本文選題：骨膜三角　切入點(diǎn)：針狀骨膜反應(yīng)　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的分析骨膜三角、針狀骨膜反應(yīng)征象與骨病變良惡性的關(guān)系。方法收集經(jīng)病理結(jié)果證實(shí)并有骨膜反應(yīng)的病例共897例,按病理結(jié)果分成惡性病變組(85例)和良性病變組(812例)。惡性組內(nèi)包括:骨肉瘤54例,軟骨肉瘤12例,轉(zhuǎn)移瘤5例,尤文肉瘤4例,原始神經(jīng)外胚層腫瘤(PNET)2例,神經(jīng)內(nèi)分泌腫瘤1例,分類困難的小圓細(xì)胞惡性腫瘤1例,淋巴瘤2例,顱骨板障內(nèi)惡性腦膜瘤1例,腺泡狀軟組織肉瘤1例,牙齦鱗狀細(xì)胞癌2例。在良性組內(nèi)包括:骨折修復(fù)期或內(nèi)固定術(shù)后725例,骨髓炎67例,朗格漢斯組織細(xì)胞增生癥5例,骨樣骨瘤6例,骨母細(xì)胞瘤3例,含牙囊腫伴慢性化膿性炎1例,骨的纖維結(jié)構(gòu)不良1例,骨結(jié)核1例,骨血管瘤1例,顱骨板障內(nèi)腦膜瘤2例,骨膜下血腫1例。分別計(jì)算良性病變組和惡性病變組中骨膜三角、針狀骨膜反應(yīng)的出現(xiàn)率,對這兩種征象在兩組中的出現(xiàn)率分別進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果有骨膜反應(yīng)的惡性病變共85例,其中50.6%(43/85)出現(xiàn)骨膜三角征象,包括:骨肉瘤33例,軟骨肉瘤5例,尤文肉瘤2例,原始神經(jīng)外胚層腫瘤(PNET)1例、分類困難的小圓細(xì)胞惡性腫瘤1例,轉(zhuǎn)移瘤1例。有骨膜反應(yīng)的良性病變812例,其中0.7%(6/812)可見骨膜三角征象,包括骨髓炎、骨膜下血腫、骨結(jié)核、骨的纖維結(jié)構(gòu)不良、含牙囊腫伴慢性化膿性炎、骨母細(xì)胞瘤各1例。進(jìn)行X2檢驗(yàn)統(tǒng)計(jì)分析,骨膜三角在良惡性病變中的出現(xiàn)率有顯著性差異(X2=360.6,P0.01)。在惡性病變組中35.3%(30/85)的病例出現(xiàn)針狀骨膜反應(yīng),包括:骨肉瘤19例,軟骨肉瘤3例,尤文肉瘤3例,神經(jīng)內(nèi)分泌腫瘤、原始神經(jīng)外胚層腫瘤(PNET)、淋巴瘤、顱骨板障內(nèi)惡性腦膜瘤、轉(zhuǎn)移瘤各1例。而在良性病變組中,僅有0.5%(4/812)的病例可見針狀骨膜反應(yīng),包括顱骨板障腦膜瘤2例,骨髓炎、顱骨血管瘤各1例。進(jìn)行X2檢驗(yàn)統(tǒng)計(jì)分析,針狀骨膜反應(yīng)在良惡性骨病變中的出現(xiàn)率有顯著性差異(X2=246.1,P0.01)。結(jié)論骨膜三角、針狀骨膜反應(yīng)在良惡性骨病變中均可出現(xiàn),多見于惡性腫瘤,少數(shù)情況下也可見于快速進(jìn)展的多種良性病變。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R68;R738;R816.8

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