摘要
[目的]研究恶性骨巨细胞瘤的临床病理和组织学特征,并评估在本中心治疗的恶性骨巨细胞瘤患者的治疗结果和预后。[方法]回顾在本院治疗的所有原发和继发恶性骨巨细胞瘤的病例,共44例,对随访的临床资料进行回顾性研究和统计学相关分析。[结果]共有26例PMGCT和18例SMGCT患者;其中8例SMGCT为放疗后肉瘤变患者。在PMGCT,患者年龄从1～66岁（平均40.6岁）;在SMGCT,患者年龄从22～67岁（平均39.9岁）。从诊断骨巨细胞瘤到诊断SMGCT的平均时间间隔在放疗后SMGCT组为12.8年（4～22年）,在手术后SMGCT组为9.8年（2～28年）。在PMGCT组中,组织分类为骨肉瘤的有13例,恶性纤维组织细胞瘤有9例,纤维肉瘤4例。在SMGCT组中组织学分类为恶性纤维组织细胞瘤13例,骨肉瘤3例,纤维肉瘤2例。29例随访资料完整的恶性骨巨细胞瘤患者的5年生存率为46.9%。广泛切除有助于减少局部复发。[结论]恶性骨巨细胞瘤是一种少见的高度恶性的预后很差的肉瘤。需要注意和良性骨巨细胞瘤相鉴别。广泛切除有助于减少局部复发,辅助化疗及局部放疗在有效控制肿瘤的局部复发和转移中的作用,仍没有得到确认。
[Objective] This study aimed to conclude the clinicopathologic and histologic features of malignant giant cell tumors （MGCTs） and to assess the outcome. [ Methods] The clinical data of 44 patients with malignant giant cell tumors ad- mitted to People＇s Hospital （Beijing, China） were retrospectively studied, including 26 primary MGCTs and 18 secondary MGCTs. [Results] Among 18 secondary MGCTs, 8 were post -radiation sarcomas. All patients with primary MGCTs were aged 15 to 66 years （ median, 40. 6years）, and all cases with secondary MGCTs were aged 22 to 67 years （ median, 39.9 years） . The average latent period between diagnosis of giant cell tumor and diagnosis of secondary MGCT was 12. 8 years （ range, 4 - 22 years） for post - radiation sarcomas cases and 9. 8 years （ range, 2 ~ 28 years） for cases resulting from sponta- neous transformation. For primary MGCTs, 13 cases were histologically diagnosed to be osteosarcoma, 9 cases were malignant fi- brous histiocytoma, and 4 cases were fibrosarcoma. For secondary MGCTs, 13 cases were malignant fibrous histiocytoma, 3 ca- ses were osteosarcoma, and 2 cases were fibrosarcoma. The 5 - year survival rate was 46. 9% in 29 patients with active follow - up. The recommended treatment was surgical resection with wide margins. [ Conclusion] Malignanct giant cell tumors are rare high - grade sarcomas with poor outcome. These lesions must be distinguished from benign giant cell tumors of bone. The recom- mended treatment is surgical resection with wide margins. There is insufficient information regarding the benefit of chemotherapy and radiation therapy in the control of local or systemic disease in MCS.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第5期417-421,共5页
Orthopedic Journal of China
关键词
恶性骨巨细胞瘤
骨巨细胞瘤
外科治疗
放疗后肉瘤变
预后因素
malignancy in giant cell tumor of bone
giant cell tumor of bone
surgical treatment
postradiation sarcoma
outcome
