摘要
目的探讨8例下颌骨朗格汉斯细胞组织细胞增生症(LCH)的临床特点、病理学特点、诊断及治疗。方法回顾性分析2010年1月至2019年8月郑州大学第一附属医院收治的8例下颌骨LCH患者的临床特点、病理学特点、治疗及预后。结果8例LCH患者中7例为单系统(SS)疾病,1例为多系统(MS)疾病。好发于儿童,儿童与成人发病率之比为5∶3。5例患者以颌面部肿胀、疼痛为主诉就诊;2例因牙龈增生溃烂就诊;1例因牙齿松动就诊。CT均提示颌骨的溶骨性破坏,免疫组化中Langerin(CD207)、CD1a均为阳性。所有患者均接受不同组合的综合序列治疗。1例术后19个月SS多病灶发病,化疗联合放疗后疾病稳定;1例术后4个月局灶复发,化疗后疾病稳定。结论对于下颌骨LCH,建议SS疾病接受手术治疗,MS疾病术后辅助化疗可取得较好的疗效及预后。
Objective To explore the clinical manifestations,pathological characteristics,diagnosis and therapy of langerhans cell histiocytosis(LCH)of mandible.Methods Eight patients with LCH of mandible in the First Affiliated Hospital of Zhengzhou University from January 2010 to August 2019 were selected.Their clinical manifestations,pathological characteristics,treatment and prognosis were retrospectively analyzed.Results Among the 8 cases,7 cases were single system(SS)disease and 1 case was multi-system(MSS)disease.The disease mainly occurred in children,and the incidence rate of children and adults was 5∶3.The chief complaints of 5 patients were maxillofacial swelling and pain.Two patients had gingival hyperplasia and ulceration.One patient was treated because of loose teeth.CT prompted extensive osteolytic destruction of mandible.Langerin(CD207)and CD1a were both positive in immunohistochemistry.All patients were treated with different combinations of comprehensive therapy.One case developed SS multiple lesions 19 months after operation,and the disease was stable after chemotherapy and radiotherapy.One case had local recurrence 4 months after operation,and the disease was stable after chemotherapy.Conclusion For LCH of mandible,surgical treatment for SS disease is recommended,and postoperative adjuvant chemotherapy for MS disease can achieve better curative effect and prognosis.
作者
陈艳
孙悦
赵志强
孙晶晶
谢卫红
CHEN Yan;SUN Yue;ZHAO Zhi-qiang;SUN Jing-jing;XIE Wei-hong(Department of Oral and Maxillofacial Surgery Ward 2,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2020年第13期2337-2340,共4页
Henan Medical Research
