Objective:To discuss the clinical presentations,diagnosis and management guidelines of calcifying epithelioma(CE) and calcifying epithelial odontogenic tumor(CEOT).Method:13 cases of CE and 4 cases of CEOT were retrospected.Result: All patients were treated surgically.The average age of CE patients was 11.2 years old.69.2%(10 cases) was less than 10 years old.The lesions located on the head and neck in 8 cases(61.5%),on the arms and legs in 4 cases(30.8%) and on the trunk in 1 case(7.7%).The average age of CEOT patients was 38.75 years old.All CEOT lesions located on the mandible or maxilla.There was no obvious sexual difference in both tumors.Both were reported for recurrent and malignant cases.Conclusion: CE and CEOT are obviously different in clinical presentations and pathological diagnosis.Complete surgical excision was necessary for CEOT.

OBJECTIVE:To study the clinical characteristics, diagnosis and treatment strategy of oral and maxillofacial malignancies in multiple primary malignant neoplasms (MPMNs).METHODS:21 cases of oral and maxillofacial malignancies associated with MPMNs admitted to our hospital between 1985 and 2000 were studied respectively.RESULTS:There were 44 malignant cases in the 21 MPMNs patients. Among the 44 cases, there were 24 cases in alimentary and respiratory tract such as oral, pharynx, esophagus, stomach and lung, and 10 cases in salivary gland, breast and female reproductive system. There were 25 cases malignant neoplasms in oral and maxillofacial region where squamous cell carcinoma was the most common pathologic type, secondly adenoid cystic carcinoma. In oral and maxillofacial region, MPMNs were often found in tongue, parotid and submandibular gland, buccal mucosa and gingival.CONCLUSION:Tongue and salivary gland were the common locations with MPMNs, and they were closely associated with alimentary and respiratory tract. Patients with malignancies of oral and maxillofacial region associated with MPMNs must be submitted to a long-term and careful follow-up. For female patients, breast and female reproductive system should be examined specially. Regular follow-up, early detection, early diagnosis, active and effective treatment can help to improve the survival quality of MPMNs patients.

Objective: To analyse the clinical features and proportion of salivary gland malignant neoplasms. Methods: The clinical data of 346 cases pathologically diagnosed as salivary gland malignant neoplasms were analysed retrospectively. Results: The patients were 43.7 years old in average. The ratio of male to female was 1.37:1. According to original sites,the most common were parotid gland,minor salivary gland in palate and submandibular gland successively; according to the original tissues,epithelial neoplasms were most commonly found; according to pathological type,adenoid cystic carcinoma,mucoepidermoid carcinoma and adenocarcinoma ranked the first three. Conclusion: Salivary gland malignant neoplasms occurs in younger patient averagely than oral-maxillofacial malignant neoplasms does. Adenoid cystic carcinoma ranks the first with the pathological type. Parotid gland and minor salivary gland in palate arethe most common original sites.

Objective: To investigate the clinical biological profiles, pathological diagnosis and treatment of verruciform xanthoma of the oral mucosa. Methods: The clinicopathological data of 6 cases with verruciform xanthoma of the oral mucosa were retrospectively analyzed, with follow-up. Results: Five patients were misdiagnosed before the operation. They were confirmed with intraoperative rapid pathological diagnosis and routine postoperative pathological diagnosis. The effective treatment was local excision. No case with recurrence or canceration was found in the follow-up. Conclusions: Misdiagnosis is common on the verruciform xanthoma. Application of the rapid pathological diagnosis during operation is needed when the suspectable malignancy occurs for fear of overtreatment. The prognosis is favourable after local excision.

Objective: To investigate the expression of p16?p21 in the tissues of pleomorphic adenoma (PA) and malignant pleomorphic adenoma (MPA) and to reveal their roles in the occurrence and development of PA and MPA. Methods: We studied the expression of p16?p21 in 10 samples of normal salivary gland tissues(NM),60 samples of PA, 40 samples of MPA by SABC immunohistochemichal technique. Results: 1.p16 expression: The positive expression rate was 100% in NM, 95% in PA and 82.5% in MPA.There were significant statistical differences (P0.05) between NM and MPA,PA and MPA,but not between NM and PA. 2.p21expression:The positive expression rate was 0% in NM,65% in PA and 72.5% in MPA.There were significant statistical differences (P0.01) between NM and PA, NM and MPA, but not between PA and MPA. Conclusion: 1.The results indicate that p16 gene aberration may be involved in the development of PA and MPA; 2.The overexpression of p21 may play an important role in the early stage of the tumorigenesis.

OBJECTIVE To study the mechanism of p16 gene inactivation in salivary adenoid cystic carcinoma. METHODS 53 cases of freshly excised salivary adenoid cystic carcinomas were studied. Polymerase chain reaction (PCR) and single-stranded conformation polymorphism analysis of polymerase chain reaction products (PCR-SSCP) were used to detect deletion and mutation of p16 gene in salivary adenoid cystic carcinomas. Methylation specific PCR (MSP) was used to detect the methylation status of p16 gene. RESULTS The homozygous deletion, mutation and hypermethylation of p16 gene were noted in 16 cases (30.2%), 4 cases (7.5%) and 26 cases (49.1%) respectively in 53 cases of salivary adenoid cystic carcinomas. CONCLUSION The main inactivation mechanisms of p16 gene in salivary adenoid cystic carcinoma were hypermethylation and homozygous deletion. The mutation p16 gene was rare in salivary adenoid cystic carcinoma.

目的研究ras基因表达与恶性多形性腺瘤(MPA)预后的相互关系.方法随访40例MPA,应用免疫组化SABC技术检测ras基因产物(ras p21)在MPA中的表达情况.结果 ras p21 阳性的患者生存率显著高于阴性(P＜0.01),生存期亦显著延长;未复发组的ras p21阳性率显著高于复发组(P＜0.05).结论 ras p21表达水平与MPA的预后密切相关.

研究牙槽嵴植骨术对Wistar大白鼠上颌骨生长发育的影响及机制.选用40只Wistar大白鼠,随机分为4组,分别为空白对照组和第4、6、8周龄手术组.应用定位X线头影测量技术,在术前和术后每隔两周对所有实验动物进行一次上颌骨长、宽、高三个方向生长发育状况的测量和比较.结果表明:(1)4周龄和6周龄手术组,上颌骨长度及前部垂直高度均小于对照组.(2)8周龄手术组,上颌长度与对照组相比无显著性差异,但其前部高度发育与对照组相比有显著性差异.(3)随手术时间的提前,上颌长度和前部高度的发育障碍更加严重.(4)与正常对照组相比,4周龄、6周龄和8周龄手术组,上颌的宽度发育没有受到影响.结论:牙槽嵴植骨术会严重影响上颌骨长度和高度的发育,鼻中隔前颌韧带系统的破坏使鼻中隔软骨的生物性生长力的刺激不能有效传导至上颌可能是牙槽嵴植骨术后上颌异常生长的主要原因.

Objective:In order to analyze the significance of ras and c-erbB-2 overexpression in human salivary gland pleomorhic adenomas.Methods:We examined 52 benign pleomorphic adenomas(BPA),13 malignant pleomorphic adenomas(MPA) and 6 normal salivary gland tissues by immunohistochemical assays.Results:The postitive tumors of ras was 50.0% in BPA and 61.5% in MPA,which levels significantly higher than in normal tissues( P0.0005). The positive tumors of c-erbB-2 was 19.2% on BPA and 53.9% in MPA,which levels significantly higher than in normal tissues( P0.0005) ,and MPA showed significantly higher levels than BPA (P 0.005).The positive tumors of c-erbB-2 in recurrent tumors also demonstrated higher levels than did in primary tumors. Conclusion:The results indicates that enhanced ras expression may be involved in the early stage of salivary gland carcinogenesis,and c-erbB-2 overexpression probably play an important role in the progression and malignant transformation of the pleomorphic adenomas and may be a latent recurrent factor.

应用免疫组织化学ＳＡＢＣ法，对５２例良性多形性腺瘤（ＢＰＡ）、１３例恶性多形性腺瘤（ＭＰＡ）、６例正常人（对照组）涎腺组织中的ｒａｓＰ２１蛋白进行检测。结果对照组ｒａｓＰ２１蛋白阳性率为０，ＢＰＡ组为８０．７７％，ＭＰＡ组为９２．３０％；ＢＰＡ及ＭＰＡ组与对照组比较均有显著性差异（Ｐ＜０．０１）；ＢＰＡ与ＭＰＡ组间无明显差异；ＢＰＡ组复发患者的阳性率较初发患者低。提示ｒａｓＰ２１的表达对多形性腺瘤的发生起始动作用。