oral pathology

口腔病理学
  • 文章类型: Journal Article
    口腔局灶性粘液病(OFM)是1974年首次描述的罕见病变,但病因尚不清楚。临床上,OFM表现为无症状性结节性病变,临床特征与其他软组织损伤的相似性使诊断变得困难。这项研究的目的是整合人口统计学,临床,和组织病理学特征从以前发表的OFM病例纳入系统评价。在以下数据库中进行了无发布日期限制的电子搜索:Embase,PubMed,Medline,WebofScience,还有Scopus.包括以英文发表并提供足够的临床和组织病理学信息的OFM病例报告或病例系列。这项系统评价确定了来自12个国家的42项研究,包括113例OFM。这种病变影响了女性多于男性,通常在生命的第四个十年。牙龈是最常见的解剖位置,其次是味觉。临床表现最常见的是无症状结节。影像学检查显示,大多数病例没有骨骼受累。手术切除是大多数病例的首选治疗方法,仅报告了一例复发病例。总之,OFM是一种罕见的病理学,其诊断依赖于组织病理学分析。该病变可作为口腔良性软组织病变的鉴别诊断。尤其是那些影响牙龈的。
    Oral focal mucinosis (OFM) is a rare lesion first described in 1974, but the aetiology remains unknown. Clinically, OFM presents as an asymptomatic nodular lesion and the similarity of clinical features to other soft tissue injuries makes the diagnosis difficult. The aim of this study was to integrate the demographic, clinical, and histopathological characteristics from previously published cases of OFM into a systematic review. Electronic searches without publication date restriction were performed in the following databases: Embase, PubMed, Medline, Web of Science, and Scopus. Case reports or case series of OFM published in English and presenting enough clinical and histopathological information were included. This systematic review identified 42 studies from 12 countries, comprising 113 cases of OFM. This lesion affected more females than males, usually in the fourth decade of life. The gingiva was the most common anatomical location, followed by the palate. Clinical presentation was most often an asymptomatic nodule. Imaging exams revealed that most cases did not have bone involvement. Surgical removal was the treatment of choice for most cases and only one recurrent case was reported. In conclusion, OFM is an uncommon pathology, and its diagnosis depends on histopathological analysis. The lesion could be included as a differential diagnosis of benign soft tissue lesions of the oral cavity, especially those affecting the gingiva.
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  • 文章类型: Case Reports
    外植体间充质软骨黏液样肿瘤(ECT)是一种罕见的软组织肿瘤,具有独特的组织发生,表现出对舌背的偏爱。分子证据表明,它可能源于外胚间充质多能细胞从神经c迁移到舌头,这些细胞可能最终增殖并经历粘液样和软骨样分化。本文说明了一例16岁的女性患者,她的舌背结节,已经存在了四年。进行了手术切除,组织病理学分析显示,在含有软骨样区域的松散基质中,由多边形和梭形细胞组成的粘液样瘤变。在免疫组织化学研究中,肿瘤细胞GFAP和S-100蛋白阳性,确认ECT的诊断。经过5年的随访,患者没有复发的证据。虽然罕见,由于其独特的临床特征,ECT可以直接诊断,组织病理学,和免疫组织化学特征。临床医生和病理学家应该熟悉这种肿瘤,以避免误诊。
    Ectomesenchymal chondromyxoid tumor (ECT) is a rare soft tissue tumor with peculiar histogenesis, exhibiting a predilection for the dorsum of the tongue. Molecular evidence suggests that it may originate from the migration of ectomesenchymal pluripotent cells from the neural crest to the tongue, where these cells may eventually proliferate and undergo myxoid and chondroid differentiation. This article illustrates a case of a 16-year-old female patient who presented with a nodule on the dorsum of her tongue, which had been present for four years. Surgical excision was performed, and histopathological analysis revealed a myxoid neoplasia composed of polygonal and spindle cells within a loose stroma containing chondroid areas. Tumor cells were positive for GFAP and S-100 proteins on immunohistochemical study, confirming the diagnosis of ECT. After a 5-year follow-up, the patient has shown no evidence of recurrence. Although rare, ECT can be diagnosed straightforwardly due to its distinctive clinical, histopathological, and immunohistochemical features. Clinicians and pathologists should become familiar with this tumor in order to avoid misdiagnosis.
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  • 文章类型: Case Reports
    脂肪瘤是人体最常见的间质瘤之一,在40至60岁之间表现出更高的患病率。然而,原发性口内脂肪瘤是罕见的。粘液样脂肪瘤,以丰富的粘液成分为特征,是一种特别罕见的脂肪瘤组织学亚型.这项研究提出了两例发生在常见年龄范围之外的粘液样脂肪瘤,一个在67岁男性的右颌下区域,另一个在3岁儿童的下唇。通过这些病例报告,目的是引入粘液样脂肪瘤,一种影响面部区域的罕见亚型,并提供一个简短的审查,以协助鉴别诊断,强调病理评估的重要性。即使在年龄组和解剖位置通常不与脂肪瘤相关,强调仔细评估的必要性至关重要。
    Lipomas are one of the most common mesenchymal tumors in the human body, exhibiting a heightened prevalence between the ages of 40 and 60 years. However, primary intraoral lipomas are rare. Myxoid lipoma, which is characterized by abundant mucoid components, is a particularly rare histological subtype of lipoma. This study presents two cases of myxoid lipoma that occurred outside the common age range for occurrence, one in the right submandibular area of a 67-year-old male and the other in the lower lip of a 3-year-old child. Through these case reports, the aim was to introduce myxoid lipoma, a rare subtype affecting facial areas, and provide a brief review to assist in the differential diagnosis, emphasizing the importance of pathological assessment. Even in age groups and anatomical locations not typically associated with lipomas, it is crucial to emphasize the necessity of careful evaluation.
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  • 文章类型: Journal Article
    背景:牙囊肿,被认为是发展起源,良性牙源性囊肿的特征是逐渐生长的速度。它们在男性中的发生率是女性的两倍。这些囊肿被认为是影响颌骨的最常见的发育性囊肿,在20至40岁的个体中具有典型表现,而在幼儿中很少发现。值得注意的是,牙质囊肿有可能达到显著的尺寸,导致下颌无痛扩大和随后的变形。
    目的:评估10年经验的牙科囊肿的临床病理特征和治疗。
    方法:从经过十年的各种牙病囊肿手术治疗的患者的回顾记录中报告了一些具有挑战性的病例,2012-2022年,仅选择经组织学证实的病例,除了拉希德,拉马迪教学医院,拉齐,伊拉克的Zuhur私人医院和私人诊所。
    结果:76例患者被纳入本临床病理研究。受影响的最高年龄组为≤18岁(68.4%),54%是男性,下颌骨受影响程度(63.1%)高于上颌骨(36.9%)。对30.3%的病例应用了袋化,而69.7%的患者进行了眼球摘除。
    结论:本案例研究证实了对X光片进行细致检查的重要性以及与未发现和未治疗的疾病相关的后果。对口腔病理学的全面了解是牙医的宝贵资源,促进准确诊断,适当的推荐,以及为努力在不同年龄段实现最佳口腔健康的患者提供预期指导。
    BACKGROUND: Dentigerous cysts, deemed of developmental origin, are benign odontogenic cysts characterized by a gradual growth rate. Their occurrence is twice as prevalent in men compared to women. These cysts are recognized as the most frequent developmental cysts affecting the jaws, with a typical manifestation in individuals aged 20 to 40, while infrequently identified in young children. Notably, dentigerous cysts have the potential to attain significant dimensions, resulting in painless enlargement of the jaw and subsequent deformation.
    OBJECTIVE: To assess the clinicopathological features and management of ten years of experience with dentigerous cysts.
    METHODS: A challenging cases were reported from reviewed records of the patients who were treated by the surgical intervention of various dentigerous cysts throughout the period of ten years, 2012-2022 and only histologically confirmed cases were selected, at Ramadi Teaching Hospital in addition to Rashid, Razi, Zuhur Private Hospitals and private clinics in Iraq.
    RESULTS: 76 patients were included in this clinicopathological research. The highest age group affected was ≤ 18 years (68.4%), 54% were male, the mandible was more affected (63.1%) than the maxilla (36.9%). Marsupialization was applied to 30.3% of the cases, while enucleation was carried out in 69.7%.
    CONCLUSIONS: The significance of meticulous examination of radiographs and the consequences associated with undetected and untreated ailments is affirmed by this case study. A comprehensive understanding of oral pathology serves as a valuable resource for dentists, facilitating accurate diagnosis, appropriate referrals, and the provision of anticipatory guidance to patients striving to achieve optimal oral health across various age groups.
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  • 文章类型: Journal Article
    背景:口腔鳞状细胞癌(OSCC)是全球最常见的癌症之一。OSCC诊断的延迟可能对管理和患者预后产生重大影响。口腔管理中最关键的因素之一是及时的组织病理学最终诊断。周转时间(TAT)被认为是质量性能评估的最重要组成部分。尽管计算机化取得了进步,但许多实验室仍在努力改善其TAT,运输系统,和分析技术。目的:本研究旨在评估OSCC病例的TAT,评估平均TAT周期,评估任何TAT延迟,并探讨TAT延误背后的原因。材料和方法:Saveetha牙科学院和医院的OSCC报告,钦奈,从2022年1月1日至2022年12月31日的一年内,从牙科信息档案软件(DIAS)检索,并记录了平均TAT。Further,还观察到TAT延迟的病例数,列出了他们拖延的原因。使用IBMSPSSStatisticsforWindows执行描述性统计和图形表示,V.23.0(IBM公司,Armonk,NY,美国)。进行单向ANOVA,其中显著性设定为小于0.05的p值。
    结果:检索到230例OSCC病例,并纳入本研究的TAT评估。230例,161例(70%)为切口活检,69例(30%)为切除活检。只有7例(4%)切口病例和7例(10%)切除活检显示TAT延迟。TAT延迟的最常见原因是需要更深的切片和骨标本的脱钙。在161例切口病例中,只有48人(29%)接受了切除和进一步治疗。在69例切除病例中,有21例(30%)是来自其他私人机构的转介病例。12个月的总平均TAT对于切开活检为3.24±0.41天,对于切除活检为11.88±2.07天。单因素方差分析显示统计学显著的p值小于0.00001。
    结论:我们的研究揭示了TAT延迟的具体挑战和改善TAT的机会。这可以导致OSCC报告的更快的TAT,进一步改善患者护理,并启用及时治疗。这项研究量化了OSCC病例的TAT,并确定了工艺改进的关键领域。这些发现可以为简化诊断工作流程的策略提供信息,减少延误,并最终提高对OSCC患者的及时护理。
    BACKGROUND: Oral squamous cell carcinoma (OSCC) is one of the most common cancers worldwide. A delay in the diagnosis of OSCC can have a drastic impact on management and patient outcomes. One of the most crucial elements in oral management is the timely histopathological final diagnosis. Turnaround time (TAT) is regarded as the most important component of the quality performance evaluation. Many labs have struggled to improve their TATs despite advancements in computerization, transport systems, and analytical technologies.  Aim: This study aimed to assess the TAT of OSCC cases, assess the mean TAT period, evaluate any TAT delays, and explore the reasons behind the TAT delays.  Materials and methods: OSCC reports in Saveetha Dental College and Hospitals, Chennai, for one year from January 1, 2022, to December 31, 2022, were retrieved from the Dental Information Archival Software (DIAS), and the mean TAT was noted. Further, the number of cases with delay in TAT was also observed, and the reason for their delay was listed. Descriptive statistics and graphical representation were performed utilizing IBM SPSS Statistics for Windows, V. 23.0 (IBM Corp., Armonk, NY, USA). One-way ANOVA was performed with a significance set at a p-value less than 0.05.
    RESULTS: 230 OSCC cases were retrieved and included in the TAT evaluation for this study. Among 230 cases, 161 (70%) were incisional and 69 (30%) were excisional biopsies. Only seven (4%) incisional cases and seven (10%) excisional biopsies showed a delay in TAT. The most common reason for the delay in TAT was the requirement for deeper sections and decalcification of bone specimens. Out of 161 incisional cases, only 48 (29%) have undergone excision and further treatment. Twenty-one out of 69 (30%) excisional cases were found to be referral cases from other private institutions. The overall average TAT for 12 months was 3.24 ± 0.41 days for incisional biopsies and 11.88 ± 2.07 days for excisional biopsies. One-way ANOVA revealed a statistically significant p-value of less than 0.00001.
    CONCLUSIONS: Our study sheds light on specific challenges in TAT delay and opportunities for the improvement of TAT. This can result in faster TAT of OSCC reports, further improve patient care, and enable prompt treatment. This study quantified the TAT for OSCC cases and identified critical areas for process improvement. The findings can inform strategies to streamline diagnostic workflows, reduce delays, and ultimately improve the timely delivery of care to patients with OSCC.
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  • 文章类型: Journal Article
    背景:考虑到口腔肿瘤的稀有性和多样性,需要一个可靠的计算机辅助病理诊断系统。已成功设计出使用深度神经网络的基于内容的图像检索(CBIR)系统,用于数字病理学。由于缺乏针对口腔病理学量身定制的广泛的图像数据库和特征提取器,因此尚未研究用于口腔病理学的CBIR系统。
    方法:本研究使用从30类口腔肿瘤中构建的大型CBIR数据库来比较深度学习方法作为特征提取器。
    结果:通过使用自监督学习(SSL)方法(SimCLR为0.900,TiCo为0.897)在数据库图像上训练的模型,获得了接收器工作特征曲线(AUC)下的最高平均面积。使用来自使用智能手机拍摄的相同案例的查询图像验证了模型的可泛化性。当智能手机图像作为查询进行测试时,两种模型的平均AUC最高(SimCLR为0.871,TiCo为0.857)。我们通过评估前10个平均准确度并检查确切的诊断类别及其鉴别诊断类别来确保检索到的图像结果很容易观察到。
    结论:使用特定于目标部位的图像数据使用SSL方法训练深度学习模型有利于口腔肿瘤组织学中的CBIR任务,以获得组织学上有意义的结果和高性能。这一结果为CBIR系统的有效开发提供了见解,以帮助提高组织病理学诊断的准确性和速度,并在未来推进口腔肿瘤研究。
    BACKGROUND:  Oral tumors necessitate a dependable computer-assisted pathological diagnosis system considering their rarity and diversity. A content-based image retrieval (CBIR) system using deep neural networks has been successfully devised for digital pathology. No CBIR system for oral pathology has been investigated because of the lack of an extensive image database and feature extractors tailored to oral pathology.
    METHODS: This study uses a large CBIR database constructed from 30 categories of oral tumors to compare deep learning methods as feature extractors.
    RESULTS: The highest average area under the receiver operating characteristic curve (AUC) was achieved by models trained on database images using self-supervised learning (SSL) methods (0.900 with SimCLR and 0.897 with TiCo). The generalizability of the models was validated using query images from the same cases taken with smartphones. When smartphone images were tested as queries, both models yielded the highest mean AUC (0.871 with SimCLR and 0.857 with TiCo). We ensured the retrieved image result would be easily observed by evaluating the top 10 mean accuracies and checking for an exact diagnostic category and its differential diagnostic categories.
    CONCLUSIONS: Training deep learning models with SSL methods using image data specific to the target site is beneficial for CBIR tasks in oral tumor histology to obtain histologically meaningful results and high performance. This result provides insight into the effective development of a CBIR system to help improve the accuracy and speed of histopathology diagnosis and advance oral tumor research in the future.
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  • 文章类型: Journal Article
    目的:唇癌和口腔癌的全球发病率持续上升,需要改进早期检测方法。本研究利用计算机视觉和深度学习的能力来增强口腔粘膜病变的早期检测和分类。
    方法:最初由2006年至2013年收集的6903幅白光宏观图像组成的数据集扩展到超过50,000幅图像,以训练YOLOv7深度学习模型。病变分为三个转诊等级:良性(绿色),潜在恶性(黄色),恶性(红色),促进有效分诊。
    结果:YOLOv7模型,尤其是YOLOv7-E6,在所有病变类别中都显示出高精确度和召回率.YOLOv7-D6模型擅长识别恶性病变,具有显著的精度,召回,和F1得分。增强功能,包括将协调注意力整合到YOLOv7-D6-CA模型中,显著提高了病变分类的准确性。
    结论:该研究强调了各种YOLOv7模型配置在口腔病变分类中的稳健比较。总体结果突出了深度学习模型有助于早期发现口腔癌的潜力。为临床设置和远程筛查应用提供有价值的工具。
    OBJECTIVE: The global incidence of lip and oral cavity cancer continues to rise, necessitating improved early detection methods. This study leverages the capabilities of computer vision and deep learning to enhance the early detection and classification of oral mucosal lesions.
    METHODS: A dataset initially consisting of 6903 white-light macroscopic images collected from 2006 to 2013 was expanded to over 50,000 images to train the YOLOv7 deep learning model. Lesions were categorized into three referral grades: benign (green), potentially malignant (yellow), and malignant (red), facilitating efficient triage.
    RESULTS: The YOLOv7 models, particularly the YOLOv7-E6, demonstrated high precision and recall across all lesion categories. The YOLOv7-D6 model excelled at identifying malignant lesions with notable precision, recall, and F1 scores. Enhancements, including the integration of coordinate attention in the YOLOv7-D6-CA model, significantly improved the accuracy of lesion classification.
    CONCLUSIONS: The study underscores the robust comparison of various YOLOv7 model configurations in the classification to triage oral lesions. The overall results highlight the potential of deep learning models to contribute to the early detection of oral cancers, offering valuable tools for both clinical settings and remote screening applications.
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  • 文章类型: Journal Article
    本文探讨了口腔黏膜色素性病变的临床鉴别,由于其范围从良性到潜在恶性疾病,因此在牙科和医学学科中提出了重大的诊断挑战。通过文献复习和临床病例分析,这项研究澄清了当前的诊断方法,强调鉴别诊断,为临床医生提供实用指南。色素性病变的分类,例如内源性的,局灶性黑素细胞,和多灶性色素沉着,根据临床和组织学特征,强调了结构化和知情方法的必要性。对我们口腔医学和病理诊所的病例进行回顾性检查,加上照片和组织学记录的分析,有助于对这些病变进行分类。这促进了更好的理解,并促进了临床医生之间的知情讨论,最终旨在加强早期和精确的诊断,从而改善患者管理和结果。
    This paper examines the clinical differentiation of pigmented lesions in the oral mucosa, which poses significant diagnostic challenges across dental and medical disciplines due to their spectrum from benign to potentially malignant conditions. Through a literature review and analysis of clinical cases, this study clarifies current diagnostic methodologies, with an emphasis on differential diagnosis, to provide a practical guide for clinicians. The classification of pigmented lesions, such as endogenous, focal melanocytic, and multifocal pigmentation, based on clinical and histological features, highlights the necessity for a structured and informed approach. A retrospective examination of cases from our oral medicine and pathology clinic, coupled with analysis of photographic and histological records, aids in classifying these lesions. This fosters a better understanding and promotes informed discussions among clinicians, ultimately aiming to enhance early and precise diagnosis, thus improving patient management and outcomes.
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  • 文章类型: Journal Article
    该病例报告旨在描述一种罕见的良性下颌骨肿瘤,并评估最新评论的结果。2017年1月至2023年8月。介绍一个详细的临床病例,这项研究提高了我们对诊断和治疗方面的理解,最终改善临床实践中类似病例的管理。正交图(OPG)显示从支中线延伸的明确的单眼射线可透性,牙齿47和48浸没在下颌骨的底部。在本案中,使用PLANMECAROMEXISPROMAX®三维(3D)最大锥束计算机断层扫描(CBCT)装置进行3D检查.优选口内方法,并通过使用W&H®DentalwerkBürmoosGmbHPiezomed压电装置创建骨窗来完全切除肿瘤,骨板用4个MEDARTIS®微孔板固定,一个主要的皮瓣关闭。采用PANORAMIC1000,3DHISTECHLtd®装置进行组织学研究。牙源性肿瘤很少见,通常无症状,经常在常规射线照相检查中偶然发现。这些良性病变大多数在完全切除后愈合良好,需要长期随访。一旦确诊,成釉细胞纤维瘤(AF)应立即治疗,以避免恶变。
    This case report aimed to describe a rare benign mandibular tumour and assess the outcomes of the most recent reviews, between January 2017 and August 2023. Presenting a detailed clinical case, this study advances our understanding of the diagnostic and therapeutic aspects, ultimately improving the management of similar cases in clinical practice. Orthopantomogram (OPG) revealed a well-defined unilocular radiolucency extending from the midline of the ramus and teeth 47 and 48 were submerged at the base of the mandible. In the presented case, a PLANMECA ROMEXIS PROMAX® three-dimensional (3D) maximum (MAX) cone-beam computed tomography (CBCT) device was used for the 3D examination. An intraoral approach was preferred and the tumour was removed in toto by creating a bone window using a W&H® Dentalwerk Bürmoos GmbH Piezomed piezoelectric device, and the bone plates were fixed with 4 MEDARTIS® microplates, with a primary flap closure. A PANORAMIC 1000, 3DHISTECH Ltd® device was employed for the histological investigation. Odontogenic tumours are rare and typically asymptomatic, often discovered incidentally during routine radiographic examinations. Most of these benign lesions heal well after complete excision and require long-term follow-up. Once diagnosed, ameloblastic fibroma (AF) should be treated immediately to avoid malignant transformation.
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  • 文章类型: Journal Article
    背景:生物表面活性剂是由各种微生物产生的两亲性化合物。当前的研究评估了针对一系列口腔病原体的各种类型的生物表面活性剂。
    目的:本系统综述旨在探索微生物衍生的生物表面活性剂在口腔应用中的潜力。
    方法:使用PubMed-MEDLINE进行了系统的文献检索,Scopus,和具有指定关键字的WebofScience数据库。结果已在PROSPERO数据库中注册,并按照PRISMA检查表进行。资格标准,在PICOS框架的指导下,为纳入和排除标准建立。QUIN工具用于评估体外牙科研究的偏倚风险。
    结果:在最初的357个发现中,选择了10项研究进行进一步分析.本系统综述的结果表明,粗制和纯化形式的生物表面活性剂均表现出对各种口腔病原体的抗菌和抗生物膜特性。生物表面活性剂在口腔产品中的值得注意的应用包括漱口水,牙膏,和植入物涂层。
    结论:生物表面活性剂已经引起了相当大的兴趣,并证明了它们在口腔健康中的应用潜力。这归因于它们的表面活性特性,抗粘附活性,生物降解性,以及对各种口腔微生物的抗菌效果,包括细菌和真菌。
    BACKGROUND: Biosurfactants are amphiphilic compounds produced by various microorganisms. Current research evaluates diverse types of biosurfactants against a range of oral pathogens.
    OBJECTIVE: This systematic review aims to explore the potential of microbial-derived biosurfactants for oral applications.
    METHODS: A systematic literature search was performed utilizing PubMed-MEDLINE, Scopus, and Web of Science databases with designated keywords. The results were registered in the PROSPERO database and conducted following the PRISMA checklist. Criteria for eligibility, guided by the PICOS framework, were established for both inclusion and exclusion criteria. The QUIN tool was used to assess the bias risk for in vitro dentistry studies.
    RESULTS: Among the initial 357 findings, ten studies were selected for further analysis. The outcomes of this systematic review reveal that both crude and purified forms of biosurfactants exhibit antimicrobial and antibiofilm properties against various oral pathogens. Noteworthy applications of biosurfactants in oral products include mouthwash, toothpaste, and implant coating.
    CONCLUSIONS: Biosurfactants have garnered considerable interest and demonstrated their potential for application in oral health. This is attributed to their surface-active properties, antiadhesive activity, biodegradability, and antimicrobial effectiveness against a variety of oral microorganisms, including bacteria and fungi.
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