Hayashi K
Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1994 Apr;68(4):151-61.
A total of 70 patients with conventional osteosarcoma underwent preoperative chemotherapy, and here we report the histopathological effects of the chemotherapy on the tumors. The changes in the tumors since pre-chemotherapy observed at resection were classified as: (1) non-degeneration, (2) degeneration, (3) coagulation necrosis, (4) granulation, (5) fibrosis, or (6) osteosclerosis, It was thought that any coagulation necrosis was due to ischemia, while any degeneration in the tumor tissue was mainly caused by the chemotherapy. Coagulation necrosis was found at the center of the tumor, while degeneration, fibrosis, and osteosclerosis tended to be present mainly at the periphery. Coagulation necrosis was less prominent in these patients with a longer period between preoperative chemotherapy and resection. The above results suggest that coagulation necrosis was not a change caused directly by the chemotherapy, and there is a possibility that the tumor cells in these regions survived until just before resection. Accordingly, when evaluating the effects of preoperative chemotherapy, it may be inappropriate to include any area of coagulation necrosis in the calculation of the necrotic ratio.
共有70例传统型骨肉瘤患者接受了术前化疗，在此我们报告化疗对肿瘤的组织病理学影响。在切除时观察到的化疗前以来肿瘤的变化分为：(1) 未退变，(2) 退变，(3) 凝固性坏死，(4) 肉芽组织，(5) 纤维化，或(6) 骨硬化。认为任何凝固性坏死均由于缺血所致，而肿瘤组织中的任何退变主要由化疗引起。凝固性坏死见于肿瘤中央，而退变、纤维化和骨硬化往往主要见于周边。在术前化疗与切除之间间隔时间较长的这些患者中，凝固性坏死不那么明显。上述结果提示凝固性坏死并非化疗直接引起的变化，并且这些区域的肿瘤细胞有可能存活至切除前。因此，在评估术前化疗效果时，在计算坏死率时纳入任何凝固性坏死区域可能不合适。
