骨肉瘤侵袭骺板的MRI表现与BMP-2表达及其临床意义

The MRI feature of epiphyseal plate invaded by osteosarcoma and its bone morphogenetic protein-2 expression

目的:研究MR I显示骨肉瘤侵袭骺板的价值,为指导治疗提供依据;并探讨BMP-2在骨肉瘤侵袭中的作用。方法:回顾分析15例经病理证实的骨肉瘤患者术前X线及MR I图像,男10例,女5例,平均年龄(14.0±1.2)岁。股骨下端10例,胫骨上端5例。结果:本组所有患者骺板未闭合,与病理组织学所见比较,发现MR诊断骨肉瘤侵袭骨骺的准确率为100%;BMP-2在瘤体、骺板浸润区、正常骺板、瘤周正常组织的阳性表达率分别为93.33%(14/15)、86.66%(13/15)、13.33%(2/15)、20.00%(3/15),瘤体、骺板浸润区与正常骺板、瘤周正常组织之间差异有显著意义(P<0.01)。结论:BMP-2与骨肉瘤侵袭骺板具有一定的关系;MR I显示骨肉瘤对骺板的侵犯评估优于X线平片,可指导治疗方案的选择,尤其在考虑保肢手术时有较高的价值。

Objective：To study the invasion extension of osteosarcoma in epiphyseal plate by MRI and its bone morphogenetic protein - 2 （ BMP - 2 ） expression. Methods： The radiographic images and MR imaging of 15 patients with osteosareomas were reviewed. There were 10 men and 5 women, with the mean age of 14.0 ± 1.2 years old. Of the 15 patients, 10 had distal femur disease and 5 had proximal tibia disease. Results： The epiphyseal plates were not closed in all the cases, and the diagnosis rate of MRI was 100%. The positive rates of BMP- 2 in tumor tissue, invaded epiphyseal plate, normal epiphyseal plate and normal tissue nearby the tumor were 93.3% （14/15）, 86.7% （13/15）, 13.3% （2/15） and 20.0% （3/15）, respectively. The positive rates in tumor tissue and invaded epiphyseal plate were significantly higher than those in normal epiphyseal plate and normal tissue nearby the tumor （ P 〈 0.01 ）. Conclusion： the BMP - 2 protein expression is correlated with the invasion degree of osteosarcoma in epiphyseal plate. MRI may be a better diagnosis instrument for the epiphyseal invasion of osteosarcoma.