Davies A Mark, Patel Anish, Botchu Rajesh, Azzopardi Christine, James Steven, Jeys Lee
Departments of Imaging &, Royal Orthopaedic Hospital, Birmingham, B21 3AP, United Kingdom.
Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, B21 3AP, United Kingdom.
J Clin Orthop Trauma. 2021 Feb 27;17:106-111. doi: 10.1016/j.jcot.2021.02.017. eCollection 2021 Jun.
To ascertain the changing incidence over time of the three commonest primary sarcomas of bone. Data obtained with particular reference to central chondrosarcoma from the annual referral rate to a large UK-based specialist orthopaedic oncology unit. To discuss how the "barnyard pen" analogy of cancers previously applied to certain commoner cancers can also be applicable to central chondrosarcoma (CS) of bone.
A retrospective review was conducted of a computerised database identifying all central cartilage tumours (CCT) of bone, including enchondroma and CS subtypes, between 1985 and 2018. These were compared with the referrals of the other two commonest primary sarcomas of bone, osteosarcoma and Ewing sarcoma.
There was a total of 1507 CS showing a 68% overall increase in annual referral rate/incidence over the study period. 68% cases were the borderline malignant lesions now known as atypical cartilaginous tumour (ACT). The annual referral rate/incidence of this entity increased by 194% over the 30 years. Whereas, the annual referral rate/incidence for osteosarcoma and Ewing sarcoma was static for the past 20 years.
The annual incidence of central CS of bone showed a marked increase over the 33-year period as compared with both osteosarcoma and Ewing sarcoma. This is especially in the ACT category and is thought to be due to the increased provision of MRI scanning flagging up a rise in incidental findings. The spectrum of CCTs from benign to highly malignant elegantly fits the "barn yard" pen analogy and could prove useful as an explanatory tool for patients and clinicians unfamiliar with these diseases.
确定三种最常见的原发性骨肉瘤的发病率随时间的变化情况。特别参考英国一家大型专业骨肿瘤学单位的年度转诊率，获取有关中央型软骨肉瘤的数据。探讨先前应用于某些较常见癌症的“谷仓围栏”癌症类比如何也适用于骨的中央型软骨肉瘤（CS）。
对一个计算机化数据库进行回顾性研究，该数据库识别了1985年至2018年间所有骨的中央软骨肿瘤（CCT），包括内生软骨瘤和CS亚型。将这些与另外两种最常见的原发性骨肉瘤骨肉瘤和尤因肉瘤的转诊情况进行比较。
共有1507例CS，在研究期间年度转诊率/发病率总体增加了68%。68%的病例是现在被称为非典型软骨肿瘤（ACT）的交界性恶性病变。该实体的年度转诊率/发病率在30年内增加了194%。而骨肉瘤和尤因肉瘤的年度转诊率/发病率在过去20年中保持稳定。
与骨肉瘤和尤因肉瘤相比，骨的中央型CS的年度发病率在33年期间显著增加。这在ACT类别中尤为明显，被认为是由于MRI扫描的增加发现了更多偶然发现。从良性到高度恶性的CCT谱完美地符合“谷仓围栏”类比，对于不熟悉这些疾病的患者和临床医生可能是一个有用的解释工具。
