骨巨细胞瘤的生物学行为研究

A study on the biological behavior of bone giant cell tumor

本文对骨巨细胞瘤（ＧＣＴ）的传统组织学分级与其生物学行为不甚相符的原因进行了研究。采用５１例ＧＣＴ为研究对象，以１３例骨囊肿（良性）和１５例骨肉瘤（恶性）为对照组，采用图像分析仪（ＩＡＴ）对细胞核（ＧＣＴ取基质细胞核），进行了形态计量研究（８项参量），ＤＮＡ含量，ＤＮＡ倍体类型研究，及术后复发病例的ＤＮＡ倍性与其传统分级的比较研究。结果经统计学处理发现ＧＣＴⅠ级和Ⅱ级之间无显著差别，且它们的生物学属性在潜在恶性和低度恶性范畴。研究还揭示ＧＣＴ的ＤＮＡ≥５ｃ细胞数超过７％者系术后复发、转移的高危病例。

This study was designed to resolve the problem that the traditional histological classification on giant cell tumor (GOT) of bone does not accord with its biological behavior. Fifty one cases with complete pathological data of GCT were studied and followed up. Thirteen cases of bone cyst (benign lesion) and 15 cases of bone sarcoma (malignant lesion) were used as controls. The cell nucleus structure in two and three dimensions was studied by image analysis technique (IAT) using quatitative morphometry: 8 morphometric parameters and DNA cellular content were measured and the types of DNA ploidy were analyzed. The relationships between DNA ploidy, traditional classification of GCT and recurrence of tumor were discussed. The authors concluded that, there was no significant difference between grade Ⅰ and Ⅱ of GCT. Both of them possessed biological characters of malignant lesion. GCT should be regarded as latent malignant or malignant tumor. The view point that grade Ⅰ of GCT belonges to benign lesion should be abandoned. In clincial practice, one must nuderstand clearly, that the pathological classification of GCT does not coincide with its biological behavior. One reason for this is that GCT has various biological features and the another reason is that two dimensional structural difference between grade Ⅰ and Ⅱ of GCT by optical ebservation does not completely reflect the intrinsic nature of tumor and its differentiation degree. The authors also established a regression equation on quantitative morphometric analysis, which is of reference value for clinical diagnosis.