应用单抗GCF-5观察骨巨细胞瘤细胞成分

采用免疫细胞化学和免疫电镜方法,以我室制备的抗骨巨细胞瘤(GCT)肿瘤细胞的单克隆抗体GCF-5,对41例GCT及其它肿瘤细胞进行观察,结果表明:41例中的35例GCT标本与GCF-5结合呈阳性反应;除1例骨肉瘤细胞系(OS-732)细胞为阳性反应外,其它骨肿瘤均为阴性反应。经免疫金染色后电镜下,在阳性细胞表面可见金颗粒,证明GCF-5抗体是抗细胞表面抗原的单克隆抗体,GCF-5与GCT中部分基质细胞(STC)结合,除与一些双核细胞和核数少的多核巨细胞(MGC)结合外,与绝大多数的MGC不发生反应,但能与GCT体外培养、多次传代后的MGC发生反应。均支持本作者以前的观点,即GCT中的MGC与STC各自包含两种截然不同的细胞成分:肿瘤细胞和与肿瘤免疫有关的细胞,仅肿瘤细胞成分能在体外培养中生长、增殖。     

Effect of cytokines on in vitro bone resorption by cells isolated from giant cell tumor of bone

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CELLULAR ELEMENTS IN GIANT CELL TUMOR OF BONE FEULGEN-DNA QUANTITATION, 3H_TdR INCORPORATION AND ULTRASTRUCTURE OBSERVATION

Anti-erythrocyte rosette assay was used to sub divide stromal cells (StCs) of cultured giant cell tumor (GCT) of bone into two groups, the rosette forming cells (RFCs) and non-rosette forming cells (NRFCs). Characteristics of Feulgen-DNA content, 3H.TdR uptake and ultrastructure of different cellular elemcnts in GCT were then investigated by micro- spectrophotometry, autoradiography and both TEM and SEM. Two types of StCs and multinucleated giant cells (MGCs) showed 2C DNA stem line, which contrasted strikingly with aneuploid DNA in osteosarcoma cells. Autoradiography revealed that the labelling index of NRFCs increased with the time of 3H.TdR incorporation in vitro, while RFCs and MGCs were scarcely tagged. The two types of StCs were distinctly different in both surface and intra- cellular structures. The phagocytic function and sur- face appearance of RFCs resembled those of ma crophages, and no polymorphism was found in RFCs. These facts suggest that NRFCs are the neoplastic element in GCT, whereas RFCs are the end-stage cells and possibly the macrophages related to tumor immunity.     

350例骨肿瘤及瘤样病变病理分析

本文对350例骨肿瘤及瘤样病变进行统计分析。其中良性瘤229例(65. 4%),恶性瘤70例(20. 0%),瘤样病变51例(14. 6%)。各组肿瘤患者年龄均以11～30岁较多见;男性多于女性;发生于股骨者较多见。良性瘤以软骨瘤最多,后依次为骨巨细胞瘤、骨瘤及骨软骨瘤。恶性瘤以骨肉瘤多见,依次为软骨肉瘤、恶性骨巨细胞瘤。骨的瘤样病变包括骨纤维结构不良、孤立性骨囊肿、动脉瘤性骨囊肿及骨嗜酸性肉芽肿。     

CONTRAST STUDY ON MULTINUCLEATED GIANT C,FLLS IN GIANT CELL TUMORS OF BONE AND OTHER MULTINUCLEATED CELLS

By means of tissue culture, electron microscopy, cytochemistry, indirect immunofluorescence and immunohistochemistry, the multinucleated giant cells(MGCs) in 12 giant cell tumors of bone (GCT) were studied in contrast with osteoclasts (OCs), foreign body giant cells (FGCs) and inflammatory giant cells (IGCs). The findings in the majority of MGCs were identical with those in OCs, suggesting that they most probably derived from the same precursor. Continuous in vitro culture revealed two kinds of MGCs, which were designated preliminarily as short-lived MGCs and long-lived MGCs for their difference in morphology and in several biological features, which suggests two kinds of MGCs exist in GCT. We conclude that the short-lived conform to the typical MGCs known generally to the pathologists, while the long-lived are deemed to be closely related to the neoplastic elements of the tumor.     

图像法DNA分析在骨肿瘤穿刺活检的应用

应用图像分析仪测定35例骨肿瘤穿刺组织的肿瘤细胞核DNA含量。结果表明恶性骨肿瘤DNA含量高于良性,良恶性之间差异非常显著。骨巨细胞瘤DNA指数广泛分布在良恶性之间,显示出“中间性肿瘤”的特征。骨巨细胞瘤复发组含量显著高于无复发组,提示DNA含量与肿瘤生物学行为有密切关系。术前穿刺DNA含量分析,有助于对肿瘤增殖能力的了解,作为术式选择,良、恶性肿瘤的鉴别和预后估计的参考。穿刺DNA图像分析法的开展是可行的,具有一定的临床价值。     

CYTOLOGIC OBSERVATION ON GIANT CELL TUMOR OF BONE

By combined immunologic, histochemical and other approaches, we studied the macro- phage content in 20 giant cell tumors of bone (GCT) as compared with that in 26 benign and malignant lesions of osseous and soft tissues. We found that many macrophages existed in GCvF. In the cell suspensions prepared by en- zymatic disaggregation, the percentage of macro- phge was apparently higher than in co.ntrol le- sions. After serial passage, macropha.ges and mult.inucleated giant cells (MGC) gradually de- creased in number, whereas spindle-shaped cells, which were negative for Fc, Cq recepitor and nonspecific esterase (NSE), maintained their growth. KeeIoin.g the cuture media uncha.nged for 7 t0 31 da.ys, cells containing Z t0 8 nuclei could be found in primary culture of macropha- ges isolated from GCT. Although Fc, C3 recep- tors and phagocytosis were not demonstrated in almost all MGC, some of them showed NSE ac- tivity and weak res.isitance to trypsin. It is worth noting that a few bi-, tri- and tetra-nucleated cells form.ed EA rosettes and phagocytosed E.A. The place of macrophages in GCT, their inter- relationship, ancl MGC are discussed.     

人骨巨细胞瘤细胞DNA含量的研究

将体外培养的人骨巨细胞瘤第四代和第五代瘤细胞,进行~3H—TdR放射自显影术和Feulgen反应,先计算出银粒标记细胞(S,G_2)的增殖比率,再用显微分光光度法测定未被标记的细胞(G_0和G_1期)的DNA含量。结果,第四代单核瘤细胞DNA含量为亚四倍体值((?)=87.36,DI=1.83),第五代单核瘤细胞DNA含量为超四倍体值((?)=118.13,DI=2.47).两代瘤细胞DNA含量经统计学处理,有显著差异(P<0.01),证实了骨巨细胞瘤细胞长期传代培养可以恶化。     

卵巢勃勒纳瘤5例临床病理观察与分析

目的:观察和分析卵巢勃勒纳(Brenner)瘤的临床和病理形态学特点,并阐明其诊断和鉴别诊断要点.方法:对5例卵巢勃勒纳瘤进行临床病理学、组织化学、免疫组织化学观察分析.结果:交界性瘤中可见良性瘤形态,但细胞巢增大、大小不一、排列较紧密、无巢与巢融合、无间质浸润.恶性瘤中可见交界性瘤区域,但不一定有良性瘤区域,且巢大、融合、有"出芽"现象等,并伴坏死、出血,向周围浸润或转移.结论:上皮巢和致密的纤维间质共存是勃勒纳瘤的基本结构成份.上皮巢和巢中上皮细胞形态的差别是鉴别良恶性瘤的要点.     

骨关节肿瘤450例分析

目的:探讨骨关节肿瘤及瘤样病变的发病情况及好发率、好发部位与性别年龄的差异性。方法:选取骨关节肿瘤及瘤样病变患者450例,按类别、发生部位、性别、年龄进行统计分析。结果:良性骨肿瘤患者215例(47.78%),好发于骨软骨瘤病(77例,35.81%);恶性骨肿瘤患者178例(39.56%),好发于转移瘤(80例,44.94%);骨瘤样病变25例(5.56%),好发于单纯性骨囊肿(9例,36%);关节肿瘤及瘤样病变患者32例(7%),好发于腱鞘巨细胞瘤(12例,37.5%);结论:骨关节肿瘤良性多于恶性,男性多于女性。     

肺软组织恶性巨细胞瘤(附1例病例报告)

软组织恶性巨细胞瘤较少见,发生于肺内者国内尚未见报道。对于其组织学来源尚无定论。本文报告1例肺软组织恶性巨细胞瘤,其主要组成为破骨细胞样巨细胞及单核性瘤细胞,组织学上颇似骨巨细胞瘤。通过特殊染色及免疫组化研究,确定其组织来源为组织细胞。     

一氧化氮合酶在骨肉瘤和骨巨细胞瘤中的表达及其与预后的关系

目的：探讨骨肉瘤和骨巨细胞瘤组织中一氧化氮合酶（nitric oxide synthase,NOS)的表达及其预后的关系。方法：用免疫组化法测定Ⅱ型iNOS在37例骨恶性肿瘤中的表达。结果：iNOS在骨肉瘤和骨巨细胞瘤的阳性表达率分别72．7％，58．8％。两组之间无差异（P＞0．05）。iNOS与骨巨细胞瘤病理分级呈现正相关（P＜0．05）。结论：iNOS与恶性骨肿瘤恶性度有关，与骨巨细胞瘤病理分级呈现正相关。对肿瘤的生长，分化及预后有重要作用。     

四肢骨肿瘤及肿瘤样病变患者99mTc-MDP骨显像特点及其鉴别诊断意义

目的：探讨四肢骨肿瘤及肿瘤样病变^99mTc-亚甲基二磷酸盐（^99mTc-MDP）骨显像放射性分布特点,阐明不同病理类型的四肢骨肿瘤及肿瘤样病变^99mTc-MDP骨显像放射性分布特点在鉴别诊断中的应用价值,为其临床诊断提供线索。方法：选择行^99mTc-MDP骨显像表现为四肢骨放射性分布异常患者76例,将^99mTc-MDP骨显像检查结果与最终临床诊断结果进行对照,分析不同病理类型患者年龄、病变部位和放射性分布特点的差异,采用半定量法（T/N）检测病灶的放射性摄取程度和良恶性病变组间T/N值的差异。结果：①76例四肢骨肿瘤及骨肿瘤样病变中良性病变24例,恶性病变52例。②年龄及病变部位。良性病变中骨巨细胞瘤患者年龄为（42.1±17.4）岁,发生部位为膝关节周围;纤维结构不良患者年龄为（48.0±17.1）岁,发生部位为股骨近端。恶性病变中转移癌患者年龄为（64.0±14.2）岁,均发生在股骨干;骨肉瘤患者年龄为（30.3±15.3）岁,发生部位为长骨骨骺端;尤文氏肉瘤患者年龄为（49.2±4.7）岁,股骨骨骺及骨干均可见;纤维肉瘤患者年龄为（39.5±17.2）岁,发生部位为长骨远端;软骨肉瘤患者年龄为（63.0±14.8）岁,发生部位为长骨近端,长骨骨骺端及长骨骨干均可见。③放射性分布特点。骨巨细胞瘤、骨肉瘤、尤文氏肉瘤、纤维肉瘤和软骨肉瘤呈"楔形"和"团块状"分布为主,骨巨细胞瘤缺损范围较尤文氏肉瘤及纤维肉瘤更大,骨肉瘤及软骨肉瘤中心区缺损罕见;纤维结构不良和骨转移癌主要呈"条形"分布,骨转移癌累及双侧骨皮质为多见伴中心区放射性缺损,而纤维结构不良沿单侧骨皮质放射性分布均匀。④恶性病变组T/N值（3.38±1.95）高于良性病变组（1.43±0.51）（t=-11.35,P<0.01）。结论：根据四肢骨肿瘤和肿瘤样病变^99mTc-MDP骨显像特点可初步推测病变的病理类型,为临床诊断及鉴别诊断提供可靠的参考。     

SURFACE CONFIGURATION OF BONE AND JOINT TUMOR AND TUMOROUS CONDITION PRELIMINARY SCANNING ELECTRON MICROSCOPIC STUDY OF 5 CASES

This paper describes the ult.rastruotural sur- face configurations of 5 cases with bone and joint tumors and tumorous conditions, observed by scanning electron microscopy (SEM). The study of pleomorphism of malignant bone tumor cells and their surface ultrastructures shows that there is increas.ed cell surface activity to meet heightened malignancy metabolism; Osteoid osteoma and pigmented villonoclular synovitis have no malignant tendencies, according to their surface ultrastructure. SEM iS valuable in in- vestigating tumor cell surface ultrastructure and the intercellular substances an.d in differentiat- ing malignant bone and ja:int tumo,rs from benign ones and tumorous conditions.     

~（99）Tc~（m）-MIBI双时相显像对四肢骨肿瘤诊断的临床应用价值

目的探讨99Tcm-甲氧基异丁基异腈（MIBI）双时相显像对四肢骨肿瘤的诊断价值及在恶性肿瘤化疗疗效评估中的作用。方法 51例经病理或影像学证实的四肢病变骨肿瘤患者[25例骨肉瘤,12例骨巨细胞瘤,6例软骨肉瘤,3例滑膜肉瘤,2例非何杰金氏淋巴瘤（NHL）,2例骨软骨瘤,1例骨髓炎],分别行99Tcm-MDP骨三相及99Tcm-MIBI早期、延迟双时相检查,进行半定量分析,数据进行统计学处理。结果 51例四肢骨病变中骨三相显像的灵敏度最高（96.4%）,但99Tcm-MIBI亲肿瘤的特异性最高（91.4%）,骨三相结果与99Tcm-MIBI亲肿瘤早期显像结果具有较高的一致性（78.3%）,99Tcm-MIBI早期显像中恶性病灶部位与对侧正常组织放射性计数比值（T/N）（3.64±1.83）明显高于良性病灶（2.21±0.89）,差异有统计学意义（P〈0.01）。结论 99Tcm-MIBI对骨结节有较好地鉴别价值,在良恶性骨肿瘤方面可增加诊断信息,在化疗疗效评估方面双时相滞留指数是一个较好的指标。     

PCNA和DNA含量估测腮腺混合瘤增殖活性

为了评价增殖细胞核抗原（ＰＣＮＡ）表达和ＤＮＡ含量在研究腮腺混合瘤细胞增殖活性中的价值，对６０例良性无复发、复发和恶性腮腺混合瘤用ＰＣＮＡ免疫组化染色技术和流式细胞测量术作ＰＣＮＡ测定和ＤＮＡ含量测量。结果显示ＰＣＮＡ表达在各组间和高Ｓ期细胞比率（ＳＰＦ）在无复发和复发组间有显著差异；恶性混合瘤组与良性无复发组或复发组间有显著差异；ＰＣＮＡ表达与高ＳＰＦ呈显著性正相关关系。提示ＰＣＮＡ表达和ＤＮＡ含量均能反映良恶性混合瘤细胞增殖活性，对良恶性混合瘤的鉴别有重要价值；ＰＣＮＡ表达对良性混合瘤复发亦有较高估测价值。     

骶尾部肿瘤212例病理分析

】报道骶尾部肿瘤２１２例病理情况，其中良性肿瘤１６８例：畸胎瘤占１１４例，且有１例合并脑脊膜膨出；表皮囊肿和脂肪瘤各１１例；纤维瘤７例；错构瘤５例；神经纤维瘤和纤维脂肪瘤各４例；纤维血管瘤、骨巨细胞瘤各２例；滑膜瘤、神经鞘瘤、血管瘤、单纯囊肿、中肾管囊肿和乳头状瘤各１例。恶性肿瘤４４例：脊索瘤１２例；恶性畸胎瘤１１例；内胚窜癌９例；胚胎性癌６例；神经母细胞瘤、滑膜肉瘤、软组织肉瘤、骨肉瘤、浆细胞瘤、鳞状细胞癌各１例。作者就骶尾部肿瘤发病年龄分布情况及组织学特点进行分析。     

流式细胞术在涎腺肿瘤诊断及预后中的应用

目的通过流式细胞仪对涎腺肿瘤DNA倍体、DI指数及S期细胞增生率的检测,分析这些参数与肿瘤组织学分级和淋巴结转移之间的关系,以探讨其对涎腺肿瘤的诊断和预后评估能力。方法对156例涎腺良性肿瘤、临界瘤及恶性肿瘤新鲜组织进行流式细胞仪分析。结果良性肿瘤组未检出异倍体;临界瘤组44例检出异倍体,S期增生率达最高,提示有恶变倾向;恶性肿瘤组异倍体的检出率最高。DI与淋巴结转移无关,与肿瘤组织学分级有关（P〈0．01）。SPF与淋巴结转移有关（P〈0．01）。结论DNA异倍体的检出是恶性肿瘤的重要特征之一;S期细胞增生率为恶性肿瘤增生的指标。临界瘤中检出异倍体预示有癌变倾向;SPF高揭示肿瘤增生活性强。DI可以鉴别细胞的良恶性;DI和SPF可以作为肿瘤细胞恶性程度及预后的指标。     

Ets-1、c-myc在骨巨细胞瘤中的表达及意义

目的 探讨Ets-1、c—myc在骨巨细胞瘤中的表达与肿瘤预后复发的关系。方法 利用免疫组化SP法检测Ets-1、c—myc在30例采用刮除手术治疗的骨巨细胞瘤患者石蜡切片中的表达。结果 30例骨巨细胞瘤患者，其中复发10例，复发率33．3％。Ets-1在复发组中阳性表达5例，未复发组4例，差异无显著性。复发组与未复发组c—myc阳性表达分别为6例、4例，存在统计学差异。两者同时表达在复发组与未复发组分别为4例、1例。Ets-1和c—myc同时过表达与骨巨细胞瘤复发有关。结论 在排除手术方式影响下，c-myc表达与Ets-1、c—myc同时表达可以作为帮助评估骨巨细胞瘤预后复发的参考指标。