【摘要】 [目的]观察地舒单抗新辅助治疗在手术治疗难治性骨巨细胞瘤中的疗效。[方法]回顾性分析2020年9月—2022年9月本科收治的12例难治性骨巨细胞瘤患者的临床资料，术前每周皮下注射地舒单抗注射液120 mg，持续4周，观察临床及影像学结果。[结果]所有患者均顺利完成手术，术中无神经、血管损伤等严重并发症。用药后肿瘤组织纤维化变韧呈灰白色，边界清晰，组织学染色显示局部可见少量破骨细胞样多核巨细胞。与用药前相比，用药后、术后3个月、末次随访时VAS评分[(4.5±0.6),(2.1±0.8),(0.8±0.6),(0.3±0.4), P<0.001]显著下降，SF-36评分[(50.8±3.3),(53.6±4.2),(65.4±5.0),(81.7±3.7), P<0.001]显著增加（P<0.05）。影像方面，与用药前相比，用药后肿瘤CT最大直径[(65.3±15.1) mm vs (52.3±14.0) mm, P<0.001]显著缩小，病灶边缘CT值[(98.2±30.5) HU vs (276.1±79.1) HU, P<0.001]显著增加，病灶中心CT值[(38.4±10.4) HU vs (97.1±20.0) HU, P<0.001]显著增加。[结论]地舒单抗可作为一种新辅助治疗手段来达到外科降级，促进肿瘤病灶彻底刮除，最大程度地保留正常骨骼结构，以满足术后功能康复。更多还原

【Abstract】 [Objective] To observe the outcomes of denosumab as neoadjuvant therapy in the surgical treatment of refractory giant cell tumor of bone. [Methods] A retrospective study was conducted on 12 patients who received treatment for refractory giant cell tumor of bone in our department from September 2020 to September 2022. Denosumab injection was injected subcutaneously once a week for 4 weeks before surgery, followed by surgical treatment, and clinical and imaging results were observed. [Results] All patients were successfully operated, with no nerve, vascular injury and other serious complications. After treatment, the tumor tissue became fibrotic and toughened to grayish white with clear boundaries, and histological staining showed a small number of osteoclast-like multinucleated giant cells in the local area.Compared to those before medication, the VAS score [(4.5±0.6),(2.1±0.8),(0.8±0.6),(0.3±0.4), P<0.001] decreased significantly, whereas the SF-36 score [(50.8 ±3.3),(53.6±4.2),(65.4±5.0),(81.7±3.7), P<0.001] increased significantly 3 months after operation, and at the time of the last follow-up. In terms of imaging, compared with those before medication, the maximum CT diameter of the lesion significantly decreased [(65.3±15.1) mm,(52.3±14.0) mm, P<0.001], whereas the lesion edge CT value [(98.2±30.5) HU,(276.1±79.1) HU, P<0.001] and the focal CT value [(38.4±10.4) HU,(97.1±20.0) HU, P<0.001] significantly increased after denosumab therapy. [Conclusion] Denosumab can be used as a neoadjuvant therapy to achieve surgical degradation, promote the complete curettage of tumor lesions, and preserve the normal bone structure to the maximum extent to meet the postoperative functional rehabilitation.更多还原