アブストラクト（25巻4号：神奈川歯学）

神奈川歯学

Japanese

Title　： 下顎歯肉扁平上皮癌の進展様式と術前治療効果について - 組織学的三次元画像解析を中心として -
Subtitle　： 原著
Authors　： 中村昌幸, 志村介三
Authors（kana）　：
Organization　： 神奈川歯科大学口腔外科学教室
Journal　： 神奈川歯学
Volume　： 25
Number　： 4
Page　： 457-474
Year/Month　： 1991 / 3
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」 下顎歯肉癌は歯根模あるいは骨膜を介し, 比較的早期に骨内に浸潤する. したがってその外科的治療として, さまざまな顎骨切除術が行われるが, 手術法の選択には明確な基準がないのが実情である. そのため安全域と称して必要以上に顎骨を切除し, 形態, 機能を損じる一方, 不十分な切除により局所再発をきたし不幸な転帰をとることも少なくない. 必要以上に顎骨を切除することなく, 腫瘍を完全に切除するには, 腫瘍の軟組織および骨組織への進展の実相を把握し, それを的確に診断することが重要である. この点については, これまでX線的, 病理組織的所見を中心に検索されてきたが, それらのほとんどは一面あるいは限られた断面での観察であり, 腫瘍の全体的, 立体的進展状況については明らかではない. 本研究はX線, 組織学的検索に加え, 組織学的三次元画像解析を行い, 腫瘍の立体的な進展様相を追求するとともに, 術前治療の有用性とその意義についても検討した.
Practice　： 歯科学
Keywords　： 下顎歯肉癌, 腫瘍の進展様式, 術前治療効果, 下顎骨切除法, 三次元画像解析

English

Title　： The Developmental Modes of Tumor and the Effects of the Preoperative Therapy on Squamous Cell Carcinoma of Lower Alveolus and Gingiva - Primarily by Histological 3-Dimentional Image Analysis -
Subtitle　：
Authors　： Masayuki NAKAMURA, Kaizo Shimura
Authors（kana）　：
Organization　： Department of Oral Surgery, Kanagawa Dental College
Journal　： Kanagawa Shigaku
Volume　： 25
Number　： 4
Page　： 457-474
Year/Month　： 1991 / 3
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] There have been controversial discussions on the evaluation of mandibular invasion by carcinoma and on the extent or range of resection. In the present study, we examined semicontinuous sections of the surgically resected speciments, using 3-dimensional image analysis. The study was performed on 26 fresh cases of S.C.C. lower alveolus and gingiva. In the T classification (UICC, 1987), there was one case of T1, 8cases of T2, one case of T3, and 16 cases of T4. As the therapeutic methods, 60Co external irradiation (average 24.4 Gy) and chemotherapy (BLM or PEP, CDDP, etc.) were performed independently or in combination. Then, marginal resection was performed for 11 cases, segmental resection for 5 cases, and hemimandibular resection for 10 cases. In the histological development of tumor, the infiltration was limited to the regions from gingiva to alveolar process (alveolar type) in 11 cases, tumor developed to buccal mucosa and buccal cortical bone (buccal type) in 2 cases, to oral floor and lingual cortical bone (lingual type) in 3 cases, and buccolingual mucosa and cortical bone (buccolingual type) in 9 cases, not to cortical bone, only to cancellous bone (intraosseous type) in 1 case. The histological effect of the preoperative therapy was higher on the tip of mandibular infiltation than on soft tissue. On the bony absorption, proliferation of fibrous connective tissues was observed, and active new bones was also seen in some cases. Bone resorption up to mandibular canal was noted in 5 cases, only one case, tumor lesion was found in the canal. The recurrence of primary lesion was found in 3 of 26 cases-all in soft tissues. The above results reveal that bone resection and extensive resetion of soft tissue with full consideration on the developmental modes of tumor are important in the cases of lower alveolus and gingival carcinoma. When considering the possibility of mandible-preserving surgery, preoperative therapy by combining radiotherapy and chemotherapy seemed to be useful.
Practice　： Dentistry
Keywords　：