川东北地区颌下颈部包块临床病理分析(1)
摘要：目的 探讨川东北地区颌下颈 部包块的临床病理特征，提高诊断准确率。方法 收集我院收治的颌下颈部包块患者资料，对其病历资料进行回顾，分析构成比，对每种疾病包含的临床和病理特征进行对比。结果 总共110例病例包括20种疾病，全部经过病理确诊，其中肿瘤性肿块占比最大，先天性肿块占比最少，良性肿块较多见，良恶比=4.24∶1。结论 川东北地区颌下颈部包块患者具有独特的临床病理特征，疾病构成比与其他地区不同，需要结合临床表现，影像学结果和病理检查结果方能确诊。
关键词：川东北地区；颌下颈部包块；临床病理分析
中图分类号：R782 文献标识码：B
A Clinical and Pathological Analysis of the Inferior Cervical Mass in Northeastern Sichuan
, 百拇医药 QIU Ya，MI Fang-lin，JIA Ai-min，LI Li-hua
(Department of Stomatology，Affiliated Hospital of Chuanbei Medical College，Nanchong 637000，Sichuan，China)
Abstract：Objective To implore the clinical pathological characteristics of patients with submandibular and cervical masses in northeast Sichuan area and improve the accurate diagnosis rate.Methods The clinical data of patients with submandibular and cervical masses in our hospital was collected and analyzed retrospectively. Constituent ratio was analyzed.Clinical features and pathologic features were compared to find out related laws and effects of different diagnosis methods.Results A total of 110 cases involved in 20 kinds of disease were all perfomed by pathological diagnosis whose result showed the tumorous masses's proportion was the largest ，however congenital masses accounting was the least， and benign was more than malignancy by contrast ratio = 4.24：1. Conclusion Patients with submandibular and cervical masses in northeast Sichuan possessd unique clinical pathological characteristics.The constituent ratio of these different kinds of disease was vary from other regions.Accurate diagnosis could be done by combining with the clinical manifestations， imaging and pathological examination results.
, 百拇医药
Key words：Northeast Sichuan area；Submandibular and cervical masses；Clinical and pathologic analysis
頜下颈部包块是头颈颌面外科常见的一组综合征，因其病因和组织来源比较复杂，病理类型多样，诊断常常比较困难。对我院收治的颌下颈部包块患者进行回顾分析，判断颌下颈部包块患者的临床病理特征，找到规律，以期对临床诊断治疗有一定的指导作用。
1 资料与方法
1.1一般资料 来自2011年9月～2015年8月我院颌面外科收治的以“颌下或颈部包块”首诊的住院患者，男性66例，女性44例，男∶女=1.5∶1，年龄1～83岁，中位年龄43岁，位于左侧68例，右侧37例，正中5例，左∶右=1.84∶1，以舌骨和环甲膜水平为界分为上颈，中颈，下颈三部分，颌下包块49例，占包块总数44.55%，颈上部包块35例，占比31.82%，颈中部包块17例，占比15.45%，颈下部包块 9例，占比8.18%。患者入院后均行B超和CT平扫或增强，其中有3例因位置深在紧邻颈鞘做了磁共振检查，另有15例行细针穿刺活检，患者均行手术切除或切取病理组织检查，其中术中冰冻活检29例，手术后均行石蜡切片病理检查，有15例行免疫组化染色。
, 百拇医药
2 结果
总共110例颌下颈部包块患者中，炎症性包块共32例，占包块总数的29.09%，先天性肿块(甲状舌管囊肿和鳃裂囊肿)7例，占比6.36%，潴留性肿块10例，占比9.09%，肿瘤性肿块61例，占比55.45%。全部病例中良性肿块89例，占包块总数的80.91%，恶性肿块21例，占比19.09%，良恶比为4.24∶1，见表1。恶性肿块全部为肿瘤性，包括颌下腺癌，淋巴瘤，淋巴结转移性癌，神经内分泌癌四种类型，转移性癌患者除了一例位于下颈部的未找到原发灶外，其余都找到原发灶，原发灶分别位于鼻咽和甲状腺，其中鼻咽癌来源的颈部包块为低分化腺癌，符合原发灶病理类型。资料中的良性肿瘤包括颌下腺多形性腺瘤，淋巴管瘤，脂肪瘤，神经鞘瘤，血管瘤，肌上皮瘤，平滑肌瘤，韧带样型纤维瘤病，乳头状淋巴囊腺瘤几种共40例。良性肿瘤∶恶性肿瘤=1.91∶1。术后病理诊断结果显示CT，核磁共振，彩超的诊断符合率为88.7%，误诊率11.3%，诊断价值高，细针穿刺活检的确诊率为100%。本组资料临床首诊与确诊相符合68例，不符合者42例，诊断符合率为61.82%，误诊率38.18%，见表1。, http://www.100md.com(邱亚 米方林 贾艾敏 李丽华)
关键词：川东北地区；颌下颈部包块；临床病理分析
中图分类号：R782 文献标识码：B
A Clinical and Pathological Analysis of the Inferior Cervical Mass in Northeastern Sichuan
, 百拇医药 QIU Ya，MI Fang-lin，JIA Ai-min，LI Li-hua
(Department of Stomatology，Affiliated Hospital of Chuanbei Medical College，Nanchong 637000，Sichuan，China)
Abstract：Objective To implore the clinical pathological characteristics of patients with submandibular and cervical masses in northeast Sichuan area and improve the accurate diagnosis rate.Methods The clinical data of patients with submandibular and cervical masses in our hospital was collected and analyzed retrospectively. Constituent ratio was analyzed.Clinical features and pathologic features were compared to find out related laws and effects of different diagnosis methods.Results A total of 110 cases involved in 20 kinds of disease were all perfomed by pathological diagnosis whose result showed the tumorous masses's proportion was the largest ，however congenital masses accounting was the least， and benign was more than malignancy by contrast ratio = 4.24：1. Conclusion Patients with submandibular and cervical masses in northeast Sichuan possessd unique clinical pathological characteristics.The constituent ratio of these different kinds of disease was vary from other regions.Accurate diagnosis could be done by combining with the clinical manifestations， imaging and pathological examination results.
, 百拇医药
Key words：Northeast Sichuan area；Submandibular and cervical masses；Clinical and pathologic analysis
頜下颈部包块是头颈颌面外科常见的一组综合征，因其病因和组织来源比较复杂，病理类型多样，诊断常常比较困难。对我院收治的颌下颈部包块患者进行回顾分析，判断颌下颈部包块患者的临床病理特征，找到规律，以期对临床诊断治疗有一定的指导作用。
1 资料与方法
1.1一般资料 来自2011年9月～2015年8月我院颌面外科收治的以“颌下或颈部包块”首诊的住院患者，男性66例，女性44例，男∶女=1.5∶1，年龄1～83岁，中位年龄43岁，位于左侧68例，右侧37例，正中5例，左∶右=1.84∶1，以舌骨和环甲膜水平为界分为上颈，中颈，下颈三部分，颌下包块49例，占包块总数44.55%，颈上部包块35例，占比31.82%，颈中部包块17例，占比15.45%，颈下部包块 9例，占比8.18%。患者入院后均行B超和CT平扫或增强，其中有3例因位置深在紧邻颈鞘做了磁共振检查，另有15例行细针穿刺活检，患者均行手术切除或切取病理组织检查，其中术中冰冻活检29例，手术后均行石蜡切片病理检查，有15例行免疫组化染色。
, 百拇医药
2 结果
总共110例颌下颈部包块患者中，炎症性包块共32例，占包块总数的29.09%，先天性肿块(甲状舌管囊肿和鳃裂囊肿)7例，占比6.36%，潴留性肿块10例，占比9.09%，肿瘤性肿块61例，占比55.45%。全部病例中良性肿块89例，占包块总数的80.91%，恶性肿块21例，占比19.09%，良恶比为4.24∶1，见表1。恶性肿块全部为肿瘤性，包括颌下腺癌，淋巴瘤，淋巴结转移性癌，神经内分泌癌四种类型，转移性癌患者除了一例位于下颈部的未找到原发灶外，其余都找到原发灶，原发灶分别位于鼻咽和甲状腺，其中鼻咽癌来源的颈部包块为低分化腺癌，符合原发灶病理类型。资料中的良性肿瘤包括颌下腺多形性腺瘤，淋巴管瘤，脂肪瘤，神经鞘瘤，血管瘤，肌上皮瘤，平滑肌瘤，韧带样型纤维瘤病，乳头状淋巴囊腺瘤几种共40例。良性肿瘤∶恶性肿瘤=1.91∶1。术后病理诊断结果显示CT，核磁共振，彩超的诊断符合率为88.7%，误诊率11.3%，诊断价值高，细针穿刺活检的确诊率为100%。本组资料临床首诊与确诊相符合68例，不符合者42例，诊断符合率为61.82%，误诊率38.18%，见表1。, http://www.100md.com(邱亚 米方林 贾艾敏 李丽华)