Morphology and in vivo growth characteristics of an atypical murine proliferative osseous lesion induced in vitro

Mandibular condyles of late embryonic NMRI mice were used to study the effect of the FBR murine osteosarcoma virus in an in vitro tissue culture system. Chondroprogenitor cells and chondroblastic cells present in the condylar tissue normally undergo rapid differentiation in vitro which results in an advanced stage of bone formation. The infection of condyles with FBR murine osteosarcoma virus induced the transformation of bone progenitor cells and the formation of an atypical proliferative osseous lesion. In markedly disorganized tissue many spindle-like cells, giant cells, and pleomorphic cells were seen together with the formation of large bone spicules and the heavy mineralization of osteoid-like material and of the remaining cartilage. Fibroblast-like cells were found to penetrate from the perichondrial zone into the condylar mass and also into the underlying collagen sponge. The in vivo growth characteristics of FBR murine osteosarcoma virus-infected condyles after 3 days in culture were studied via s.c. transplantation into syngeneic mice. Control condyles developed normal trabecular bone, whereas the infected condyles induced a strong cellular response with the presence of atypical cells and newly formed connective tissue and bone in situ. These observations raise the possibility of a novel approach for further investigations related to numerous aspects of virus-induced osteosarcomagenesis.     

Radiation therapy of osseous metastasis

Palliative irradiation for bone metastasis is very effective. In more than 80% of the patients the effective pain relief can be obtained by the administration of 20-30 Gy in total dose. A review of the literature as well as our clinical experiences indicates that within wide ranges no optimal radiation schedule or dose exist for reducing pain in bone metastasis. The most important purpose of radiotherapy is not the pain relief bt the prevention of the fracture and the spinal palsy. Therefore, the method and schedule of the radiotherapy should be decided in due consideration of the location of the primary lesion and its extension, the location and extent of the bone metastasis, and the general condition of the patient.     

Osteopoikilosis masquerading as osseous metastases in breast cancer

Osteopoikilosis (OPK) is a rare, congenital bone disorder characterised by multiple round or ovoid radio densities appearing throughout the axial and appendicular skeleton. It is usually an asymptomatic condition diagnosed incidentally on radiological imaging, and may mimic other bone disorders, including osseous metastases. In this case report, we present a patient with lobular breast cancer whose computed tomography findings were thought to be consistent with osseous cancer metastases. Radionuclide bone scintigraphy plays a key role in distinguishing OPK from osteoblastic bone metastases. This case demonstrates the importance of a clinical awareness of OPK to ensure that patients with potentially curable disease are properly diagnosed.     

Clinical approaches to osseous metastases in prostate cancer

BACKGROUND: Prostate cancer is unique among solid tumors in its proclivity to metastasize primarily to bone. Osseous metastases pose a formidable health threat to patients with metastatic disease, putting them at risk for pain, marrow crowding, fracture, and other sequelae. Treatments directed against bone disease have the potential both to palliate pain and to increase survival. CONCLUSIONS: A number of agents exist that have the potential to palliate the effects of osseous metastases and should be routinely applied in the clinical care of the patient with advanced prostate cancer. These include hormones, bone-seeking radiopharmaceuticals, chemotherapy, and bisphosphonates. Strategies under investigation aim to eradicate bone disease, and not merely palliate symptoms. These approaches combine those listed above with tumor-directed targeting of osseous disease and manipulation of the biology that underlies the cancer's relationship to bone.     

Osteoprotegerin overexpression by breast cancer cells enhances orthotopic and osseous tumor growth and contrasts with that delivered therapeutically

Osteoprotegerin (OPG) acts as a decoy receptor for receptor activator of NF-kappaB ligand (RANKL), which is a pivotal molecule required for osteoclast formation. In vitro OPG inhibits osteoclast formation and in vivo (administered as Fc-OPG) it reduces hypercalcemia and the establishment of osteolytic lesions in mouse models of tumor cell growth in bone. Osteolysis can be induced by parathyroid hormone-related protein (PTHrP) produced by breast cancer cells that results in an increased osteoblastic RANKL/OPG ratio. We examined the effect of local tumor production of OPG on the ability of breast cancer cells to establish and grow in bone and mammary fat pad. MCF-7 cells or MCF-7 cells overexpressing PTHrP were transfected with full-length OPG and inoculated into the proximal tibiae of athymic nude mice. Mice injected with cells overexpressing PTHrP and OPG showed enhanced tumor growth, increased osteolysis (2-fold compared with MCF-7 cells overexpressing PTHrP), and altered histology that was reflective of a less differentiated (more aggressive) phenotype compared with MCF-7 cells. In contrast, administration of recombinant Fc-OPG reduced tumor growth and limited osteolysis even in mice inoculated with OPG overexpressing cells. Similarly, OPG overexpression by breast cancer cells enhanced tumor growth following orthotopic inoculation. These results indicate that OPG overexpression by breast cancer cells increases tumor growth in vivo and that there are strikingly different responses between therapeutically administered Fc-OPG and full-length OPG produced by tumor cells.     

骨骼Rosai-Dorfman病的诊疗进展

Rosai-Dorfman病，又称窦组织细胞增生伴巨大淋巴结病，是一种罕见的组织细胞病，通常表现为青少年的无痛性双侧颈部淋巴结肿大。Rosai-Dorfman病发病累及骨骼者不到10%，并且多达75%的骨骼Rosai-Dorfman病患者同时存在软组织病灶。颅骨、颌面骨和胫骨是骨骼Rosai-Dorfman病最常见的发病部位。该病临床表现缺乏特异性，诊断主要依靠常规病理学和免疫组织化学染色检查。临床表现主要是局部疼痛和肿胀。影像学上，通常表现为髓内的溶解性病变，有时伴有周围硬化。目前，Rosai-Dorfman病的病因尚不明确，可能涉及潜在的宿主免疫失调、IgG4相关疾病、多种自身免疫性疾病和基因突变等。目前伴有症状的骨骼Rosai-Dorfman病的治疗方案主要取决于具体病灶位置，主要包括手术刮除或切除，其他治疗方案包括激素治疗和化疗等。由于骨骼Rosai-Dorfman病的临床和影像学表现通常提示恶性病变可能，部分患者可能接受比较激进的治疗。全身PET/CT可以用于Rosai-Dorfman病的分期、随访和评估。     

乳腺癌骨转移患者生存分析

目的 提高对乳腺癌骨转移患者预后影-向因素的进一步认识，指导临床个体化治疗。方法 回顾分析有完整病例资料的乳腺癌骨转移患者68例。结果 68例患者的中位生存期20个月，乳腺癌骨转移合并肝脏和/或肺转移同时存在时，患者的中位生存期13．5个月；乳腺癌骨转移不合并肝脏和/或肺转移患者的中位生存期为26个月；仅有骨转移而不合并其他脏器转移的患者的平均生存时间为44.2个月。结论 乳腺癌转移患者中肝脏和/或肺转移是预后不良指标。骨转移而不合并其他转移的患者生存期较长，其次是骨转移合并肺转移者、合并淋巴结转移、骨转移合并多个脏器转移者及合并肝脏转移者。     

Fibro osseous lesions of cranio facial bones

In a review of all tumours and tumour like lesions of the craniofacial bones between the years 1963 and 1980, 19 cases were diagnosed as fibro osseous lesions. The mean age of occurrence was 23.8 years with a slight male predominance (1.6:1). The clinical and histological aspects of the various lesions, the problems in diagnosis and the impact of diagnosis on clinical behaviour are discussed.     

Percutaneous radiofrequency ablation of painful osseous metastases

BACKGROUND:

The study was conducted to determine whether radiofrequency ablation (RFA) can safely reduce pain from osseous metastatic disease.

METHODS:

The single‐arm prospective trial included patients with a single painful bone metastasis with unremitting pain with a score >50 on a pain scale of 0‐100. Percutaneous computed tomography‐guided RFA of the bone metastasis to temperatures >60°C was performed. Endpoints were the toxicity and pain effects of RFA before and at 2 weeks, 1 month, and 3 months after RFA.

RESULTS:

Fifty‐five patients completed RFA. Grade 3 toxicities occurred in 3 of 55 (5%) patients. RFA reduced pain at 1 and 3 months for all pain assessment measures. The average increase in pain relief from pre‐RFA to 1‐month follow‐up is 26.3 (95% confidence interval [CI], 17.7‐34.9; P < .0001), and the increase from pre‐RFA to 3‐month follow‐up is 16.38 (95% CI, 3.4‐29.4; P = .02). The average decrease in pain intensity from pre‐RFA to 1‐month follow‐up was 26.9 (P < .0001) and 14.2 for 3‐month follow‐up (P = .02). The odds of lower pain severity at 1‐month follow‐up were 14.0 (95% CI, 2.3‐25.7; P < .0001) times higher than at pre‐RFA, and the odds at 3‐month follow‐up were 8.0 (95% CI, 0.9‐15.2; P < .001) times higher than at pre‐RFA. The average increase in mood from pre‐RFA to 1‐month follow‐up was 19.9 (P < .0001) and 14.9 to 3‐month follow‐up (P = .005).

CONCLUSIONS:

This cooperative group trial strongly suggests that RFA can safely palliate pain from bone metastases. Cancer 2010. © 2010 American Cancer Society     

原发性脊柱骨肿瘤的放射治疗

原发性脊柱骨肿瘤的治疗是临床工作中的难点,治疗过程中最大的挑战在于提高肿瘤局部控制率和最大程度保留神经功能之间的权衡取舍.手术是原发性脊柱骨肿瘤的一线治疗方式.然而,由于患者基础情况、肿瘤大小、位置等限制因素,手术治疗仍有其局限性.过去,常规放疗常常作为手术的辅助治疗方式;但常规放疗往往因为靶区邻近脊髓而使靶区放射剂量不足,进而导致远期预后不佳.随着放疗技术的不断发展,放射治疗在原发性脊柱骨肿瘤的治疗中发挥着越来越重要的作用.在原发性脊柱肿瘤的治疗领域,最新的放疗技术使肿瘤区域受照剂量在增加的同时将正常组织受照剂量控制在可耐受的范围内成为可能,这些放疗技术包括调强放射治疗、立体定向体部放射治疗、质子及重离子治疗以及近距离治疗.     

Carbohydrates and colorectal cancer risk among Chinese in North America.

Previous studies have analyzed total carbohydrate as a dietary risk factor for colorectal cancer (CRC) but obtained conflicting results, perhaps attributable in part to the embedded potential confounder, fiber. The aim of this study was to analyze the nonfiber ("effective") carbohydrate component (eCarb) separately and to test the hypothesis that effective carbohydrate consumption is directly related to CRC risk. The data (473 cases and 1192 controls) were from a large, multicenter, case-control study of Chinese residing in North America. Multivariate logistic regression was used to perform a secondary analysis controlling for age; sex; consumption of fat, fiber, calcium, and total kilocalories; body mass (Quetelet's) index; family history; education; and years in North America. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate risk among subgroups by sex and cancer site. A statistically significant positive association was observed between eCarb consumption and risk of CRC in both men (OR, 1.7 comparing highest with lowest tertile of eCarb consumption; 95% CI, 1.1-2.7) and women (OR, 2.7; 95% CI, 1.5-4.8). As expected, the ORs for total carbohydrate were somewhat lower than those for effective carbohydrate, but the differences were not large. A sex difference in risk by colorectal subsite was observed, with risk concentrated in the right colon for women (OR, 6.5; 95% CI, 2.4-18.4) and in the rectum for men (OR, 2.4; 95% CI, 1.2-4.8). These data indicate that increased eCarb and total carbohydrate consumption are both associated with increased risk of CRC in both sexes, and that among women, relative risk appears greatest for the right colon, whereas among men, relative risk appears greatest for the rectum.