Roessner Albert, Smolle Maria, Schoeder Victor, Haybaeck Johannes
Institut für Pathologie, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Graz, Graz, Österreich.
Pathologe. 2020 Mar;41(2):143-152. doi: 10.1007/s00292-020-00752-5.
Cartilage tumors are a heterogeneous group of mesenchymal tumors whose common characteristic is the formation of a chondroblastic differentiated groundsubstance by the tumor cells. The basic features of their histological classification were already developed in the 1940s and supplemented by further entities in the following decades. Only in the past 10-15 years have fundamental new insights been gained through molecular genetic analysis. So, osteochondromas are characterized by alterations in the EXT1 and EXT2 genes. The description of mutations of isocitrate dehydrogenase 1 and 2 (IDH 1 and 2) in chondromas and chondrosarcomas is particularly important. The mesenchymal chondrosarcoma is characterized by a fusion of the HEY1-NCOA2 genes. The molecular genetic alterations characteristic for the individual tumor entities are first of all an essential supplement for the differential diagnosis of radiologically and histologically difficult cases. They also provide the basis for the establishment of molecular target therapies for malignant chondrogenic tumors. This applies in particular to conventional chondrosarcoma, for which all approaches to chemo- and radiotherapy have proven to be ineffective. However, the use of target therapies is still in its beginnings.
软骨肿瘤是一组异质性间充质肿瘤,其共同特征是肿瘤细胞形成软骨母细胞分化的基质。其组织学分类的基本特征在20世纪40年代就已形成,并在随后几十年中增加了更多类型。仅在过去10至15年中,通过分子遗传学分析才获得了根本性的新见解。例如,骨软骨瘤的特征是EXT1和EXT2基因发生改变。软骨瘤和软骨肉瘤中异柠檬酸脱氢酶1和2(IDH 1和2)突变的描述尤为重要。间叶性软骨肉瘤的特征是HEY1-NCOA2基因融合。各个肿瘤实体特有的分子遗传学改变首先是对放射学和组织学诊断困难病例进行鉴别诊断的重要补充。它们也为恶性软骨源性肿瘤分子靶向治疗的建立提供了基础。这尤其适用于传统型软骨肉瘤,所有化疗和放疗方法对其均已证明无效。然而,靶向治疗的应用仍处于起步阶段。