177例儿童口腔颌面部恶性肿瘤临床病理分析

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (2): 134-139.

177例儿童口腔颌面部恶性肿瘤临床病理分析

李思源¹, 郭雪生², 单小峰¹, 蔡志刚¹

1.北京大学口腔医院口腔颌面外科,北京100081;
2.北京市平谷区医院口腔科,北京 101200

收稿日期:2015-04-09 出版日期:2016-03-20 发布日期:2016-04-06
通讯作者: 蔡志刚,E-mail:czg4209@126.com
作者简介:李思源（1989-）,女,硕士,E-mail:lisiyuan@mail3.sysu.edu.cn
基金资助:
国家自然科学基金（81371162,81100762,30973336）

Clinical features of oral and maxillofacial malignant tumors in 177 Chinese children

LI Si-yuan¹, GUO Xue-sheng², SHAN Xiao-feng¹, CAI Zhi-gang¹

1.Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology. Beijing 100081; 2.Department of Stomatology, Capital Medical University Pinggu Teaching Hospital. Beijing 101200, China

Received:2015-04-09 Online:2016-03-20 Published:2016-04-06

摘要/Abstract

摘要： 目的:分析儿童口腔颌面部恶性肿瘤的构成和分布特点。方法:回顾2004—2013年于本院口腔颌面外科住院治疗的18岁以下口腔颌面部恶性肿瘤病例,按照性别、年龄、部位、病理类型、治疗方法等进行统计分析。结果:共收集儿童口腔颌面部肿瘤及瘤样病变住院病例1892例,其中恶性肿瘤177例,占9.4%。恶性肿瘤中,男77例,女100例,男女比例1:1.3;患者年龄2个月~17.8岁,中位年龄10岁。腮腺（28.8%）、下颌骨（15.3%）、面侧深区（11.9%）、上颌骨（10.7%）是最常见的发病部位。肉瘤（46.3%）、唾液腺癌（28.8%）和恶性淋巴瘤（11.9%）是最常见的病种。其中,黏液表皮样癌、横纹肌肉瘤、非霍奇金淋巴瘤是最常见的病理类型。口腔颌面部肉瘤与腺癌的治疗采取以手术为主的综合序列治疗,而恶性淋巴瘤主要采取以化疗为主的综合序列治疗。结论:儿童口腔颌面部恶性肿瘤构成和分布特点与成年人不同,病理类型是决定儿童口腔颌面部恶性肿瘤患者治疗方案的关键因素。

关键词: 儿童, 口腔颌面部, 恶性肿瘤

Abstract: PURPOSE: To evaluate the composition and distribution of oral and maxillofacial malignant tumors in Chinese children. METHODS: A retrospective review of oral and maxillofacial malignant tumors of children under 18 years old, and in 2004-2013 from the records of the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology was carried out. All cases were analyzed according to site, age, gender, histological type and treatment method. RESULTS: Of all 1892 cases of tumors and tumor-like lesions in children admitted to our hospital from 2004 to 2013, 177 were malignant tumors, which constituted 9.4% of all cases. In malignant tumors, the male to female ratio was 1(n=77) to 1.3 (n=100). Their age ranged from 2 months to 17.8 years, and the median age was 10 years. The most common sites were parotid gland (28.8%), mandible (15.3%), lateral deep face (11.9%), and maxilla (10.7%). Sarcoma (46.3%) was the most common malignancy, followed by adenocarcinomas (28.8%) and malignant lymphomas (11.9%). Mucoepidermoid carcinomas, rhabdomyosarcomas, non-Hodgkin's lymphomas were the most common pathological types. Surgery dominated sequential therapy was the mainstay of treatment for sarcomas and carcinomas, while chemotherapy based comprehensive and sequential therapy was predominant treatment of malignant lymphomas. CONCLUSIONS: The composition and distribution of oral and maxillofacial malignant tumors in Chinese children are different from adults. Pathological type is an important factor which determines the therapeutic schedule of these patients.

Key words: Children, Oral and maxillofacial, Malignant tumor

中图分类号:

R739.8

李思源, 郭雪生, 单小峰, 蔡志刚. 177例儿童口腔颌面部恶性肿瘤临床病理分析[J]. 中国口腔颌面外科杂志, 2016, 14(2): 134-139.

LI Si-yuan, GUO Xue-sheng, SHAN Xiao-feng, CAI Zhi-gang. Clinical features of oral and maxillofacial malignant tumors in 177 Chinese children[J]. China J Oral Maxillofac Surg, 2016, 14(2): 134-139.

参考文献

[1] Skinner RL, Davenport WD Jr, Weir JC, et al. A survey of biopsied oral lesions in pediatric dental patients [J]. Pediatr Dent, 1986, 8(2): 163-167.
[2] Das S, Das AK. A review of pediatric oral biopsies from a surgical pathology service in a dental school [J]. Pediatr Dent, 1993, 15(3): 208-211.
[3] Ulmansky M, Lustmann J, Balkin N. Tumors and tumor-like lesions of the oral cavity and related structures in Israeli children [J]. Int J Oral Maxillofac Surg, 1999, 28(4): 291-294.
[4] Adebayo ET, Ajike SO, Adekeye EO. Tumours and tumour-like lesions of the oral and perioral structures of Nigerian children [J]. Int J Oral Maxillofac Surg, 2001, 30(3): 205-208.
[5] Aregbesola SB, Ugboko VI, Akinwande JA, et al. Orofacial tumours in suburban Nigerian children and adolescents [J]. Br J Oral Maxillofac Surg, 2005, 43(3): 226-231.
[6] Lei F, Chen JY, Lin LM, et al. Retrospective study of biopsied oral and maxillofacial lesions in pediatric patients from Southern Taiwan [J]. J Dent Sci, 2014, 9(4): 351-358.
[7] Sato M, Tanaka N, Sato T, et al. Oral and maxillofacial tumours in children: a review [J]. Br J Oral Maxillofac Surg, 1997, 35(2): 92-95.
[8] 陆先韫, 汪阿冬. 儿童口腔颌面部肿瘤的特点894例病理活检分析 [J]. 实用口腔医学杂志, 1986, 2(2): 84-87.
[9] 孟庆荣, 张三友, 刘果生. 儿童口腔颌面部肿瘤803例临床分析 [J].华西口腔医学杂志, 1990, 8(4): 280-282.
[10] 张金哲. 现代小儿肿瘤外科学 [M]. 第2版. 北京: 科学出版社, 2009.
[11] 张金哲, 杨启政. 实用小儿肿瘤学 [M]. 郑州: 河南医科大学出版社, 2001.
[12] 温玉明,代晓明,王昌美,等.口腔颌面部恶性肿瘤6539例临床病理分析 [J].华西口腔医学杂志, 2001, 19(5): 296-299.
[13] Li LJ, Li Y, Wen YM, et al. Clinical analysis of salivary gland tumor cases in West China in past 50 years [J]. Oral Oncol, 2008, 44(2): 187-192.
[14] 张震康, 俞光岩. 口腔颌面外科学 [M]. 北京: 北京大学医学出版社, 2007: 285-286.
[15] Yu GY, Li ZL, Ma DQ, et al. Diagnosis and treatment of epithelial salivary gland tumours in children and adolescents [J]. Br J Oral Maxillofac Surg, 2002, 40(5): 389-392.
[16] Dubey S, Sengupta SK, Kaleh LK, et al. Paediatric head and neck lymphomas in Papua New Guinea: a review and analysis of 67 cases [J]. Int J Pediatr Otorhinolaryngol, 1998, 43(3): 235-240.
[17] Roh JL, Huh J, Moon HN. Lymphomas of the head and neck in the pediatric population [J]. Int J Pediatr Otorhinolaryngol, 2007, 71(9): 1471-1477.
[18] Gaini RM, Romagnoli M, Sala A, et al. Lymphomas of head and neck in pediatric patients [J]. Int J Pediatr Otorhinolaryngol, 2009, 73(Suppl 1): S65-70.
[19] Hanna E, Wanamaker J, Adelstein D, et al. Extranodal lymphomas of the head and neck. A 20-year experience [J]. Arch Otolaryngol Head Neck Surg, 1997, 123(12): 1318-1323.