家兎下顎骨内における VX_2 癌の増殖に関する神経組織学的研究

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Primary intraosseous carcinoma of the mandible and carcinoma that invades into and grows in the mandible from the gingiva spread widely in the mandible. Extended surgical resection of such carcinoma however results in postoperative morphological and functional hindrance and in great impediment from the viewpoint of quality of life. With advances in the ages of patients with oral cancer in recent years, limited surgery is desirable. It is therefore very important to plan the surgical safety margin which is minimal yet radical enough. In planning such surgical safety margin, X-ray and computed tomography with destruction image of the mandibles as guide have been utilized. At the same time, peripheral nerves and periosteum next to the tumor mass are suggested to be correlated with extension of the cancer histopathologically. In the present experiment, VX_2 carcinoma tissue was experimentally transplanted into the mandibles of domestic rabbits, and growth and entension of VX_2 carcinoma tissue and reaction of the inferior alveolar nerve were investigated neurohistologically. The results were as follows : 1. Invasion by and growth of VX_2 carcinoma tissue in the inferior alveolar nerve was classified roughly into two types. In one, the tissue pressed against or surrounded the nerve bundle and invaded and grew through the perineurium. In the other, the tissue destroyed the perineurium and invaded and grew through the endoneurium. 2. Invasion into perineurium and endoneurium was observed in the cases from 10 days after transplantation, and the invasive area into the bone marrow and that into the inferior alveolar nerves were about the same in scope. In the cases 15 to 20 days after transplantation, the invasive and growth area in the inferior alveolar nerve spread further toward the central side than the invasive and growth area in the bone marrow. 3. The nerve fibers of the inferior alveolar nerve which was near, surrounded by, or invaded by VX_2 carcinoma tissue showed slight degeneration such as swelling, meandering and winding, and also severe degeneration such as beading, fragmentation, and granular decomposition. With time, VX_2 carcinoma tissue was growing gradually in the inferior alveolar nerve. 4. The nerve fibers from the invasive area to the central side of VX_2 carcinoma tissue in the inferior alveolar nerve showed slight degeneration such as swelling and meandering and so called retrograde degeneration like hypochromatosis. The nerve trunk and mental nerve from the transplanted site to peripheral side showed comparatively slight degeneration such as swelling, meandering, and hypochromatosis, and also severe degeneration like fragmentation and granular decomposition. 5. In the center of growing VX_2 carcinoma tissue, cytolysis and necrosis were seen and no nerve fibers or nerve bundles were observed. In the region outward where growth was in progress with formation of cellulae, nerve fibers seemingly intact were observed sporadically in addition to severe degeneration of nerve fibers. With time, however, degenerated nerve fibers increased and severity of degeneration was also intensified. 6. On the anterior and posterior sides, sufficiently away from VX_2 carcinoma tissue, slightly degenerated fibers and nerve bundles in addition to intact nerve fibers were increasing with time. These degenerated nerve fibers were seen more on the posterior side than on the anterior side. 7. On the basis of the foregoing findings, invasion by and growth of VX_2 carcinoma tissue in the mandible spread along the peripheral nerve by was of the inferior alveolar nerve. Roentogenologically, VX_2 carcinoma tissue spread further to the posterior side, namely the central side, than the region of invasion, growth and destruction. These findings give important suggestions in planning the safety margin for surgical resection in the cases where central carcinoma of the mandible or carcinoma of the gingiva invades into the mandible.
九州歯科学会の論文
1991-02-25

家兎下顎骨内における VX_2 癌の増殖に関する神経組織学的研究

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