尤因肉瘤骨髓转移的诊断策略与临床实践

Diagnostic Strategies and Clinical Practice of Bone Marrow Metastases from Ewing Sarcoma

尤因肉瘤(EWS)是一种侵袭性原发性骨肿瘤,在儿童及青少年中发病率较高。诊断时转移的存在和转移程度仍然是判断患者预后的重要因素。迄今为止,关于检测骨髓转移的最佳方式仍然存在相当大的模糊性。骨髓活检和(或)抽吸(BMBA)是判断骨髓转移的金标准;这种侵入性和痛苦的过程可能被18F-FDG PET/CT取代,因其对检测EWS骨和骨外转移高度敏感。本文概述了当前相关文献,达成对于EWS骨髓转移的诊断不再系统地执行BMAB的标准共识,并总结出目前诊断EWS骨髓转移相应的实用策略与临床实践。

Ewing sarcoma(EWS)is an invasive and primary bone tumor with a high incidence in children and adolescents.The presence and extent of metastases at the time of diagnosis remains the most important prognostic factor in determining a patient’s prognosis.Up now,considerable ambiguity exists regarding the optimal modality for detecting bone marrow metastases.Bone marrow biopsy and/or aspiration(BMBA)is the gold standard for determining bone marrow metastases.This invasive and painful procedure may be amenable to being replaced by 18F-FDG PET/CT because of its high sensitivity in detecting EWS bone and extraosseous metastases.This review provides an overview of the current literature,concludes that there is no longer a systematic consensus on the implementation of BMAB criteria for the diagnosis of bone marrow metastases in EWS,and summarizes the current practical strategies and clinical practices for the diagnosis of EWS bone marrow metastases accordingly.