Ju Wu-Tong, Fu Yong, Liu Ying, Tan Yi-Ran, Dong Min-Jun, Wang Li-Zhen, Li Jiang, Zhong Lai-Ping
Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Jan;125(1):44-51. doi: 10.1016/j.oooo.2017.09.015. Epub 2017 Sep 28.
The aim of this study was to analyze tuberculosis (TB) in the oral cavity according to clinical appearance, clinical differential diagnosis, treatment, and outcome.
We enrolled 11 patients with TB in the oral cavity between November 2012 and November 2016. Glossal lymphoid TB was excluded. Clinical symptoms, auxiliary examinations, treatments, and outcomes were recorded and analyzed.
The study population comprised 6 men and 5 women, with a mean age of 59 years. Five patients presented with ulcer, 5 with a mass, and 1 with osteomyelitis. Excisional biopsy was performed in 3 patients, mass resection in 7, and curettage of mandibular lesion in 1. After pathologic diagnosis of TB in the oral cavity in 8 patients; 6 of them underwent purified protein derivative examination, and 4 of them had positive results and received drug therapy. The mean follow-up period was 24.9 months, and there was no recurrence.
TB in the oral cavity is rare and has no specific clinical features. Pathology, acid-fast staining, polymerase chain reaction, and DNA testing for Mycobacterium tuberculosis are useful for final diagnosis. Surgery is recommended as the treatment of choice to achieve good clinical outcomes.
本研究旨在根据临床表现、临床鉴别诊断、治疗方法及治疗结果，对口腔结核进行分析。
我们纳入了2012年11月至2016年11月期间11例口腔结核患者，排除了舌部淋巴结核。记录并分析临床症状、辅助检查、治疗方法及治疗结果。
研究对象包括6名男性和5名女性，平均年龄59岁。5例表现为溃疡，5例表现为肿物，1例表现为骨髓炎。3例行切除活检，7例行肿物切除，1例行下颌病变刮除术。8例经病理诊断为口腔结核；其中6例接受了结核菌素试验，4例结果呈阳性并接受了药物治疗。平均随访期为24.9个月，无复发情况。
口腔结核较为罕见，且无特异性临床特征。病理检查、抗酸染色、聚合酶链反应及结核分枝杆菌DNA检测对最终诊断有帮助。建议手术作为首选治疗方法，以获得良好的临床效果。
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