骨膜三角、针状骨膜反应与骨病变良恶性的关系

发布时间：2018-03-20 12:53

本文选题：骨膜三角　切入点：针状骨膜反应　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的分析骨膜三角、针状骨膜反应征象与骨病变良恶性的关系。方法收集经病理结果证实并有骨膜反应的病例共897例,按病理结果分成恶性病变组(85例)和良性病变组(812例)。恶性组内包括:骨肉瘤54例,软骨肉瘤12例,转移瘤5例,尤文肉瘤4例,原始神经外胚层肿瘤(PNET)2例,神经内分泌肿瘤1例,分类困难的小圆细胞恶性肿瘤1例,淋巴瘤2例,颅骨板障内恶性脑膜瘤1例,腺泡状软组织肉瘤1例,牙龈鳞状细胞癌2例。在良性组内包括:骨折修复期或内固定术后725例,骨髓炎67例,朗格汉斯组织细胞增生症5例,骨样骨瘤6例,骨母细胞瘤3例,含牙囊肿伴慢性化脓性炎1例,骨的纤维结构不良1例,骨结核1例,骨血管瘤1例,颅骨板障内脑膜瘤2例,骨膜下血肿1例。分别计算良性病变组和恶性病变组中骨膜三角、针状骨膜反应的出现率,对这两种征象在两组中的出现率分别进行统计学分析。结果有骨膜反应的恶性病变共85例,其中50.6%(43/85)出现骨膜三角征象,包括:骨肉瘤33例,软骨肉瘤5例,尤文肉瘤2例,原始神经外胚层肿瘤(PNET)1例、分类困难的小圆细胞恶性肿瘤1例,转移瘤1例。有骨膜反应的良性病变812例,其中0.7%(6/812)可见骨膜三角征象,包括骨髓炎、骨膜下血肿、骨结核、骨的纤维结构不良、含牙囊肿伴慢性化脓性炎、骨母细胞瘤各1例。进行X2检验统计分析,骨膜三角在良恶性病变中的出现率有显著性差异(X2=360.6,P0.01)。在恶性病变组中35.3%(30/85)的病例出现针状骨膜反应,包括:骨肉瘤19例,软骨肉瘤3例,尤文肉瘤3例,神经内分泌肿瘤、原始神经外胚层肿瘤(PNET)、淋巴瘤、颅骨板障内恶性脑膜瘤、转移瘤各1例。而在良性病变组中,仅有0.5%(4/812)的病例可见针状骨膜反应,包括颅骨板障脑膜瘤2例,骨髓炎、颅骨血管瘤各1例。进行X2检验统计分析,针状骨膜反应在良恶性骨病变中的出现率有显著性差异(X2=246.1,P0.01)。结论骨膜三角、针状骨膜反应在良恶性骨病变中均可出现,多见于恶性肿瘤,少数情况下也可见于快速进展的多种良性病变。
[Abstract]:Objective to analyze the relationship between the signs of periosteal triangle, acicular periosteal reaction and benign and malignant bone lesions. Methods 897 cases with periosteal reaction confirmed by pathology were collected. According to the pathological results, there were 85 cases of malignant lesions and 812 cases of benign lesions, including 54 cases of osteosarcoma, 12 cases of chondrosarcoma, 5 cases of metastatic tumor, 4 cases of Ewing's sarcoma and 2 cases of primitive neuroectodermal tumor. One case of neuroendocrine tumor, 1 case of small round cell malignant tumor, 2 cases of lymphoma, 1 case of malignant meningioma in skull plate barrier, 1 case of acinar soft tissue sarcoma. Two cases of squamous cell carcinoma of gingival were included in benign group: 725 cases of fracture repair or internal fixation, 67 cases of osteomyelitis, 5 cases of Langerhans histiocytosis, 6 cases of osteoid osteoma, 3 cases of osteoblastoma, 5 cases of Langerhans histiocytosis, 6 cases of osteoid osteoma, 3 cases of osteoblastoma. There were 1 case of dental cyst with chronic suppurative inflammation, 1 case of fibrous dysplasia of bone, 1 case of bone tuberculosis, 1 case of bone hemangioma, 2 cases of meningioma of skull plate barrier. Subperiosteal hematoma in 1 case. The occurrence rate of periosteal triangle and acicular periosteal reaction in benign lesion group and malignant lesion group were calculated respectively. Results there were 85 cases of malignant lesions with periosteal reaction, including 50.643 / 85), including 33 cases of osteosarcoma, 5 cases of chondrosarcoma, 2 cases of Ewing's sarcoma, 3 cases of osteosarcoma, 5 cases of chondrosarcoma, 2 cases of Ewing's sarcoma, 5 cases of osteosarcoma, 5 cases of chondrosarcoma and 2 cases of Ewing's sarcoma. There were 1 case of primitive neuroectodermal tumor, 1 case of small round cell malignant tumor with difficult classification, 1 case of metastatic tumor, 812 cases of benign lesions with periosteal reaction, of which 0.7% of 812 cases showed signs of periosteum triangulation, including osteomyelitis, subperiosteal hematoma, bone tuberculosis. The fibrous structure of bone was poor, including dental cyst with chronic suppurative inflammation, osteoblastoma in 1 case each. There was significant difference in the occurrence rate of periosteal triangle in benign and malignant lesions (P 0.01). Acicular periosteal reaction was found in 35. 33% of 85 cases of malignant lesions, including 19 cases of osteosarcoma, 3 cases of chondrosarcoma, 3 cases of Ewing's sarcoma, 3 cases of neuroendocrine tumor, 3 cases of osteosarcoma, 3 cases of Ewing's sarcoma, and 3 cases of neuroendocrine tumor. Primary neuroectodermal tumors, lymphoma, malignant meningiomas within the cranial plate barrier, and metastatic tumors were found in 1 case each. In benign lesions, only 0.5% of 812 cases showed acicular periosteal reactions, including 2 cases of meningoma of the skull plate barrier, 2 cases of osteomyelitis, and 1 case of osteomyelitis. The incidence of acicular periosteal reaction in benign and malignant bone lesions was significantly different from that in benign and malignant bone lesions. Conclusion both periosteal triangle and acicular periosteal reaction can be found in benign and malignant bone lesions. It is more common in malignant tumors and, in a few cases, in rapid progression of various benign lesions.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R68;R738;R816.8

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