Stenzel I, Pösl M, Ritzel H, Hentz M, Werner M, Delling G
Abteilung Osteopathologie, Hamburger Knochentumorregister Pathologisches Institut, Universität Hamburg.
Pathologe. 1996 Jan;17(1):56-62. doi: 10.1007/s002920050135.
Bone tumors represent a group of tumors of various dignity. In spite of this single tumor entities may display strong morphological resemblance to each other which can in turn result in profound difficulties in differential diagnosis. The biological behaviour of a tumor is mainly determined by its rate of proliferation. In this study the rate of proliferation of 64 bone tumors (30 high-grade central osteosarcomas, 6 low-grade osteosarcomas, 8 giant cell tumors, 8 aneurysmatic bone cysts, 5 osteoidosteomas/osteoblastomas, 7 fibrous dysplasias and 5 cases of a myositis ossificans) were analysed. Immunohistochemistry was performed on paraffin-embedded tissue sections using the MIB-1 monoclonal antibody. MIB-1 recognizes the proliferation-associated Ki-67 protein which is expressed during the active phases of the cell cycle but cannot be detected in senescent cells. Among high-grade central osteosarcomas a significantly higher rate of proliferation (average value 30%) was found in comparison with low-grade osteosarcomas and other benign intraosseous bone tumors. This approach proved to be very useful in the distinction between high-grade and low-grade osteosarcomas as well as bone-forming intraosseous tumors. However distinguishing low-grade osteosarcomas from benign bone tumors by determining only the rate of proliferation was not possible, although interestingly, the proliferative rate of myositis ossificans, a purely reactive lesion, was in the range of the values determined for high-grade osteosarcoma.
骨肿瘤是一组具有不同性质的肿瘤。尽管如此，单个肿瘤实体之间可能在形态上有很强的相似性，这反过来可能导致鉴别诊断出现严重困难。肿瘤的生物学行为主要由其增殖速率决定。在本研究中，分析了64例骨肿瘤（30例高级别中央骨肉瘤、6例低级别骨肉瘤、8例骨巨细胞瘤、8例动脉瘤样骨囊肿、5例骨样骨瘤/骨母细胞瘤、7例骨纤维异常增殖症和5例骨化性肌炎）的增殖速率。使用MIB-1单克隆抗体对石蜡包埋的组织切片进行免疫组织化学检测。MIB-1识别与增殖相关的Ki-67蛋白，该蛋白在细胞周期的活跃期表达，但在衰老细胞中无法检测到。与低级别骨肉瘤和其他良性骨内肿瘤相比，在高级别中央骨肉瘤中发现增殖速率明显更高（平均值为30%）。这种方法在区分高级别和低级别骨肉瘤以及骨形成性骨内肿瘤方面被证明非常有用。然而，仅通过确定增殖速率来区分低级别骨肉瘤和良性骨肿瘤是不可能的，尽管有趣的是，作为一种纯粹反应性病变的骨化性肌炎的增殖速率处于高级别骨肉瘤所确定的值范围内。
