Rockberg Julia, Bach Bruce A, Amelio Justyna, Hernandez Rohini K, Sobocki Patrik, Engellau Jacob, Bauer Henrik C F, Liede Alexander
IMS Health (Pygargus), Sveavägen 155, SE-113 46, Stockholm, Sweden.
Amgen Inc., One Amgen Center Drive, MS 38-2-B, Thousand Oaks, CA 91320-1799.
J Bone Joint Surg Am. 2015 Nov 4;97(21):1756-66. doi: 10.2106/JBJS.O.00156.
The Swedish Cancer Registry (founded in 1958) constitutes a unique resource for epidemiological studies of giant cell tumor of bone with potential for use for population-based studies of incidence over time. The aim of this study was to provide what we believe is the first modern population-based assessment of the incidence trends of giant cell tumor, a unique osteoclastogenic lytic stromal tumor with both benign and malignant histological forms, and to compare the findings with data from the same registry on osteosarcoma, a tumor that may display similar histological characteristics.
Cases were identified with use of codes for pathological bone tumor (International Classification of Diseases [ICD]-7 196). Specific morphological coding distinguishes benign (PAD 741) from malignant giant cell tumor (PAD 746) and osteosarcoma (PAD 766).
During the period of 1958 to 2011, 4625 bone tumors were reported, including 505 giant cell tumors (383 benign and 122 malignant) and 1152 osteosarcomas. From 1958 to 1982 the ratio of malignant to benign giant cell tumors was 1.3, whereas from 1983 to 2011 the ratio inverted to 0.09, suggesting a change in the reporting or diagnosis of malignant or benign cases. Cases of giant cell tumor diagnosed from 1983 to 2011 displayed an age and sex distribution (median age at diagnosis, 34.0 years; 54% female) that were consistent with those in large published case series but differed from those in 1958 to 1982 (median age at diagnosis, 31.5 years; 48% female). The most current data (1983 to 2011) showed the giant cell tumor incidence in Sweden to be 1.3 per million per year, while the osteosarcoma incidence was 2.3 per million per year.
Early Swedish Cancer Registry data (1958 to 1982) revealed a higher proportion of malignant giant cell tumors than seen in large sequential case series and a distinct age and sex profile compared with more recent data (1983 to 2011). This likely represents changes in the diagnostic workup and introduction of multidisciplinary review of giant-cell-containing tumors around 1982. Recent data may reflect the impact of expert centralized biopsy and multidisciplinary case review and more comprehensive reporting of benign giant cell tumors.
瑞典癌症登记处（成立于1958年）是骨巨细胞瘤流行病学研究的独特资源，有潜力用于基于人群的发病率随时间变化的研究。本研究的目的是提供我们认为的对骨巨细胞瘤发病率趋势的首次现代基于人群的评估，骨巨细胞瘤是一种独特的破骨细胞性溶骨性间质肿瘤，具有良性和恶性组织学形式，并将研究结果与同一登记处骨肉瘤的数据进行比较，骨肉瘤是一种可能表现出相似组织学特征的肿瘤。
使用病理性骨肿瘤编码（国际疾病分类[ICD]-7 196）确定病例。特定的形态学编码可区分良性骨巨细胞瘤（PAD 741）与恶性骨巨细胞瘤（PAD 746）及骨肉瘤（PAD 766）。
在1958年至2011年期间，共报告了4625例骨肿瘤，其中包括505例骨巨细胞瘤（383例良性和122例恶性）和1152例骨肉瘤。1958年至1982年，恶性与良性骨巨细胞瘤的比例为1.3，而1983年至2011年该比例颠倒为0.09，这表明恶性或良性病例的报告或诊断发生了变化。1983年至2011年诊断的骨巨细胞瘤病例显示出的年龄和性别分布（诊断时的中位年龄为34.0岁；54%为女性）与大型已发表病例系列中的情况一致，但与1958年至1982年的情况不同（诊断时的中位年龄为31.5岁；48%为女性）。最新数据（1983年至2011年）显示瑞典骨巨细胞瘤的发病率为每年每百万人1.3例，而骨肉瘤的发病率为每年每百万人2.3例。
瑞典癌症登记处早期数据（1958年至1982年）显示，恶性骨巨细胞瘤的比例高于大型连续病例系列中的情况，且与近期数据（1983年至2011年）相比，年龄和性别分布有所不同。这可能代表了1982年左右诊断检查工作的变化以及对含巨细胞肿瘤引入多学科评估。近期数据可能反映了专家集中活检和多学科病例评估的影响以及对良性骨巨细胞瘤更全面的报告。
