Ran Xiang-ying, Huang Jin, Zhang Hui-zhen, Jiang Zhi-ming, Chen Jie
Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China.
Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China. E-mail:
Zhonghua Bing Li Xue Za Zhi. 2013 Oct;42(10):669-74.
To study the histogenesis of giant cell tumor (GCT) and factors related to tumor recurrence, invasiveness and malignant transformation.
The clinical features, radiologic classification, surgical approach, pathologic findings, immunophenotypes and follow-up data of 123 cases of GCT were analyzed.
There was a significant correlation between tumor recurrence and radiographic classification (P = 0.032), over-expression of CD147 (P = 0.034) and p53 (P = 0.005), and surgical approach (P = 0.0048) in GCT. The biologic behavior showed no correlation with intramedullary infiltration, cortical bone involvement, parosteal soft tissue extension, tumor thrombi, fusiform changes of mononuclear tumor cells, mitotic count, Ki-67 index, coagulative tumor necrosis, secondary aneurysmal bone cyst formation, and adjoining bony reaction. The positive rate of p63 in stromal cells of GCT (79.7%, 94/118) was significantly higher than that in chondroblastoma (44.7%, 21/47), osteosarcoma (22.2%, 10/45) and other giant cell-rich tumors.
GCT is a bone tumor of low malignant potential. It is sometimes characterized by locally invasive growth, active proliferation, coagulative necrosis, secondary aneurysmal bone cyst and surrounding bony reaction. It is difficult to predict the biologic behavior of GCT. Over-expression of p53 in the tumor cells and CD147 in all components of GCT correlate with tumor invasiveness, recurrence and malignant transformation. Selection of suitable surgical approach with reference to radiologic classification is considered as an important factor in reducing the recurrence rate.
研究骨巨细胞瘤（GCT）的组织发生及与肿瘤复发、侵袭和恶变相关的因素。
分析123例GCT的临床特征、放射学分类、手术方式、病理表现、免疫表型及随访资料。
GCT中肿瘤复发与放射学分类（P = 0.032）、CD147过表达（P = 0.034）、p53过表达（P = 0.005）及手术方式（P = 0.0048）之间存在显著相关性。生物学行为与髓内浸润、皮质骨受累、骨膜下软组织延伸、肿瘤血栓、单核肿瘤细胞梭形改变、有丝分裂计数、Ki-67指数、凝固性肿瘤坏死、继发性动脉瘤样骨囊肿形成及相邻骨质反应无关。GCT间质细胞中p63阳性率（79.7%，94/118）显著高于成软骨细胞瘤（44.7%，21/47）、骨肉瘤（22.2%，10/45）及其他富含巨细胞的肿瘤。
GCT是一种低恶性潜能的骨肿瘤。其有时表现为局部侵袭性生长、活跃增殖、凝固性坏死、继发性动脉瘤样骨囊肿及周围骨质反应。难以预测GCT的生物学行为。肿瘤细胞中p53过表达及GCT所有成分中CD147过表达与肿瘤侵袭、复发及恶变相关。参照放射学分类选择合适的手术方式是降低复发率的重要因素。
