术前化疗对骨肉瘤细胞超微结构的影响

The influence of preoperative chemotherapy on the ultrastructure of osteosarcoma cells

目的探讨术前化疗对体内骨肉瘤细胞超微结构的改变。方法男女各4例,年龄平均19.5岁。股骨远端6例,胫骨近段和股骨近段各1例。ⅡB7例,ⅢB1例。术前应用DIA方案化疗2疗程后行保肢手术。对本组骨肉瘤标本,应用透射电镜观察细胞超微结构的变化。结果本组患者均完成术前化疗,并获得平均术后18个月的随访。1例复发,6例肺转移,4例死亡,2例带瘤生存。透射电镜观察发现,7例化疗后的骨肉瘤细胞超微结构表现为不同程度的细胞毒性损伤。仅1例可见相对完整的骨肉瘤细胞结构。结论化疗药物在体内能诱导骨肉瘤细胞凋亡,最终导致细胞坏死。

Objective To investigate the uhrastruetural changes of osteosareoma cells after preoperative chemotherapy. Methods Eight patients （4 male and 4 female） were involved, with the mean age of 19.5. The location of the tumor was in the distal femur （n=6）, the proximal tibia（n=1）, and the proximal femur （n=1）. Seven patients were in stage ⅡB, and one in stage ⅢB. Limb salvage surgery was performed after 2 courses of chemotherapy with DIA protocol. The uhrastructure of the osteosarcoma cells was observed with transmission electron microscope （TEM）. Results All patients underwent preoperative chemotherapy, and were followed up was for 18 months. Local recurrence occured in 1 patient, and 6 patients had pulmonary metastasis. Four of them died, and two survived with tumor. The uhrastructure of the osteosarcoma cells showed different cytotoxicity injury in 7 patients, and relatively intact osteosarcoma cells were observed in only 1 patient. Conclusions Chemotherapy can induce osteosarcoma cells apoptosis, and lead to cells necrosis at the end.