Marcelli C, Chappard D, Rossi J F, Jaubert J, Alexandre C, Dessauw P, Baldet P, Bataille R
Laboratoire d'Anatomie Pathologique, Hôpital Lapeyronie, Montpellier, France.
Cancer. 1988 Sep 15;62(6):1163-70. doi: 10.1002/1097-0142(19880915)62:6<1163::aid-cncr2820620620>3.0.co;2-6.
In a prospective study of the quantitative bone changes induced by B-cell cancers other than multiple myeloma (MM), but including chronic lymphocytic leukemia (CLL; n = 8), hairy cell leukemia (HCL; n = 3), and Waldenström disease (WD; n = 7), an abnormal bone remodeling close to malignant cells was found in 80% of the patients. This was observed more frequently in cases of diffuse, but not nodular, bone marrow involvement by tumor cells. More particularly, excessive bone resorption (a major feature of MM) associated with a normal to low bone formation (i.e., uncoupling bone disease) was the most frequent feature and in the same range of that observed in overt MM. However, as opposed to MM, this bone resorption was characteristically mediated by small mononucleated osteoclasts (i.e., microresorption). The same phenomena of abnormal bone remodeling, the uncoupling process, excessive bone resorption, and above all microresorption were confirmed by the detailed bone study of five cases of B-cell cancers other than MM presenting lytic bone lesions and hypercalcemia. The current findings are important for clarifying the biology of these B-cell malignant diseases, and also could be of diagnostic and prognostic value.
在一项对除多发性骨髓瘤（MM）外的B细胞癌（包括慢性淋巴细胞白血病（CLL；n = 8）、毛细胞白血病（HCL；n = 3）和华氏巨球蛋白血症（WD；n = 7））所致定量骨变化的前瞻性研究中，80%的患者在靠近恶性细胞处发现骨重塑异常。在肿瘤细胞弥漫性而非结节性累及骨髓的病例中，这种情况更常见。更具体地说，与正常至低骨形成相关的过度骨吸收（MM的主要特征），即骨解偶联疾病，是最常见的特征，且与明显MM中观察到的情况处于同一范围。然而，与MM不同的是，这种骨吸收的特征是由小单核破骨细胞介导的（即微吸收）。对5例除MM外伴有溶骨性骨病变和高钙血症的B细胞癌进行详细的骨研究，证实了相同的异常骨重塑现象、解偶联过程、过度骨吸收，尤其是微吸收。目前的研究结果对于阐明这些B细胞恶性疾病的生物学特性很重要，并且可能具有诊断和预后价值。
