Seoane Juan, Van der Waal Isaäc, Van der Waal Rutger I F, Cameselle-Teijeiro José, Antón Iosu, Tardio Antoni, Alcázar-Otero Juan J, Varela-Centelles Pablo, Diz Pedro
Department of Stomatology, School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
J Clin Periodontol. 2009 Jun;36(6):488-92. doi: 10.1111/j.1600-051X.2009.01407.x.
To describe survival from oral metastases, particularly gingival metastases, and to identify clinical prognostic variables.
A series of 39 patients were studied, analysing age, gender, primary tumour site, oral metastases site and histological type.
Mean age: 62.3+/-9.2 years, with similar prevalence by gender. The most frequent sites for primary tumours were the kidney (20.5%), lung (20.5%) and breast (20.5%). Gingival metastases represented 63.6% of all oral soft tissue metastases (7/11). The average time between primary tumour diagnosis and appearance of the gingival metastases was 9.7+/-13.4 months. The median survival time since gingival metastases appearance was 5.2 months [95% confidence interval (CI)=0-13.6]; no statistically significant difference with other oral locations was found by the Kaplan-Meier curves (log rank: 0.29; p>0.05). Oral metastases involving the gingiva were more frequently found in the maxilla (85.7%versus 14.3%), whereas intra-osseous metastatic tumours were more frequent in the mandible (77.8%versus 22.2%; p<0.05; odds ratio=21; 95% CI=2.0-210.1). None of the variables considered had a prognostic value as indicated by the Kaplan-Meier test.
The data in this paper show that 25% (and in other studies up to 37%) of oral metastases came from unknown primary tumours; thus a biopsy with histopathologic analysis is mandatory for every patient with a gingival mass.
This study reinforces the significance of gingival metastases as a poor prognosis indicator. Dental practitioners should suspect that gingival masses mimicking benign or inflammatory lesions may represent a sign of underlying malignant tumours.
描述口腔转移瘤尤其是牙龈转移瘤的生存率，并确定临床预后变量。
对39例患者进行了研究，分析了年龄、性别、原发肿瘤部位、口腔转移瘤部位和组织学类型。
平均年龄：62.3±9.2岁，性别患病率相似。原发肿瘤最常见的部位是肾脏（20.5%）、肺（20.5%）和乳腺（20.5%）。牙龈转移瘤占所有口腔软组织转移瘤的63.6%（7/11）。原发肿瘤诊断至牙龈转移瘤出现的平均时间为9.7±13.4个月。牙龈转移瘤出现后的中位生存时间为5.2个月[95%置信区间（CI）=0-13.6]；Kaplan-Meier曲线未发现与其他口腔部位有统计学显著差异（对数秩：0.29；p>0.05）。涉及牙龈的口腔转移瘤在上颌更常见（85.7%对14.3%），而骨内转移瘤在下颌更常见（77.8%对22.2%；p<0.05；优势比=21；95%CI=2.0-210.1）。Kaplan-Meier检验表明，所考虑的变量均无预后价值。
本文数据显示，25%（其他研究中高达37%）的口腔转移瘤来自未知原发肿瘤；因此，对于每一位有牙龈肿物的患者，必须进行组织病理学分析的活检。
本研究强化了牙龈转移瘤作为预后不良指标的重要性。牙科医生应怀疑模仿良性或炎性病变的牙龈肿物可能是潜在恶性肿瘤的迹象。
