Invasion of the mandible by squamous carcinomas of the oral cavity and oropharynx.
Invasion of the mandible by squamous carcinomas of the oral cavity and oropharynx.
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口腔和口咽鳞状细胞癌侵犯下颌骨。
DOI：
10.1002/hed.2890080404
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
H. Shaw
中科院分区：
文献类型：
--
作者：
C. O'brien;R. Carter;K. Soo;L. Barr;P. Hamlyn;H. Shaw
下颌骨侵犯的放射学和组织学特征，及其临床意义，被认为是在一个回顾性系列的111例口腔和口咽鳞癌复合切除治疗。整个组中80%的患者有复发或晚期（T3，T4）局部疾病，33例患者（30%）有肿瘤侵犯下颌骨的组织学证据。术前放射学评估是不可靠的情况下，浸润性肿瘤仅限于骨膜和浅表皮质-44%的假阴性。骨侵犯的程度与肿瘤的大小有关，但与其组织学分级无关。下颌骨骨膜在形态学上并不是一个离散的“屏障”，沿下颌骨体沿着的各个点都有浸润，主要与下牙管的走向有关。骨浸润的大体和显微镜模式似乎是相似的照射和非照射切除。复合切除术后复发疾病的发生率和模式在有和无下颌骨侵犯的组中是相同的：在每组中，一半的患者死于疾病，三分之一的患者在2年时存活且无疾病。在这个系列中，单独的下颌骨侵犯似乎并不影响预后。
The radiologic and histologic features of mandibular invasion, and its clinical implications, are considered in a retrospective series of 111 patients with squamous carcinomas of the oral cavity and oropharynx treated by composite resection. Eighty percent of the entire group had either recurrent or advanced (T3, T4) local disease, and 33 patients (30%) had histologic evidence of mandibular invasion by tumor. Preoperative radiologic assessment was unreliable in cases in which infiltrating tumor was confined to the periosteum and superficial cortex-44% false negatives. The extent of bone invasion was found to correlate with the size of the tumor, but not with its histologic grade. The mandibular periosteum was not seen as a morphologically discrete "barrier" and infiltration occurred at various points along the mandibular body, mainly related to the course of the inferior dental canal. The gross and microscopic patterns of bone invasion appeared to be similar in irradiated and nonirradiated resections. The incidence and pattern of recurrent disease following composite resection was the same in the groups with and without mandibular invasion: in each group half the patients were dead from disease and one third alive and free of disease at 2 years. Mandibular invasion alone did not appear to influence prognosis in this series.