骨与预后、分级与预后以及预后与受影响的颌骨部位之间观察到显著关联(P = 0.02)。然而,在本系列的OSJ中,未观察到CT表现与组织学特征之间的显著关联。
在这个有限的系列研究中,CT上的成骨、分级和受影响的颌骨部位被认为是OSJ的预后因素。