长骨骨巨细胞瘤影像学表现与病理分期的相关性分析

Study on the Correlation between Imaging Features and Pathological Stage of Giant Cell Tumor of Long Bone

目的探讨长骨骨巨细胞瘤(GCT)影像学表现与病理分期的相关性,为肿瘤生物学评估及临床诊疗方案提供依据。方法回顾经手术病理证实的38例GCT影像学资料,观察肿瘤的生长方式、体积大小、内部骨嵴、囊变、出血、邻近骨皮质受侵、瘤体距关节面距离、关节面破坏面积百分比及伴发病理性骨折等影像学特征,比较上述表现与病理分期的差异并分析其相关性。结果38例GCT患者中Ⅰ期13例,Ⅱ期17例,Ⅲ期8例。GCT的影像学表现中生长方式、瘤内囊变、距关节面距离及伴发病理性骨折与病理分期均无统计学差异(P>0.05);体积大小、邻近骨皮质受侵及关节面破坏面积百分比与病理分期有明显差异且为显著正相关性(P<0.05,r>0.4);瘤内骨嵴及出血与病理分期差异有统计学意义但为弱正相关性(P<0.05,0<r<0.4)。结论GCT的影像学表现在一定程度上与病理分期具有相关性,可为肿瘤组织学特点评估、诊疗方案制定及患者预后提供指导。

Objective To investigate the correlation between imaging findings and pathological stages of GCT,and to provide a basis for tumor biological evaluation and clinical treatment.Methods Review confirmed by surgical pathology of 38 cases of GCT imaging materials,observe the tumor growth way,size,internal bone crest,capsule,hemorrhage,adjacent cortical bone invaded,tumors of depth from the joint surface,joint surface damage area percentage and follows a rational fractures,imaging characteristics,such as comparing the differences of the expression and the pathological staging above and analyze its relevance.Results 38 cases of GCT patientsⅠperiod 13 cases,Ⅱperiod of 17 cases,8 cases ofⅢperiod.There were no statistically significant differences in the growth pattern,intratumoral cystic degeneration,distance from articular surface,and pathologic fracture associated with each stage of GCT imaging(P>0.05).There were significant differences and positive correlations between the size of the adjacent cortical bone and the percentage of damaged joint surface area and pathological stage(P<0.05,r>0.4).The difference of intraosseous ridge and hemorrhage and pathological stage was statistically significant but weakly positive(P<0.05,0<r<0.4).Conclusion The imaging findings of GCT are correlated with the pathological stage to some extent,which can provide guidance for the evaluation of tumor histological characteristics,the formulation of diagnosis and treatment plan and the prognosis of patients.