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成釉细胞瘤的回顾性研究:保守治疗的可能性

Retrospective study of ameloblastoma: the possibility of conservative treatment.

作者信息

Hasegawa Takumi, Imai Yusuke, Takeda Daisuke, Yasuoka Daisuke, Ri Shinshou, Shigeta Takashi, Minamikawa Tsutomu, Shibuya Yasuyuki, Komori Takahide

机构信息

Department of Oral and Maxillofacial Surgery, Kobe University School of Medicine, Kobe, Japan.

出版信息

Kobe J Med Sci. 2013 Nov 9;59(4):E112-21.

Abstract

At our institutions, most cases of the solid or multicystic type were treated as conservatively as possible in order to avoid disadvantages of radical treatment. The aim of present study was to retrospectively analyze the ameloblastoma cases diagnosed at our two institutions, to classify them according to the criteria of the 2005 WHO classification, and to evaluate the possibility of using a conservative approach for the surgical treatment of ameloblastoma. Maxillary cases, unicystic cases, peripheral cases and resection-treated cases were excluded from this study. In 23 tumors of mandibular solid or multicystic ameloblastoma, a patient's age, gender, location, clinical signs, duration, radiographic appearance, preoperative diagnosis, ameloblastoma subtypes, treatment, and recurrence were investigated. The recurrence rate (48.7%) in this study was lower than the reported recurrence rate after conservative treatment for solid or multicystic ameloblastoma and was higher than the reported recurrence rate of ameloblastoma, inclusive of other types. However, all patients who were diagnosed with recurrences have maintained their quality of life and were satisfied for at least several years after the conservative treatment. In conclusion, we demonstrated one possibility that a conservative approach might be employed in the surgical treatment of ameloblastoma (even of the solid or multicystic type).

摘要

在我们的机构中,大多数实性或多囊型病例都尽可能进行保守治疗,以避免根治性治疗的弊端。本研究的目的是回顾性分析在我们两个机构诊断出的成釉细胞瘤病例,根据2005年世界卫生组织分类标准对其进行分类,并评估采用保守方法进行成釉细胞瘤手术治疗的可能性。本研究排除了上颌病例、单囊型病例、外周型病例和接受切除术治疗的病例。对23例下颌实性或多囊型成釉细胞瘤患者的年龄、性别、部位、临床症状、病程、影像学表现、术前诊断、成釉细胞瘤亚型、治疗方法及复发情况进行了调查。本研究中的复发率(48.7%)低于报道的实性或多囊型成釉细胞瘤保守治疗后的复发率,高于报道的包括其他类型在内的成釉细胞瘤复发率。然而,所有被诊断为复发的患者在保守治疗后至少数年都保持了生活质量并感到满意。总之,我们证明了一种可能性,即成釉细胞瘤(甚至实性或多囊型)的手术治疗可能采用保守方法。

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