骨巨细胞瘤60例手术分析

1.本文报告60例骨巨细胞瘤手术,男性33例、女性27例,平均31.75岁,21—40岁占75%。部位以四肢长骨端为多见,占78.33%,其中好发于膝部,占长骨端的68%。随访55的,有9例死亡,二例肺转移及3例局部复发。共占25.45%。2.病理:5年生存率Ⅰ级93.8%,Ⅱ级80.2%,Ⅲ级0,肿瘤间质细胞的形态与预后亦有关,F型5年生存率95%,H型75.9%。且H型及有血窦样结构者,肺转移较多。3.刮除加植骨术。复发率为13.3%,疗效较好,大块截除关节融合术,复发转移率为13.3%,截肢术主要用于Ⅲ级,但亦不能挽救生命。

Analysis of 60 Operated Cases of Giant—cell Tumor of Bones

60 cases of Giant-cell tumor of bones are reported in this paper.Of the 60 cases, 37 were males and 23 females. Their age was 16-67 andthe average age was 31. 75%. 75% was in the age of 21-40 5 were undertwenty and 4 out of them were females. The knee region was the commonest site. In 16 patients tumors werein the distal part of the femur, 13 in the proximal part of the tibia, 7 inthe proximal part of the femur. According to the different forms of the stromatic cells of the tumor.they were divided into spindle cell type(F) and ovalcell type (H). Thesurvial rate for five years of type F were obviously higher than that of typeH. However, lung metastasis were found in type H than in type F. Onthe other hand, in the pathological pattern of the metastatic cases of thelung 75% got plentiful blood sinusoid structures. All of this group underwent different opeations. Four cases were givenbiopsy. Sixteen cases were curetted and packed with bone chips with therecurrence rate 13. 3%. Sixteen cases were enbloc removal of the tumorand arthrodesis with the recurrence rate 13. 3%. Six cases (grade Ⅲ) wereamputated. All of them died within two and a half years. Fifty-five cases were followed and in two yaers seven out of themdied, and local recurrence was present in one case and lung metastasis wasfound in one case. Fourty-six cases were followed for 2 to 20 yearsand the average period was 7 years. There were 2 deaths, 2 local recurre-nces and one lung metastasis. The total recurrence-death rate was 25. 45%.