【摘要】 <正> 骨巨细胞瘤好发于长骨两端,以股骨下端和胫骨上端多见。刮除术后复发率约50％,因此目前多主张尽量采用截除手术治疗。 这种骨肿瘤过去曾被认为是良性病变,由于有些骨巨细胞瘤侵犯和破坏骨质,术后能复发,恶性程度较高者也能转移,所以目前将它看作介于良性与恶性之间的半恶性肿瘤。其细胞成分主要是多核巨细胞和单核间质细胞。更多还原

【Abstract】 In vitro tissue culture of 22 giant cell tumors of bone, which were graded accordingto the criteria set by Jaffe and Lichtenstein were undertaken. All showed growth. Studywas made on several aspects with 18 tumors, the culture of which had terminated beforeJuly 1979. There were 9 grade Ⅰ tumors maintaining growth for 153 days on average (range:56--266 days); 8 grade Ⅱ tumors with growth for 197 days on average (range: 39--363 days);and 1 grade Ⅲ tumor in continuous culture for 625 days with 75 passages. Among these, 4 were post-operative recurring tumors and the life span of their culturedcells were 198,294,363 and 625 days respectively. This fact bespeaks that the higher thepathological grade the longer the life span of the cultured tumor cells. The recurring tu-mors also manifest active growth potential. Thus, the in vitro growth behavior of the tumorcells tends to reflect the clinical pattern. This lends considerable support to the view thatpathological grading of giant cell tumor of bone is of value in selecting the modality oftreatment and predicting the outcome, especially for the grade Ⅰ and Ⅲ tumors. In tissue culture, giant cells usually survived about 3 weeks, though very occasionallythey lasted 3 months or more. However, these giant cells should be differentiated from themultinucleated cells containing only a few and even irregular nuclei, found in long standingcultues of grade Ⅱ and Ⅲ specimens. The latter multinucleted cells were most probablyresulted from abnormal division of fusion of the neoplastic stromal cells. Growth of stromal cells usually maintained at least 5-6 weeks and even up to 1 2/3years as observed in the present study. The circumstantial evidence points out that the stro-mal cells rather than the giant cells should be considered as the offending neoplasticinvader. The authors also carried out cinemicrographic observations of the cultured cells whichis helpful to the interpretation of morphology on stained slides. The giant cells displayedameboid movements and may at times contract into ovoid or spherical cells. So far, forma-tion of giant cells either by syncytial aggregates of stromal cells or by intracellular nuclealdivision had not been observed. The last mentioned work is to be published.更多还原