エナメル上皮腫再発に関与する因子の臨床病理学的検討

DOI Web Site Web Site 参考文献19件
  • 倉沢 泰浩
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 森田 圭一
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 高原 楠旻
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 友松 伸允
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 佐久間 朋美
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 原園 陽介
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野
  • 池田 通
    東京医科歯科大学大学院医歯学総合研究科口腔病理学分野
  • 依田 哲也
    東京医科歯科大学大学院医歯学総合研究科顎顔面外科学分野

書誌事項

タイトル別名
  • A clinicopathological study on the recurrence of ameloblastoma
  • エナメル ジョウヒ シュ サイハツ ニ カンヨ スル インシ ノ リンショウ ビョウリガクテキ ケントウ

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<p>Ameloblastoma is a benign odontogenic tumor with locally aggressive characteristics and a high recurrence rate. The aim of this study was to evaluate the risk factors for recurrence, and to determine the appropriate treatment for ameloblastoma. The study was conducted in the Department of Maxillofacial Surgery, Tokyo Medical and Dental University Hospital, covering the years 1992–2018. The following were recorded and analyzed: patient demographic data, tumor site and maximum tumor size, World Health Organization classification, treatment method, positional relationship between tumor and mandibular canal, whether or not patients had a preoperative biopsy confirmation report, effect of marsupialization, treatment of teeth in contact with the tumor, duration of follow-up, and timing of recurrence. The treatment methods were classified into four groups: enucleation after marsupialization, enucleation, resection with bone margin after marsupialization, and resection with bone margin. The potential risk factors were analyzed using exploratory factor analysis and Cox regression tests. 101 cases of ameloblastoma were reviewed, including 60 male patients and 41 female patients. A wide age range (11 to 84 years) and a median age at first visit of 36 were recorded, with most cases being mandibular tumors (93.1%). The recurrence rate was 23.8% (24 of 101 cases), and all recurrent cases received enucleation after marsupialization, or enucleation. Cox regression tests showed that recurrence was significantly associated with conservative treatment of teeth in contact with the tumor (hazard ratio = 2.45, 95% confidence interval = 1.06 − 5.67, p = 0.036). In addition, exploratory factor analysis showed that it is also important to obtain a definitive diagnosis by biopsy in order to prevent recurrence. The observation period for recurrent cases ranged from 3.7 months to 127.9 months (median 34.6 months), and 75% of recurrences developed within 5 years after enucleation. There were also cases of recurrence more than 10 years after enucleation, therefore long-term follow-up is recommended.</p>

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