颌骨单纯性骨囊肿的临床分析

doi:10.3969/j.issn.1005-4979.2023.01.007

摘要/Abstract

摘要： 目的: 探讨颌骨单纯性骨囊肿（simple bone cyst, SBC）的临床诊断要点。方法: 选择南昌大学附属口腔医院口腔颌面外科2010—2020年间收治的63例SBC及100例颌骨囊肿患者作为研究对象，收集2组患者的临床、影像学及手术资料，采用筛检试验评价的方法探讨SBC的临床诊断要点，从而为该疾病的临床诊断及治疗方式的选择提供依据。结果: 本研究共纳入63例SBC患者，其平均诊断年龄为20岁（7~79岁）。其中，上颌骨2例，下颌骨61例。采用串联实验进行筛检变量组合，结果显示，x1（年龄分组）和x3（体格检查有无阳性体征）组合的受试者工作特征曲线下面积（area under the curve，AUC）为0.831，灵敏度为68.18%，特异度为98.10%，约登指数为0.662 8；x2（部位：上/下）和x3组合的AUC为0.865，灵敏度为86.36%，特异度为86.67%，约登指数为0.730 3；x1、x3、x5（骨质是否膨隆、吸收）组合的AUC为0.776，灵敏度为56.06%，特异度为99.05%，约登指数为0.551 1。结论: 年龄小于20岁、体格检查无阳性体征、影像学表现为边界清楚的单房型囊性透射影，且颌骨无明显骨质膨隆的患者可以初步诊断为SBC。

关键词: 单纯性骨囊肿, 颌骨

Abstract:

Objective: To explore the clinical diagnostic essentials of simple bone cyst (SBC) of jaw. Methods: A total of 63 patients with SBC and 100 patients with jaw cyst treated in Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Nanchang University from 2010 to 2020 were included. The clinical, imaging and surgical data of the two groups of patients were collected, and the evaluation method of screening test was used to explore the clinical diagnostic essentials of SBC, so as to provide a basis for the clinical diagnosis and treatment of the disease. Results: 63 SBC patients were included and the mean average age of admittance was 20 years (7-79 years). Among them, there were 2 cases in maxilla and 61 cases in mandible. The results of the combination of screening variables using tandem experiment showed that the area under the curve (AUC) value of the combination of x1 (age grouping) and x3 (physical examination with or without positive signs) was 0.831, the sensitivity was 68.18%, the specificity was 98.10%, and the Youden index was 0.662 8; The AUC value of the combination of x2 (location: upper or lower) and x3 was 0.865, the sensitivity was 86.36%,the specificity was 86.67%, and the Youden index was 0.730 3; the AUC value of the combination of x1, x3 and x5 (whether the bone was bulging and absorbed) was 0.776, the sensitivity was 56.06%, the specificity was 99.05%, and the Youden index was 0.551 1. Conclusion: Patients who are younger than 20 years old, have no positive signs on physical examination, have single-chamber cystic radiography on imaging with clear boundaries and no obvious bulging of the jaw, can initially be diagnosed as SBC.

Key words: simple bone cyst, jaw bone

中图分类号:

R782

郭凌燕, 吴平凡, 陈芬, 李羽, 雷振革, 陈林林. 颌骨单纯性骨囊肿的临床分析[J]. 《口腔颌面外科杂志》, 2023, 33(1): 36-41.

GUO Lingyan, WU Pingfan, CHEN Fen, LI Yu, LEI Zhenge, CHEN Linlin. Clinical analysis of simple bone cyst of jaw[J]. 《Journal of Oral and Maxillofacial Surgery》, 2023, 33(1): 36-41.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2023/V33/I1/36

图/表 6

参考文献 18

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指标	AUC	灵敏度/%	特异度/%	约登指数
x1、x2	0.759	98.48	53.33	0.518 2
x1、x2、x3	0.829	66.67	99.05	0.657 1
x1、x2、x3、x4	0.730	46.97	99.05	0.460 2
x1、x2、x3、x4、x5	0.715	43.94	99.05	0.429 9
x1、x3	0.831	68.18	98.10	0.662 8
x1、x4	0.606	21.21	100.00	0.212 1
x1、x5	0.770	60.61	93.33	0.539 4
x2、x3	0.865	86.36	86.67	0.730 3
x2、x3、x4	0.713	53.03	89.52	0.425 5
x2、x3、x4、x5	0.571	15.15	99.05	0.142 0
x2、x3、x5	0.738	59.09	88.57	0.476 6
x2、x4	0.806	95.45	65.71	0.611 7
x2、x5	0.671	63.64	70.48	0.341 1
x3	0.860	86.36	85.71	0.720 8
x1	0.789	78.79	79.05	0.578 4
x3、x4	0.720	54.55	89.52	0.440 7
x3、x4、x5	0.687	46.97	90.48	0.374 5
x3、x5	0.735	62.12	88.57	0.506 9
x4、x5	0.644	46.97	81.90	0.288 7

指标	AUC	灵敏度/%	特异度/%	约登指数
x1、x2	0.759	98.48	53.33	0.518 2
x1、x2、x3	0.829	66.67	99.05	0.657 1
x1、x2、x3、x4	0.730	46.97	99.05	0.460 2
x1、x2、x3、x4、x5	0.715	43.94	99.05	0.429 9
x1、x3	0.831	68.18	98.10	0.662 8
x1、x4	0.606	21.21	100.00	0.212 1
x1、x5	0.770	60.61	93.33	0.539 4
x2、x3	0.865	86.36	86.67	0.730 3
x2、x3、x4	0.713	53.03	89.52	0.425 5
x2、x3、x4、x5	0.571	15.15	99.05	0.142 0
x2、x3、x5	0.738	59.09	88.57	0.476 6
x2、x4	0.806	95.45	65.71	0.611 7
x2、x5	0.671	63.64	70.48	0.341 1
x3	0.860	86.36	85.71	0.720 8
x1	0.789	78.79	79.05	0.578 4
x3、x4	0.720	54.55	89.52	0.440 7
x3、x4、x5	0.687	46.97	90.48	0.374 5
x3、x5	0.735	62.12	88.57	0.506 9
x4、x5	0.644	46.97	81.90	0.288 7

指标	AUC	灵敏度/%	特异度/%	约登指数
x1、x2、x3、x4、x5	0.715	43.94	99.05	0.429 9
x1、x2、x3、x5	0.768	54.55	59.55	0.535 9
x1、x2、x4、x5	0.698	42.42	97.14	0.395 7
x1、x2、x5	0.772	59.09	95.24	0.543 3
x1、x3、x5	0.776	56.06	99.05	0.551 1
x1、x4、x5	0.705	43.94	97.14	0.410 8
x1、x5	0.770	60.61	93.33	0.539 4
x2、x3、x4、x5	0.571	15.15	99.05	0.142 0
x2、x3、x5	0.738	59.09	88.57	0.476 6
x2、x4、x5	0.646	45.45	83.81	0.292 6
x2、x5	0.671	63.64	70.48	0.341 1
x3、x4、x5	0.687	46.97	90.48	0.374 5
x3、x5	0.735	62.12	88.57	0.506 9
x4、x5	0.644	46.97	81.90	0.288 7
x5	0.646	68.18	60.95	0.291 3

指标	AUC	灵敏度/%	特异度/%	约登指数
x1、x2、x3、x4、x5	0.715	43.94	99.05	0.429 9
x1、x2、x3、x5	0.768	54.55	59.55	0.535 9
x1、x2、x4、x5	0.698	42.42	97.14	0.395 7
x1、x2、x5	0.772	59.09	95.24	0.543 3
x1、x3、x5	0.776	56.06	99.05	0.551 1
x1、x4、x5	0.705	43.94	97.14	0.410 8
x1、x5	0.770	60.61	93.33	0.539 4
x2、x3、x4、x5	0.571	15.15	99.05	0.142 0
x2、x3、x5	0.738	59.09	88.57	0.476 6
x2、x4、x5	0.646	45.45	83.81	0.292 6
x2、x5	0.671	63.64	70.48	0.341 1
x3、x4、x5	0.687	46.97	90.48	0.374 5
x3、x5	0.735	62.12	88.57	0.506 9
x4、x5	0.644	46.97	81.90	0.288 7
x5	0.646	68.18	60.95	0.291 3

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