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題 名 | The Factors of Postoperative Tumor Recurrence and Associated Strategies for Diagnosis and Treatment in Kimura Disease--A Study of 19 Cases and Review of Literatures=木村氏症術後腫瘤復發之因子及診斷、治療之策略--19個臨床病例研究及文獻回顧 |
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作 者 | 劉志信; 林政達; 林穎聖; 楊國強; 徐圭璋; 劉文忠; 陳錦時; 陳理維; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 21:3 2012.09[民101.09] |
頁 次 | 頁180-187 |
分類號 | 416.21 |
關鍵詞 | 木村氏症; 腫瘤復發; Kimura disease; Eosinophilia; Microabscess; |
語 文 | 英文(English) |
中文摘要 | 背景:木村氏症為一罕見之良性發炎性疾病,好發於亞洲中年男性之頭頸部。易於復發之傾向為其治療之主要問題。然而目前關於術後復發相關因子之文獻十分有限,而基於這些因子之治療更為罕有。目的及目標:定義木村氏症術後復發之相關因子,並據以建立合理的診斷及治療策略。材料及方法:2000年一月至2012年一月止,共計19個木村氏症病例。以邏輯分析、線性分析及費雪氏精確檢定分析手術後腫瘤復發與疾病相關之因子(含年齡、性別、部位、大小、嗜伊紅性球比、淋巴腫大、治療時程)。結果:腫瘤大小(直徑大於6公分)及血中嗜伊紅性球(大於或等於48%)均為與術後復發顯著相關之因子(依序,p<0.039及p<0.038)。腫瘤大小與血中嗜伊紅性球比例呈正相關(p<0.001)。年輕病患(小於30歲)易以多發性腫瘤呈現(p=0.017)。結論:經分析,腫瘤大小及血中嗜伊紅性球為術後復發之顯著相關因子。30歲內之年輕病患易以多發病灶呈現。基於我們的發現,我們提出木村氏症之診斷及治療建議流程。 |
英文摘要 | Background: Kimura disease is a rare and benign inflammatory lesion which mainly involves the head and neck region of middle-aged Asian males. The tendency to recur remains the leading problem in current treatments. However, the information about the factors of the postoperative tumor recurrence is few in the literatures while the treatment options based on those factors are even fewer. Aims and objectives: To define the factors related to the postoperative tumor recurrence of Kimura disease, and establish the strategy of diagnosis and treatment. Materials and methods: Nineteen patients with Kimura disease were enrolled between January 2000 and January 2012. The relationship between postoperative tumor recurrence and the parameters of disease (age, gender, locations, tumor size, serum eosinophil levels, nephropathy, lymphadenopathy, onset of disease to surgical treatment) were analyzed by logistic regression, linear regression and Fisher's exact test.Results: The tumor size (>6cm in diameter) and serum eosinophil level (≧48%) are two factors related to the increase of postoperative tumor recurrence in Kimura disease (p=0.039 and p=0.038, respectively). A linear relation between the eosinophil level and the tumor size is found (p<0.001). Younger patients (≦30 years) have higher incidence to develop multifocal lesions (p=0.017). Conclusions: The tumor size and the serum eosinophil level are significantly related to the increase of postoperative tumor recurrence in Kimura disease. Younger patients less than 30 years are prone to develop multifocal lesions. A flowchart according to our findings is presented to improve the diagnosis and management of Kimura disease. |
本系統中英文摘要資訊取自各篇刊載內容。