Szendröi Miklós, Antal Imre, Kiss János
Semmelweis Egyetem, Altalános Orvostudományi Kar, Ortopédiai Klinika, Budapest.
Orv Hetil. 2003 Jun 15;144(24):1171-7.
The giant-cell tumor of bone (GCT) is an aggressive benign, potentially malignant lesion, which biological behaviour is unpredictable. Its aggressivity is usually increasing through the recurrences and is related to the mitotic activity, the excessive metalloproteinase expression and to the alterations in different oncogens of the tumor cells. Statistically, 80% of the GCT-s have a benign course, with a local recurrence rate of 10-50%; about 10% of GCT-s undergo malignant transformation through their recurrences and 1-4% give pulmonary metastases even in case of a benign histology. Despite of the frequent recurrences, adequate treatment results in 96% to 98% cure in patients with GCT. The goal of surgery should be both in primary and recurrent cases: joint-sparing and careful curettage with use of adjuvants (bone cement and phenol, etc.) for decreasing the rate of recurrences. Resection is only in case of extensive joint destruction or malignancy indicated. Radiotherapy with modern supervoltage equipment minimalized the occurrence of secondary malignant transformation, however, its use is only in locations difficult for surgery (vertebra, sacrum, pelvis) recommended.
骨巨细胞瘤（GCT）是一种侵袭性良性、具有潜在恶性的病变，其生物学行为不可预测。其侵袭性通常会随着复发而增加，与有丝分裂活性、金属蛋白酶过度表达以及肿瘤细胞中不同癌基因的改变有关。据统计，80%的GCT病程呈良性，局部复发率为10%-50%；约10%的GCT会通过复发发生恶性转化，即使组织学为良性，1%-4%也会出现肺转移。尽管复发频繁，但对GCT患者进行充分治疗的治愈率为96%至98%。手术目标在原发性和复发性病例中都应是：保留关节并仔细刮除，使用辅助剂（骨水泥和苯酚等）以降低复发率。仅在出现广泛关节破坏或恶性指征时才进行切除。使用现代超高压设备进行放射治疗可将继发性恶性转化的发生率降至最低，然而，仅建议在手术困难的部位（椎体、骶骨、骨盆）使用。
