Stokkel M P M, Linthorst M F G, Borm J J J, Taminiau A H, Pauwels E K J
Department of Nuclear Medicine, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
J Cancer Res Clin Oncol. 2002 Jul;128(7):393-9. doi: 10.1007/s00432-002-0350-5. Epub 2002 Jun 13.
In patients with an osteosarcoma, the prognosis is still poor. The aim of the present study was to investigate whether routinely tested biochemical parameters or additional parameters on bone scintigraphy could be identified which can select prognostic subgroups at the time of diagnosis.
A retrospective study was performed in 115 consecutive patients (70 male, 45 female) (mean age: 25.6 years; range: 3.50-78.0 years) who were referred for bone scintigraphy prior to treatment from March 1986 to September 2000 because of a newly diagnosed osteosarcoma. All bone scans were reassessed for the intensity and pattern of uptake and a bone-scan index. All pre-treatment general, histological, biochemical, and scintigraphic data were correlated with clinical outcome during follow-up.
During follow-up 54 patients died. Tumour volume and GGT showed significance as independent variables for metastases. Patients with metastases demonstrated a significantly lower survival rate (23% 5-year survival) than patients without metastases (98% 5-year survival). Tumours of the humerus and femur had a significantly lower survival rate. With respect to significant biochemical parameters (ALP, GGT, ASAT), it was not possible to determine a cut-off value that could be used to differentiate between high- and low-risk patients. Additional parameters assessed on bone scintigraphy were not important for prognostic stratification.
The strongest predictor of survival in osteosarcoma is the presence or absence of metastasis. Some biochemical parameters have prognostic value, but they cannot be used for the unequivocal identification of subgroups. Additional scintigraphic parameters are irrelevant for prognostic stratification.
骨肉瘤患者的预后仍然很差。本研究的目的是调查常规检测的生化参数或骨闪烁显像的其他参数是否能够在诊断时识别出可区分预后亚组的指标。
对1986年3月至2000年9月期间因新诊断的骨肉瘤在治疗前接受骨闪烁显像检查的115例连续患者（男70例，女45例）进行回顾性研究。所有骨扫描均重新评估摄取强度、模式及骨扫描指数。所有治疗前的一般、组织学、生化和闪烁显像数据均与随访期间的临床结局相关。
随访期间54例患者死亡。肿瘤体积和谷氨酰转肽酶（GGT）显示为转移的独立变量。有转移的患者生存率（5年生存率23%）显著低于无转移的患者（5年生存率98%）。肱骨和股骨肿瘤的生存率显著较低。关于重要的生化参数（碱性磷酸酶、GGT、谷草转氨酶），无法确定可用于区分高危和低危患者的临界值。骨闪烁显像评估的其他参数对预后分层并不重要。
骨肉瘤生存的最强预测因素是有无转移。一些生化参数具有预后价值，但不能用于明确识别亚组。其他闪烁显像参数与预后分层无关。
