Sommer H J, Riebel T, Winkler K, Heise U, Delling G
Rofo. 1985 Jul;143(1):74-82. doi: 10.1055/s-2008-1052763.
Since the introduction of pre-operative chemotherapy, osteosarcomas have shown a more favourable prognosis. Reaction of the tumour due to chemotherapy is judged pre-operative primarily by radiology (plain films, angiography, CT, scintigraphy). There is little evidence concerning the radiological appearances after pre-operative chemotherapy and morphological changes, particularly in respect of tumour regression. Specific radiological changes were therefore compared with pathological findings following chemotherapy and operation in 17 patients with osteosarcomas. Tumours were examined which showed radiological evidence of intra-and extra-osseous sclerosis or lysis and which still were classified as vital tumour tissue. Tumour planes were reconstructed from large histological sections of the operative specimen and compared with the radiological appearances. Sclerosis was found to be due to reactive new bone formation or to mineralisation of the osteosarcomatous tissue. Lysis correlated with persistent vital tumour, or in connective tissue. Nine out of ten cases, regarded as vital on radiological evidence, showed vital tumour cells on histological section. Lyses and scleroses were not reliable indications of the pre-operative state of the osteosarcoma following chemotherapy. On the other hand, combined qualitative radiological criteria for assessing tumour vitality, proved to be helpful.
自从引入术前化疗以来，骨肉瘤的预后已显示出更为有利的趋势。化疗对肿瘤的反应在术前主要通过放射学检查（平片、血管造影、CT、闪烁扫描）来判断。关于术前化疗后的放射学表现及形态学变化，尤其是肿瘤消退方面的证据很少。因此，对17例骨肉瘤患者化疗及手术后的特定放射学变化与病理结果进行了比较。检查的肿瘤表现出骨内及骨外硬化或溶解的放射学证据，且仍被归类为有活性的肿瘤组织。从手术标本的大组织切片重建肿瘤层面，并与放射学表现进行比较。发现硬化是由于反应性新骨形成或骨肉瘤组织的矿化所致。溶解与持续存在的有活性肿瘤或结缔组织相关。在放射学证据显示为有活性的10例病例中，有9例在组织学切片上显示有活性的肿瘤细胞。溶解和硬化并非化疗后骨肉瘤术前状态的可靠指标。另一方面，用于评估肿瘤活性的综合定性放射学标准被证明是有帮助的。
