Ag─NoRs和电镜观察在骨巨细胞瘤的诊断应用

The Signlficance of Ag-NoRs Staining and Electron- Microscopic Obseration of Giant Cell Tumor of Bone

应用Ａｇ－ＮｏＲｓ染色技术及电镜观察，对４８例骨巨细胞瘤各个级别的基质细胞，多核巨细胞进行了分析，以揭示其细胞增生活跃，结果表明Ａｇ－ＮｏＲｓ计数除Ⅱ─Ⅲ级之间基质细胞无显著性外（Ｐ＞０．０５）其它各级之间均有高度显著性，电镜下分化差的骨巨细胞核畸变显著、内质网极度不规则并呈迷宫样，多核巨细胞随着级别增大，其数量减少。Ａｇ－ＮｏＲｓ在Ⅰ─Ⅱ级ＧＣＴ之间无明显差异（Ｐ＞０．０５）而面积有高度显著性。其他各级之间Ａｇ－ＮｏＲｓ和面积均有高度显著性。通过Ａｇ－ＮｏＲｓ和电镜观察可反应出各级之间细胞增生活跃的关系，可作为判断良、恶性的指标，指导临床手术治疗。

orty eight specimens of giant cell tumor of bone were studied usinga modified Ag-NoRs staining technique and electron-microscopic obser-vation, with a view to clarify the proliferative activites of the tumorcells, Observation was focused on the Ag-NoRs Rranules withinthe nuclei of 100 stromal cells and 20 multinucleate cells.Nine specimenswere observed under the electron-microscope.The study showed thatthe Ag-NoRs granule counts within the nuclei of strolmal cells increasedwhen pathological grading become high. The differences between twopathological gradings, except grade Ⅱ and gradeⅢ, were statisticallysignificant. The nuclear abnormity in bad differiated stromal cellswas obvious under electron-microscope. This study demonstrates thatJaffe’s pathological grading method genreally reflects the Proliferativeactivities of the giant cell tumor of bone. If combining with the Ag-NoRsstaining technique, the pathological grading is still an index to guidethe clinical and to foretell the clinical prognosis.