脊柱骨巨细胞瘤的手术治疗及术后复发的相关因素分析
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摘要
第一部分靶血管栓塞后手术治疗脊柱骨巨细胞瘤的疗效分析
目的：探讨靶血管栓塞后手术治疗脊柱骨巨细胞瘤的临床疗效。
方法：对1995年6月至2011年8月在我院接受手术治疗的28名脊柱骨巨细胞瘤患者的临床资料进行回顾性分析。其中男性12例，女性16例，平均年龄29.6岁（11~58岁）。病变位于胸椎8例，腰椎5例，骶椎15例。患者术前均存在不同程度的疼痛症状，合并神经功能受累者17例，8例有大小便功能障碍。所有患者术前均行靶血管栓塞，栓塞后1～2天内手术。记录术中出血量、输血量，并观察术后神经功能及肿瘤复发情况。
结果：所有患者未出现栓塞相关并发症，栓塞后均行病灶内肿瘤切除，手术过程顺利，无围手术期死亡病例。术中平均出血量1528.6mL（400～5800mL），平均输血量1514.3mL（400～6000mL）。28例手术患者中，前路手术8例，后路手术18例，前后联合入路2例，14例（50%）行内固定重建，6例（21.4%）行术后辅助放疗。平均随访时间86.5月（16～193月），复发8例（28.6%），死亡2例（7.1%）。8例（28.6%）发生并发症，其中6例伤口并发症，1例脑脊液漏，1例胸椎后凸畸形。14例行内固定重建的患者术后均未出现内固定松动、移位或断裂。24例（85.7%）患者术后神经功能正常，仅4例（14.3%）骶骨患者有不同程度的大小便功能障碍。
结论：靶血管栓塞后手术治疗脊柱骨巨细胞瘤，能有效减少术中出血，使术野清晰，有助于肿瘤的彻底切除，是一项安全有效的技术。术前靶血管联合病灶内肿瘤切除，手术创伤小，并发症发生率低，患者术后神经功能满意。
第二部分脊柱骨巨细胞瘤术后复发的相关因素分析
目的：探讨影响脊柱骨巨细胞瘤术后局部无复发生存期（local recurrence-freesurvival time, LRFS）的因素。为今后预防或延缓脊柱骨巨细胞瘤术后复发，延长术后LRFS期提供参考依据。
方法：对1995年6月～2011年8月间在我院完成手术的28例脊柱骨巨细胞瘤患者进行随访。收集这些患者的发病年龄、性别、肿瘤部位、肿瘤大小、侵袭范围、放疗、复发等资料，用免疫组化法检测肿瘤组织中胰岛素样生长因子Ⅱ mRNA结合蛋白3（insulin-like growth factor II mRNA-binding protein3, IMP3）及胰岛素样生长因子2（insulin-like growth factor2, IGF2）的表达情况。将患者术后LRFS期作为应变量，选取上述8个因素作为自变量，Kaplan-Meier法绘制LRFS曲线，Log-Rank检验进行统计学分析。以P <0.05为差异有显著性意义。
结果：28例患者均行病灶内肿瘤切除。平均随访时间86.5月（16～193月），至随访结束时，复发8例（28.6%），平均复发时间35.6月（5～79月）。统计结果显示：间室内肿瘤组术后中位LRFS期73月，间室外肿瘤组43月；IMP3阳性组术后中位LRFS期43月，阴性组73月；IGF2阳性组术后中位LRFS期46.5月，阴性组75月。肿瘤侵袭范围、IMP3阳性与阴性组、IGF2阳性与阴性组之间术后LRFS期差异具有显著性意义，P值分别是0.025、0.002、0.007。不同年龄组、不同性别组、不同肿瘤部位组、不同肿瘤大小组及是否放疗之间术后LRFS期差异无统计学意义（P>0.05）。
结论：间室外肿瘤、IMP3高表达及IGF2高表达的患者术后复发率较高，术后LRFS期较短。选择手术方式时需要权衡手术并发症与术后复发之间的关系，间室内肿瘤可以选择病灶内切除，对于间室外肿瘤，则需选择更加积极的手术方式。IMP3和IGF2可作为脊柱骨巨细胞瘤术后复发的预测指标。
Part ⅠSurgical Treatment of Giant Cell Tumors of the SpineCombined with Preoperative Transarterial Embolization
Objective: To investigate the efficacy of surgical excision with preoperativetransarterial embolization for the giant cell tumor of spine.
Methods: Between June1995and August2011,28patients with giant cell tumor ofthe spine were interviewed retrospectively. There were12males and16females with theaverage age of29.6years (range:11~58years).15cases were located in the sacrum and13in the mobile spine (8thoracic and5lumbar). Most patients presented with pain at the siteof tumor involvement before surgery.17patients existed neurologic deficit, and8caseshad bowel and/or bladder dysfunction. All the patients were operated1to2days aftertranscatheter arterial embolization. The intraoperative blood loss and transfusion werereviewed. The local recurrence, complications, follow-up status and functional outcomewere observed.
Results: There were no symptomatic complications associated with embolization, andall the patients were treated with intralesional excision after preoperative transarterialembolization. There were no perioperative deaths. The average intraoperative blood losswas1528.6mL (range:400~5800mL), and the average transfusion volume was1514.3mL(range:400~6000mL). The anterior approach was used for8cases, posterior approach wasused for18cases, and combined anterior and posterior approach was used for2cases.There were14(50%) patients underwent reconstruction, and6(21.4%) patients weretreated postoperatively with adjuvant radiation therapy. The average follow-up was86.5months (range:16-193months). Eight (28.6%) patients developed recurrence and two(7.1%) patients died. Eight (28.6%) patients experienced complications perioperatively orduring the follow-up, six (21.4%) patients had wound complications, one patientexperienced cerebrospinal fluid leakage and one thoracic patient developed kyphosis. The14patients who underwent reconstruction did not experience hardware failure requiring surgical revision. Twenty-four (85.7%) patients retained normal neurologic function, whilethe function of the sphincter muscles were impaired in only4sacral GCT patients.
Conclusion: Preoperative embolization can significantly decrease intraoperativeblood loss, and facilitate the maximal removal of the tumor. It is a safe and effectivetechnique for excising giant cell tumors of the spine. Intralesional excision withpreoperative embolization may be a feasible choice for GCT of the spine.
Part ⅡAnalysis of Risk Factors for Recurrence of Giant CellTumor of Spine
Objective: To investigate the factors related to the local recurrence-free survival time(LRFS) after surgical treatment of giant cell tumor of the spine, in order to providetheoretic foundation for an improvement of LRFS.
Methods: We retrospectively reviewed28consecutive patients with GCT of thesacrum and mobile spine who underwent initial surgical excision combined withpreoperative embolization between June,1995and August,2011. Data regarding age,gender, tumor location, tumor size, tumor extension, radiation therapy, and localrecurrences were reviewed. The expression of IMP3and IGF2was detected byimmunohistichemical staining. Local recurrence-free survival time was calculatedaccording to the Kaplan-Meier method and statistical analysis was performed usingLog-Rank test.
Results: All the patients underwent intralesional resection. The average duration offollow-up was86.5months (range,16~193months).8(28.6%) patients developed localrecurrence. The average recurrence time was35.6months (range,5-79months). LRFSwas found statistically longer in intracompartmental (T1) tumors as compared toextracompartmental (T2) tumors (median:73versus43months, P=0.025). LRFS was alsofound significantly longer in IMP3negative group than IMP3positive group (median:73versus43months, P=0.002), and in IGF2negative group than IGF2positive group(median:75versus46.5months, P=0.007). LRFS was not found significant difference forage, gender, tumor location, tumor size, and radiation therapy.
Conclusion: Extracompartmental tumor, positive expression of IMP3, and positiveexpression of IGF2will probably lead to shorter LRFS. The choice of surgical treatment should be balanced between the complications and tumor recurrence. Intralesional excisionmay be a feasible choice for T1tumors of the spine, but for T2tumors, more aggressivetreatment may be required. Overexpression of IMP3and IGF2may be used as prognosticindications of the recurrence of GCT of the spine.
目的：探讨靶血管栓塞后手术治疗脊柱骨巨细胞瘤的临床疗效。
方法：对1995年6月至2011年8月在我院接受手术治疗的28名脊柱骨巨细胞瘤患者的临床资料进行回顾性分析。其中男性12例，女性16例，平均年龄29.6岁（11~58岁）。病变位于胸椎8例，腰椎5例，骶椎15例。患者术前均存在不同程度的疼痛症状，合并神经功能受累者17例，8例有大小便功能障碍。所有患者术前均行靶血管栓塞，栓塞后1～2天内手术。记录术中出血量、输血量，并观察术后神经功能及肿瘤复发情况。
结果：所有患者未出现栓塞相关并发症，栓塞后均行病灶内肿瘤切除，手术过程顺利，无围手术期死亡病例。术中平均出血量1528.6mL（400～5800mL），平均输血量1514.3mL（400～6000mL）。28例手术患者中，前路手术8例，后路手术18例，前后联合入路2例，14例（50%）行内固定重建，6例（21.4%）行术后辅助放疗。平均随访时间86.5月（16～193月），复发8例（28.6%），死亡2例（7.1%）。8例（28.6%）发生并发症，其中6例伤口并发症，1例脑脊液漏，1例胸椎后凸畸形。14例行内固定重建的患者术后均未出现内固定松动、移位或断裂。24例（85.7%）患者术后神经功能正常，仅4例（14.3%）骶骨患者有不同程度的大小便功能障碍。
结论：靶血管栓塞后手术治疗脊柱骨巨细胞瘤，能有效减少术中出血，使术野清晰，有助于肿瘤的彻底切除，是一项安全有效的技术。术前靶血管联合病灶内肿瘤切除，手术创伤小，并发症发生率低，患者术后神经功能满意。
第二部分脊柱骨巨细胞瘤术后复发的相关因素分析
目的：探讨影响脊柱骨巨细胞瘤术后局部无复发生存期（local recurrence-freesurvival time, LRFS）的因素。为今后预防或延缓脊柱骨巨细胞瘤术后复发，延长术后LRFS期提供参考依据。
方法：对1995年6月～2011年8月间在我院完成手术的28例脊柱骨巨细胞瘤患者进行随访。收集这些患者的发病年龄、性别、肿瘤部位、肿瘤大小、侵袭范围、放疗、复发等资料，用免疫组化法检测肿瘤组织中胰岛素样生长因子Ⅱ mRNA结合蛋白3（insulin-like growth factor II mRNA-binding protein3, IMP3）及胰岛素样生长因子2（insulin-like growth factor2, IGF2）的表达情况。将患者术后LRFS期作为应变量，选取上述8个因素作为自变量，Kaplan-Meier法绘制LRFS曲线，Log-Rank检验进行统计学分析。以P <0.05为差异有显著性意义。
结果：28例患者均行病灶内肿瘤切除。平均随访时间86.5月（16～193月），至随访结束时，复发8例（28.6%），平均复发时间35.6月（5～79月）。统计结果显示：间室内肿瘤组术后中位LRFS期73月，间室外肿瘤组43月；IMP3阳性组术后中位LRFS期43月，阴性组73月；IGF2阳性组术后中位LRFS期46.5月，阴性组75月。肿瘤侵袭范围、IMP3阳性与阴性组、IGF2阳性与阴性组之间术后LRFS期差异具有显著性意义，P值分别是0.025、0.002、0.007。不同年龄组、不同性别组、不同肿瘤部位组、不同肿瘤大小组及是否放疗之间术后LRFS期差异无统计学意义（P>0.05）。
结论：间室外肿瘤、IMP3高表达及IGF2高表达的患者术后复发率较高，术后LRFS期较短。选择手术方式时需要权衡手术并发症与术后复发之间的关系，间室内肿瘤可以选择病灶内切除，对于间室外肿瘤，则需选择更加积极的手术方式。IMP3和IGF2可作为脊柱骨巨细胞瘤术后复发的预测指标。
Part ⅠSurgical Treatment of Giant Cell Tumors of the SpineCombined with Preoperative Transarterial Embolization
Objective: To investigate the efficacy of surgical excision with preoperativetransarterial embolization for the giant cell tumor of spine.
Methods: Between June1995and August2011,28patients with giant cell tumor ofthe spine were interviewed retrospectively. There were12males and16females with theaverage age of29.6years (range:11~58years).15cases were located in the sacrum and13in the mobile spine (8thoracic and5lumbar). Most patients presented with pain at the siteof tumor involvement before surgery.17patients existed neurologic deficit, and8caseshad bowel and/or bladder dysfunction. All the patients were operated1to2days aftertranscatheter arterial embolization. The intraoperative blood loss and transfusion werereviewed. The local recurrence, complications, follow-up status and functional outcomewere observed.
Results: There were no symptomatic complications associated with embolization, andall the patients were treated with intralesional excision after preoperative transarterialembolization. There were no perioperative deaths. The average intraoperative blood losswas1528.6mL (range:400~5800mL), and the average transfusion volume was1514.3mL(range:400~6000mL). The anterior approach was used for8cases, posterior approach wasused for18cases, and combined anterior and posterior approach was used for2cases.There were14(50%) patients underwent reconstruction, and6(21.4%) patients weretreated postoperatively with adjuvant radiation therapy. The average follow-up was86.5months (range:16-193months). Eight (28.6%) patients developed recurrence and two(7.1%) patients died. Eight (28.6%) patients experienced complications perioperatively orduring the follow-up, six (21.4%) patients had wound complications, one patientexperienced cerebrospinal fluid leakage and one thoracic patient developed kyphosis. The14patients who underwent reconstruction did not experience hardware failure requiring surgical revision. Twenty-four (85.7%) patients retained normal neurologic function, whilethe function of the sphincter muscles were impaired in only4sacral GCT patients.
Conclusion: Preoperative embolization can significantly decrease intraoperativeblood loss, and facilitate the maximal removal of the tumor. It is a safe and effectivetechnique for excising giant cell tumors of the spine. Intralesional excision withpreoperative embolization may be a feasible choice for GCT of the spine.
Part ⅡAnalysis of Risk Factors for Recurrence of Giant CellTumor of Spine
Objective: To investigate the factors related to the local recurrence-free survival time(LRFS) after surgical treatment of giant cell tumor of the spine, in order to providetheoretic foundation for an improvement of LRFS.
Methods: We retrospectively reviewed28consecutive patients with GCT of thesacrum and mobile spine who underwent initial surgical excision combined withpreoperative embolization between June,1995and August,2011. Data regarding age,gender, tumor location, tumor size, tumor extension, radiation therapy, and localrecurrences were reviewed. The expression of IMP3and IGF2was detected byimmunohistichemical staining. Local recurrence-free survival time was calculatedaccording to the Kaplan-Meier method and statistical analysis was performed usingLog-Rank test.
Results: All the patients underwent intralesional resection. The average duration offollow-up was86.5months (range,16~193months).8(28.6%) patients developed localrecurrence. The average recurrence time was35.6months (range,5-79months). LRFSwas found statistically longer in intracompartmental (T1) tumors as compared toextracompartmental (T2) tumors (median:73versus43months, P=0.025). LRFS was alsofound significantly longer in IMP3negative group than IMP3positive group (median:73versus43months, P=0.002), and in IGF2negative group than IGF2positive group(median:75versus46.5months, P=0.007). LRFS was not found significant difference forage, gender, tumor location, tumor size, and radiation therapy.
Conclusion: Extracompartmental tumor, positive expression of IMP3, and positiveexpression of IGF2will probably lead to shorter LRFS. The choice of surgical treatment should be balanced between the complications and tumor recurrence. Intralesional excisionmay be a feasible choice for T1tumors of the spine, but for T2tumors, more aggressivetreatment may be required. Overexpression of IMP3and IGF2may be used as prognosticindications of the recurrence of GCT of the spine.
引文
1. Szendroi M. Giant-cell tumour of bone. J Bone Joint Surg Br.2004,86B(1):5-12.
2. Sung HW, Kuo DP, Shu WP, et al. Giant-cell tumor of bone: analysis of208cases inChinese patients. J Bone Joint Surg Am.1982,64(5):755-761.
3. Unni KK. Dahlin’s Bone Tumors. General Aspects and Data on11,087Cases.5th edn.Philadelphia: Lippincoot-Raven.1996:263–283.
4. Schwartz HS. Update on giant cell tumor of bone. Compr Ther.1998,24(10):488-493.
5. Jaffe HL, Lichtenstein L, Portis RB. Giant cell tumor of bone Its pathologic appearancegrading supposed variants and treatment. Arch Pathol.1940,30(5):993-1031.
6. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
7. Luther N, Bilsky MH, Hartl R. Giant cell tumor of the spine. Neurosurg Clin N Am.2008,19(1):49-55.
8. Xu W, Li X, Huang W, et al. Factors affecting prognosis of patients with giant celltumors of the mobile spine: retrospective analysis of102patients in a single center.Ann Surg Oncol.2013,20(3):804-810.
9. Junming M, Cheng Y, Dong C, et al. Giant cell tumor of the cervical spine: a series of22cases and outcomes. Spine.2008,33(3):280-288.
10. Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Giant Cell Tumor of Bone:risk factors for recurrence. Clin Orthop Relat Res.2011,469(2):591-599.
11. van der Heijden L, van de Sande MAJ, Dijkstra PDS. Soft tissue extension increasesthe risk of local recurrence after curettage with adjuvants for giant-cell tumor of thelong bones. A retrospective study of93patients. Acta Orthop.2012,83(4):401-405.
12. Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment andoutcome of214cases. J Cancer Res Clin Oncol.2008,134(9):969-978.
13. Mueller-Pillasch F, Pohl B, Wilda M, et al. Expression of the highly conserved RNAbinding protein KOC in embryogenesis. Mech Dev.1999,88(1):95-99.
14. Nielsen J, Christiansen J, Lykke-Andersen J, et al. A family of insulin-like growthfactor II mRNA-binding proteins represses translation in late development. Mol CellBiol.1999,19(2):1262-1270.
15. Liao B, Hu Y, Herrick DJ, Brewer G. The RNA-binding protein IMP-3is a translationalactivator of insulin-like growth factor II leader-3mRNA during proliferation of humanK562leukemia cells. J Biol Chem.2005,280(18):18517-18524.
16. Findeis-Hosey JJ, Xu HD. The use of insulin like-growth factor II messenger RNAbinding protein-3in diagnostic pathology. Hum Pathol.2011,42(3):303-314.
17. Do SI, Kim YW, Park HR, Park YK. Expression of insulin-like growth factor-II mRNAbinding protein3(IMP3) in osteosarcoma. Oncol Res.2008,17(6):269-272.
18. Jiang Z, Chu PG, Woda BA, et al. Analysis of RNA-binding protein IMP3to predictmetastasis and prognosis of renal-cell carcinoma: a retrospective study. Lancet Oncol.2006,7(7):556-564.
19. Szarvas T, vom Dorp F, Niedworok C, et al. High insulin-like growth factormRNA-binding protein3(IMP3) protein expression is associated with poor survival inmuscle-invasive bladder cancer. BJU Int.2012,110(6): E308-317.
20. Muller S, Zirkel D, Westphal M, Zumkeller W. Genomic imprinting of IGF2and H19in human meningiomas. Eur J Cancer.2000,36(5):651-655.
21. Cui H, Cruz-Correa M, Giardiello FM, et al. Loss of IGF2imprinting: a potentialmarker of colorectal cancer risk. Science.2003,299(5613):1753-1755.
22. Hernando E, Charytonowicz E, Dudas ME, et al. The AKT-mTOR pathway plays acritical role in the development of leiomyosarcomas. Nat Med.2007,13(6):748-753.
23. Lennartsson J, Blume-Jensen P, Hermanson M, et al. Phosphorylation of Shc by Srcfamily kinases is necessary for stem cell factor receptor/c-kit mediated activation of theRas/MAP kinase pathway and c-fos induction. Oncogene.1999,18(40):5546-5553.
24. Goddard NC, McIntyre A, Summersgill B, et al. KIT and RAS signalling pathways intesticular germ cell tumours: new data and a review of the literature. Int J Androl.2007,30(4):337-348.
25. Kohda M, Hoshiya H, Katoh M, et al. Frequent loss of imprinting of IGF2and MESTin lung adenocarcinoma. Mol Carcinog.2001,31(4):184-191.
1. Luther N, Bilsky MH, Hartl R. Giant cell tumor of the spine. Neurosurg Clin N Am.2008,19(1):49-55.
2. Shimada Y, Hongo M, Miyakoshi N, et al. Giant cell tumor of fifth lumbar vertebrae:two case reports and review of the literature.Spine J.2007,7(4):499-505.
3.杨惠林，倪才方，唐天驷，等.靶血管栓塞后手术治疗骶骨肿瘤.中华骨科杂志.1998,18(11):646-648.
4. Guzman R, Dubach-Schwizer S, Heini P, et al. Preoperative transarterial embolization ofvertebral metastases. Eur Spine J.2005,14(3):263-268.
5. Ozkan E, Gupta S. Embolization of spinal tumors: vascular anatomy, indications, andtechnique.Tech Vasc Interv Radiol.2011,14(3):129-140.
6. Shi HB, Suh DC, Lee HK, et al. Preoperative transarterial embolization of spinal tumor:Embolization techniques and results. Am J Neuroradiol.1999,20(10):2009-2015.
7. Harrop JS, Schmidt MH, Boriani S, et al. Aggressive “Benign” Primary SpineNeoplasms Osteoblastoma, Aneurysmal Bone Cyst, and Giant Cell Tumor. Spine,2009.34(22S): S39-S47.
8. Ozaki T, Liljenqvist U, Halm H, et al. Giant cell tumor of the spine. Clin Orthop RelatRes.2002,401:194-201.
9. Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum. Clin Orthop Relat Res.1993,291:215-221.
10.马乐群，徐亮，代成浦，等.骶骨脊索瘤手术切除及并发症的防治.中国骨肿瘤骨病.2004,3(3):156-157.
11.唐顺，董森，郭卫，等.腹主动脉球囊阻断控制骶骨肿瘤切除术中出血的效果.中国脊柱脊髓杂志.2009,19(2):85-89.
12.陈卫东.骶骨肿瘤术前靶血管栓塞相关的应用解剖学研究.苏州:苏州大学,
2007.
13. Simpson AHRW, Porter A, Davis A, et al. Cephalad sacral resection with a combinedextended ilioinguinal and posterior approach. J Bone Jiont Surg Am.1995,77A(3):405-411.
14. Tang XD, Guo W, Yang RL, et al. Use of Aortic Balloon Occlusion to Decrease BloodLoss During Sacral Tumor Resection. J Bone Jiont Surg Am.2010,92A(8):1747-1753.
15. Wilson MA, Cooke DL, Ghodke B, et al. Retrospective analysis of preoperativeembolization of spinal tumors. Am J Neuroradiol.2010,31(4):656-660.
16. Yang HL, Chen KW, Wang GL, et al. Pre-operative transarterial embolization fortreatment of primary sacral tumors. J Clin Neurosci.2010,17(10):1280-1285.
17.彭晓新，程志远，范志斌，等.术前经动脉栓塞脊柱骨巨细胞瘤.中国介入影像与治疗学.2011,08(1):10-13.
18. Gellad FE, Sadato N, Numaguchi Y, et al. Vascular metastatic lesions of the spine-preoperative embolization. Radiology.1990,176(3):683-686.
19. Kunstlinger F, Brunelle F, Chaumont P, et al. Vascular occlusive agents. Am JRoentgenol.1981,136(1):151–156.
20.杨述华，程福平，许伟华.髂内动脉栓塞后观察侧支循环重建的实验研究.中华骨科杂志.2000,20(7):431-434.
21. Finstein JL, Chin KR, Alvandi F, et al. Postembolization paralysis in a man with athoracolumbar giant cell tumor. Clin Orthop Relat Res.2006,453:335-340.
22. Wuisman P, Lieshout O, Sugihara S, et al. Total sacrectomy and reconstruction–Oncologic and functional outcome. Clin Orthop Relat Res.2000,381:192-203.
23. Cloyd JM, Acosta FL Jr, Polley MY, et al. En bloc resection for primary and metastatictumors of the spine: a systematic review of the literature. Neurosurgery.2010,67(2):435-444.
24. Sanjay BK, Sim FH, Unni KK, et al. Giant-cell tumours of the spine. J Bone Joint SurgBr.1993,75(1):148-154.
25. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
1. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J BoneJoint Surg Am.1987,69(1):106-114.
2. Turcotte RE, Sim FH, Unni KK. Giant-cell tumor of the sacrum. Clin Orthop Relat Res.1993,291:215-221.
3. Refai D, Dunn GP, Santiago P. Giant cell tumor of the thoracic spine: case report andreview of the literature. Surg Neurol.2009,71(2):228-233.
4. Xu W, Li X, Huang W, et al. Factors affecting prognosis of patients with giant celltumors of the mobile spine: retrospective analysis of102patients in a single center.Ann Surg Oncol.2013,20(3):804-810.
5. Wang H, Wan N, Hu Y. Giant cell tumour of bone: a new evaluating system is necessary.Int Orthop.2012,36(12):2521-2527.
6. Junming M, Cheng Y, Dong C, et al. Giant cell tumor of the cervical spine: a series of22cases and outcomes. Spine.2008,33(3):280-288.
7. Klenke FM, Wenger DE, Inwards CY, et al. Giant cell tumor of bone. Risk factors forRecurrence. Clin Orthop Relat Res.2011,469:591-599.
8. van der Heijden L, van de Sande MAJ, Dijkstra PDS. Soft tissue extension increases therisk of local recurrence after curettage with adjuvants for giant-cell tumor of the longbones. A retrospective study of93patients. Acta Orthop.2012,83(4):401-405.
9. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging ofmusculoskeletal sarcoma. Clin Orthop Relat Res.1980,153:106-120.
10. Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res.1986,204:9-24.
11. Li DW, Yan DW, Tang HM, et al. IMP3is a novel prognostic marker that correlateswith colon cancer progression and pathogenesis. Ann Surg Oncol.2009,16(12):3499-3506.
12. Boriani S, Bandiera S, Casadei R, et al. Giant cell tumor of the mobile spine: a reviewof49cases. Spine.2012,37(1): E37-45.
13. Komiya S, Zenmyo M, Inoue A. Bone tumors in the pelvis presenting growth duringpregnancy. Arch Orthop Trauma Surg.1999,119(1-2):22-29.
14. Ross AE, Bojescul JA, Kuklo TR. Giant cell tumor: a case report of recurrence duringpregnancy. Spine.2005,30(12): E332-335.
15. Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment andoutcome of214cases. J Cancer Res Clin Oncol.2008,134(9):969-978.
16. Errani C, Ruggieri P, Asenzio MAN, et al. Giant cell tumor of the extremity: A reviewof349cases from a single institution. Cancer Treat Rev.2010,36(1):1-7.
17. Su YP, Chen WM, Chen TH. Giant-cell tumors of bone: an analysis of87cases. IntOrthop.2004,28(4):239-243.
18. Jeys LM, Suneja R, Chami G, et al. Impending fractures in giant cell tumours of thedistal femur: incidence and outcome. Int Orthop.2006,30(2):135-138.
19. Kivioja AH, Blomqvist C, Hietaniemi K, et al. Cement is recommended in intralesionalsurgery of giant cell tumors-A Scandinavian Sarcoma Group study of294patientsfollowed for a median time of5years. Acta Orthop.2008,79(1):86-93.
20. Miszczyk L, Wydmanski J, Spindel J. Efficacy of radiotherapy for giant cell tumor ofbone: Given either postoperatively or as sole treatment. Int J Radiat Oncol Biol Phys.2001,49(5):1239-1242.
21. Becker WT, Dohle J, Bernd L, et al. Local recurrence of giant cell tumor of bone afterintralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am.2008,90(5):1060-1067.
22. Dahlin DC, Cupps RE, Johnson EW. Giant-cell tumor: a study of195cases. Cancer.1970,25(5):1061-1070.
23. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis oftwo hundred and eighteen cases. J Bone Joint Surg Am.1970,52(4):619-664.
24. McGrath PJ. Giant-cell tumour of bone: an analysis of fifty-two cases. J Bone JointSurg Am.1972,54(2):216-229.
25. Larsson SE, Lorentzon R, Boquist L. Giant-cell tumors of thespine and sacrum causing neurological symptoms. Clin Orthop Relat Res.1975,111:201-211.
26. Nair MK, Jyothirmayi R. Radiation therapy in the treatment of giant cell tumor of bone.Int J Radiat Oncol Biol Phys.1999,43(5):1065-1069.
27. Rock JP, Ryu S, Shukairy MS, et al. Postoperative radiosurgery for malignant spinaltumors. Neurosurgery.2006,58(5):891-897.
28. Kriz J, Eich HT, Mucke R, et al. Radiotherapy for giant cell tumors of the bone: a safeand effective treatment modality. Anticancer Res.2012,32(5):2069-2073.
29. Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases:clinical experience in500cases from a single institution. Spine.2007,32(2):193-199.
30. Roeder F, Timke C, Zwicker F, et al. Intensity modulated radiotherapy (IMRT) inbenign giant cell tumors-a single institution case series and a short review of theliterature. Radiat Oncol.2010,5:18.
31. Nielsen J, Christiansen J, Lykke-Andersen J, et al. A family of insulin-like growthfactor II mRNA-binding proteins represses translation in late development. Mol CellBiol.1999,19(2):1262-1270.
32. Mueller-Pillasch F, Pohl B, Wilda M, et al. Expression of the highly conserved RNAbinding protein KOC in embryogenesis. Mech Dev.1999,88(1):95-99.
33. Monk D, Bentley L, Beechey C, et al. Characterisation of the growth regulating geneIMP3, a candidate for Silver-Russell syndrome. J Med Genet.2002,39(8):575-581.
34. Mueller-Pillasch F, Lacher U, Wallrapp C, et al. Cloning of a gene highlyoverexpressed in cancer coding for a novel KH-domain containing protein. Oncogene.1997,14(22):2729-2733.
35. Liao B, Hu Y, Herrick DJ, Brewer G. The RNA-binding protein IMP-3is a translationalactivator of insulin-like growth factor II leader-3mRNA during proliferation of humanK562leukemia cells. J Biol Chem.2005,280(18):18517-18524.
36. Findeis-Hosey JJ, Xu HD. The use of insulin like-growth factor II messenger RNAbinding protein-3in diagnostic pathology. Hum Pathol.2011,42(3):303-314.
37.李康华,黄跃平,张俊,李国军,李思鸿. IMP3蛋白在骨肉瘤组织中的表达与临床意义.细胞与分子免疫学杂志.2009,5:426-427.
38. Do SI, Kim YW, Park HR, Park YK. Expression of insulin-like growth factor-II mRNAbinding protein3(IMP3) in osteosarcoma. Oncol Res.2008,17(6):269-272.
39. Jiang Z, Chu PG, Woda BA, et al. Analysis of RNA-binding protein IMP3to predictmetastasis and prognosis of renal-cell carcinoma: a retrospective study. Lancet Oncol.2006,7(7):556-564.
40. Szarvas T, vom Dorp F, Niedworok C, et al. High insulin-like growth factormRNA-binding protein3(IMP3) protein expression is associated with poor survival inmuscle-invasive bladder cancer. BJU Int.2012,110(6): E308-317.
41. Jeng YM, Chang CC, Hu FC, et al. RNA-binding protein insulin-like growth factor IImRNA-binding protein3expression promotes tumor invasion and predicts earlyrecurrence and poor prognosis in hepatocellular carcinoma. Hepatology.2008,48(4):1118-1127.
42. Chen YL, Jeng YM, Hsu HC, et al. Expression of insulin-like growth factor IImRNA-binding protein3predicts early recurrence and poor prognosis in intrahepaticcholangiocarcinoma. Int J Surg.2013,11(1):85-91.
43. Muller S, Zirkel D, Westphal M, Zumkeller W. Genomic imprinting of IGF2and H19in human meningiomas. Eur J Cancer.2000,36(5):651-655.
44. Cui H, Cruz-Correa M, Giardiello FM, et al. Loss of IGF2imprinting: a potentialmarker of colorectal cancer risk. Science.2003,299(5613):1753-1755.
45.张锋锐,何小兵,杨玉华,谢维.大肠癌中胰岛素样生长因子2基因的印迹状态和表达.中华医学遗传学杂志.2003,20(1):31-34.
46. Kohda M, Hoshiya H, Katoh M, et al. Frequent loss of imprinting of IGF2and MESTin lung adenocarcinoma. Mol Carcinog.2001,31(4):184-191.
47. Hernando E, Charytonowicz E, Dudas ME, et al. The AKT-mTOR pathway plays acritical role in the development of leiomyosarcomas. Nat Med.2007,13(6):748-753.
48. Lennartsson J, Blume-Jensen P, Hermanson M, et al. Phosphorylation of Shc by Srcfamily kinases is necessary for stem cell factor receptor/c-kit mediated activation of theRas/MAP kinase pathway and c-fos induction. Oncogene.1999,18(40):5546-5553.
49. Duensing A, Medeiros F, McConarty B, et al. Mechanisms of oncogenic KIT signaltransduction in primary gastrointestinal stromal tumors (GISTs). Oncogene.2004,23(22):3999-4006.
50. Goddard NC, McIntyre A, Summersgill B, et al. KIT and RAS signalling pathways intesticular germ cell tumours: new data and a review of the literature. Int J Androl.2007,30(4):337-348.
51. Braconi C, Bracci R, Bearzi I, et al. Insulin-like growth factor (IGF)1and2help topredict disease outcome in GIST patients. Ann Oncol.2008,19(7):1293-1298.
1. Szendroi M. Giant-cell tumour of bone. J Bone Joint Surg Br.2004,86B(1):5-12.
2. Sung HW, Kuo DP, Shu WP, et al. Giant-cell tumor of bone: analysis of208cases inChinese patients. J Bone Joint Surg Am.1982,64(5):755-761.
3. Unni KK. Dahlin’s Bone Tumors. General Aspects and Data on11,087Cases.5th edn.Philadelphia: Lippincoot-Raven.1996:263–283.
4. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
5.杜联军，丁晓毅，江浩，陈克敏.脊柱骨巨细胞瘤的影像学表现及临床意义.实用放射学杂志,2006,22(3):300-303.
6. Enneking WF. Musculoskeletal Tumor Surgery. New York: Churchill Livingstone.1983,69-122.
7. Sanjay BK, Sim FH, Unni KK, et al. Giant-cell tumours of the spine. J Bone Joint SurgBr.1993,75(1):148-154.
8. Fidler MW. Surgical treatment of giant cell tumours of the thoracic and lumbar spine:report of nine patients. Eur Spine J.2001,10(1):69-77.
9. Boriani S, Weinstein JN, Biagini R. Spine update–Primary bone tumors of the spine–Terminology and surgical staging. Spine.1997,22(9):1036-1044.
10. Tomita K, Kawahara N, Baba H, et al. Total en bloc spondylectomy–A new surgicaltechnique for primary malignant vertebral tumors. Spine.1997,22(3):324-333.
11. Cloyd JM, Acosta FL, Polley MY, et al. En bloc resection for primary and metastatictumors of the spine: a systematic review of the literature. Neurosurgery.2010,67(2):435-444.
12. Marcove RC, Sheth DS, Brien EW, Huvos, et al. Conservative surgery for giantcell tumors of the sacrum. The role of cyosurgery as a supplement to curettage andpartial excision. Cancer.1994,74(4):1253-1260.
13. Takeda N, Kobayashi T, Tandai S, et al. Treatment of giant cell tumors in the sacrumand spine with curettage and argon beam coagulator. J Orthop Sci.2009,14(2):210-214.
14. Boriani S, Bandiera S, Casadei R, et al. Giant cell tumor of the mobile spine: a reviewof49cases. Spine.2012,37(1): E37-45.
15. Gille O, Soderlund C, Berge J, et al. Triple total cervical vertebrectomy for a giant celltumor–Case report. Spine.2005,30(10): E272-E275,.
16. Ma JM, Yang C, Cao D, et al. Giant cell tumor of the cervical spine–A series of22cases and outcomes. Spine.2008,33(3):280-288.
17. Shimizu K, Ido K, Fujio K, et al. Total spondylectomy and spinal shortening forgiant-cell tumour of spine. Lancet.1996,348(9023):342-342.
18. Ozaki T, Liljenqvist U, Halm H, et al. Giant Cell Tumor of the Spine. Clin OrthopRelat Res.2002,401:194-201.
19. Guo W, Ji T, Tang XD, et al. Outcome of Conservative Surgery for Giant Cell Tumor ofthe Sacrum. Spine.2009,34(10):1025-1031.
20.彭晓新,程志远,范志斌,等.术前经动脉栓塞脊柱骨巨细胞瘤.中国介入影像与治疗学.2011,8(1):10-12.
21. Finstein JL, Chin KR, Alvandi F, et al. Postembolization paralysis in a man with athoracolumbar giant cell tumor. Clin Orthop Relat Res.2006,453:335-340.
22. Wilson MA, Cooke DL, Ghodke B, et al. Retrospective analysis of preoperativeembolization of spinal tumors. Am J Neuroradiol.2010,31(4):656-660.
23. Martin C, McCarthy EF. Giant cell tumor of the sacrum and spine: series of23casesand a review of the literature. Iowa Orthop J.2010,30:69-75.
24. Hosalkar HS, Jones KJ, King JJ, et al. Serial arterial embolization for large sacralgiant-cell tumors–Mid-to long-term results. Spine.2007,32(10):1107-1115.
25. Balke M, Henrichs MP, Gosheger G, et al. Giant cell tumors of the axial skeleton.Sarcoma.2012,2012:410973.
26. Nair MK, Jyothirmayi R. Radiation therapy in the treatment of giant cell tumor of bone.Int J Radiat Oncol Biol Phys.1999,43(5):1065-1069.
27. Feigenberg SJ, Marcus RB, Zlotecki RA, et al. Radiation therapy for giant cell tumorsof bone. Clin Orthop Relat Res.2003,411:207-216.
28. Rock JP, Ryu S, Shukairy MS, et al. Postoperative radiosurgery for malignant spinaltumors. Neurosurgery.2006,58(5):891-897.
29. Gerszten PC, Burton SA, Ozhasoglu C, et al. Radiosurgery for spinal metastases–Clinical experience in500cases from a single institution. Spine.2007,32(2):193-199.
30. Roeder F, Timke C, Zwicker F, et al. Intensity modulated radiotherapy (IMRT) inbenign giant cell tumors–a single institution case series and a short review of theliterature. Radiat Oncol.2010,5:18.
31. Mendenhall WM, Zlotecki RA, Scarborough MT, et al. Giant cell tumor of bone. Am JClin Oncol.2006,29(1):96-99.
32. Kriz J, Eich HT, Muecke R, et al. Radiotherapy for Giant Cell Tumors of the Bone: ASafe and Effective Treatment Modality. Anticancer Res.2012,32(5):2069-2073.
33. Cheng YY, Huang L, Lee KM, et al. Bisphosphonates induce apoptosis of stromaltumor cells in giant cell tumor of bone. Calcif Tissue Int.2004,75(1):71-77.
34. Chang SS, Suratwala SJ, Jung KM, et al. Bisphosphonates may reduce recurrence ingiant cell tumor by inducing apoptosis. Clin Orthop Relat Res.2004,426:103-109.
35. Tse LF, Wong KC, Kumta SM, et al. Bisphosphonates reduce local recurrence inextremity giant cell tumor of bone: a case-control study. Bone.2008,42(1):68-73.
36. Gille O, Oliveira BA, Guerin P, et al. Regression of Giant Cell Tumor of the CervicalSpine With Bisphosphonate as Single Therapy. Spine.2012,37(6): E396-E399.
37. Morgan T, Atkins GJ, Trivett MK, et al. Molecular profiling of giant cell tumor of boneand the osteoclastic localization of ligand for receptor activator of nuclear factor kappaB. Am J Pathol.2005,167(1):117-128.
38. Kim N, Odgren PR, Kim DK, et al. Diverse roles of the tumor necrosis factor familymember TRANCE in skeletal physiology revealed by TRANCE deficiency and partialrescue by a lymphocyte-expressed TRANCE transgene. Proc Natl Acad Sci U S A.2000,97(20):10905-10910.
39. Thomas D, Henshaw R, Skubitz K, et al. Denosumab in patients with giant-cell tumourof bone: an open-label, phase2study. Lancet Oncol.2010,11(3):275-280.
40. Branstetter DG., Nelson SD, Manivel JC, et al. Denosumab induces tumor reductionand bone formation in patients with giant-cell tumor of bone. Clin Cancer Res.2012,18(16):4415-4424.
2. Sung HW, Kuo DP, Shu WP, et al. Giant-cell tumor of bone: analysis of208cases inChinese patients. J Bone Joint Surg Am.1982,64(5):755-761.
3. Unni KK. Dahlin’s Bone Tumors. General Aspects and Data on11,087Cases.5th edn.Philadelphia: Lippincoot-Raven.1996:263–283.
4. Schwartz HS. Update on giant cell tumor of bone. Compr Ther.1998,24(10):488-493.
5. Jaffe HL, Lichtenstein L, Portis RB. Giant cell tumor of bone Its pathologic appearancegrading supposed variants and treatment. Arch Pathol.1940,30(5):993-1031.
6. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
7. Luther N, Bilsky MH, Hartl R. Giant cell tumor of the spine. Neurosurg Clin N Am.2008,19(1):49-55.
8. Xu W, Li X, Huang W, et al. Factors affecting prognosis of patients with giant celltumors of the mobile spine: retrospective analysis of102patients in a single center.Ann Surg Oncol.2013,20(3):804-810.
9. Junming M, Cheng Y, Dong C, et al. Giant cell tumor of the cervical spine: a series of22cases and outcomes. Spine.2008,33(3):280-288.
10. Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Giant Cell Tumor of Bone:risk factors for recurrence. Clin Orthop Relat Res.2011,469(2):591-599.
11. van der Heijden L, van de Sande MAJ, Dijkstra PDS. Soft tissue extension increasesthe risk of local recurrence after curettage with adjuvants for giant-cell tumor of thelong bones. A retrospective study of93patients. Acta Orthop.2012,83(4):401-405.
12. Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment andoutcome of214cases. J Cancer Res Clin Oncol.2008,134(9):969-978.
13. Mueller-Pillasch F, Pohl B, Wilda M, et al. Expression of the highly conserved RNAbinding protein KOC in embryogenesis. Mech Dev.1999,88(1):95-99.
14. Nielsen J, Christiansen J, Lykke-Andersen J, et al. A family of insulin-like growthfactor II mRNA-binding proteins represses translation in late development. Mol CellBiol.1999,19(2):1262-1270.
15. Liao B, Hu Y, Herrick DJ, Brewer G. The RNA-binding protein IMP-3is a translationalactivator of insulin-like growth factor II leader-3mRNA during proliferation of humanK562leukemia cells. J Biol Chem.2005,280(18):18517-18524.
16. Findeis-Hosey JJ, Xu HD. The use of insulin like-growth factor II messenger RNAbinding protein-3in diagnostic pathology. Hum Pathol.2011,42(3):303-314.
17. Do SI, Kim YW, Park HR, Park YK. Expression of insulin-like growth factor-II mRNAbinding protein3(IMP3) in osteosarcoma. Oncol Res.2008,17(6):269-272.
18. Jiang Z, Chu PG, Woda BA, et al. Analysis of RNA-binding protein IMP3to predictmetastasis and prognosis of renal-cell carcinoma: a retrospective study. Lancet Oncol.2006,7(7):556-564.
19. Szarvas T, vom Dorp F, Niedworok C, et al. High insulin-like growth factormRNA-binding protein3(IMP3) protein expression is associated with poor survival inmuscle-invasive bladder cancer. BJU Int.2012,110(6): E308-317.
20. Muller S, Zirkel D, Westphal M, Zumkeller W. Genomic imprinting of IGF2and H19in human meningiomas. Eur J Cancer.2000,36(5):651-655.
21. Cui H, Cruz-Correa M, Giardiello FM, et al. Loss of IGF2imprinting: a potentialmarker of colorectal cancer risk. Science.2003,299(5613):1753-1755.
22. Hernando E, Charytonowicz E, Dudas ME, et al. The AKT-mTOR pathway plays acritical role in the development of leiomyosarcomas. Nat Med.2007,13(6):748-753.
23. Lennartsson J, Blume-Jensen P, Hermanson M, et al. Phosphorylation of Shc by Srcfamily kinases is necessary for stem cell factor receptor/c-kit mediated activation of theRas/MAP kinase pathway and c-fos induction. Oncogene.1999,18(40):5546-5553.
24. Goddard NC, McIntyre A, Summersgill B, et al. KIT and RAS signalling pathways intesticular germ cell tumours: new data and a review of the literature. Int J Androl.2007,30(4):337-348.
25. Kohda M, Hoshiya H, Katoh M, et al. Frequent loss of imprinting of IGF2and MESTin lung adenocarcinoma. Mol Carcinog.2001,31(4):184-191.
1. Luther N, Bilsky MH, Hartl R. Giant cell tumor of the spine. Neurosurg Clin N Am.2008,19(1):49-55.
2. Shimada Y, Hongo M, Miyakoshi N, et al. Giant cell tumor of fifth lumbar vertebrae:two case reports and review of the literature.Spine J.2007,7(4):499-505.
3.杨惠林，倪才方，唐天驷，等.靶血管栓塞后手术治疗骶骨肿瘤.中华骨科杂志.1998,18(11):646-648.
4. Guzman R, Dubach-Schwizer S, Heini P, et al. Preoperative transarterial embolization ofvertebral metastases. Eur Spine J.2005,14(3):263-268.
5. Ozkan E, Gupta S. Embolization of spinal tumors: vascular anatomy, indications, andtechnique.Tech Vasc Interv Radiol.2011,14(3):129-140.
6. Shi HB, Suh DC, Lee HK, et al. Preoperative transarterial embolization of spinal tumor:Embolization techniques and results. Am J Neuroradiol.1999,20(10):2009-2015.
7. Harrop JS, Schmidt MH, Boriani S, et al. Aggressive “Benign” Primary SpineNeoplasms Osteoblastoma, Aneurysmal Bone Cyst, and Giant Cell Tumor. Spine,2009.34(22S): S39-S47.
8. Ozaki T, Liljenqvist U, Halm H, et al. Giant cell tumor of the spine. Clin Orthop RelatRes.2002,401:194-201.
9. Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum. Clin Orthop Relat Res.1993,291:215-221.
10.马乐群，徐亮，代成浦，等.骶骨脊索瘤手术切除及并发症的防治.中国骨肿瘤骨病.2004,3(3):156-157.
11.唐顺，董森，郭卫，等.腹主动脉球囊阻断控制骶骨肿瘤切除术中出血的效果.中国脊柱脊髓杂志.2009,19(2):85-89.
12.陈卫东.骶骨肿瘤术前靶血管栓塞相关的应用解剖学研究.苏州:苏州大学,
2007.
13. Simpson AHRW, Porter A, Davis A, et al. Cephalad sacral resection with a combinedextended ilioinguinal and posterior approach. J Bone Jiont Surg Am.1995,77A(3):405-411.
14. Tang XD, Guo W, Yang RL, et al. Use of Aortic Balloon Occlusion to Decrease BloodLoss During Sacral Tumor Resection. J Bone Jiont Surg Am.2010,92A(8):1747-1753.
15. Wilson MA, Cooke DL, Ghodke B, et al. Retrospective analysis of preoperativeembolization of spinal tumors. Am J Neuroradiol.2010,31(4):656-660.
16. Yang HL, Chen KW, Wang GL, et al. Pre-operative transarterial embolization fortreatment of primary sacral tumors. J Clin Neurosci.2010,17(10):1280-1285.
17.彭晓新，程志远，范志斌，等.术前经动脉栓塞脊柱骨巨细胞瘤.中国介入影像与治疗学.2011,08(1):10-13.
18. Gellad FE, Sadato N, Numaguchi Y, et al. Vascular metastatic lesions of the spine-preoperative embolization. Radiology.1990,176(3):683-686.
19. Kunstlinger F, Brunelle F, Chaumont P, et al. Vascular occlusive agents. Am JRoentgenol.1981,136(1):151–156.
20.杨述华，程福平，许伟华.髂内动脉栓塞后观察侧支循环重建的实验研究.中华骨科杂志.2000,20(7):431-434.
21. Finstein JL, Chin KR, Alvandi F, et al. Postembolization paralysis in a man with athoracolumbar giant cell tumor. Clin Orthop Relat Res.2006,453:335-340.
22. Wuisman P, Lieshout O, Sugihara S, et al. Total sacrectomy and reconstruction–Oncologic and functional outcome. Clin Orthop Relat Res.2000,381:192-203.
23. Cloyd JM, Acosta FL Jr, Polley MY, et al. En bloc resection for primary and metastatictumors of the spine: a systematic review of the literature. Neurosurgery.2010,67(2):435-444.
24. Sanjay BK, Sim FH, Unni KK, et al. Giant-cell tumours of the spine. J Bone Joint SurgBr.1993,75(1):148-154.
25. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
1. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J BoneJoint Surg Am.1987,69(1):106-114.
2. Turcotte RE, Sim FH, Unni KK. Giant-cell tumor of the sacrum. Clin Orthop Relat Res.1993,291:215-221.
3. Refai D, Dunn GP, Santiago P. Giant cell tumor of the thoracic spine: case report andreview of the literature. Surg Neurol.2009,71(2):228-233.
4. Xu W, Li X, Huang W, et al. Factors affecting prognosis of patients with giant celltumors of the mobile spine: retrospective analysis of102patients in a single center.Ann Surg Oncol.2013,20(3):804-810.
5. Wang H, Wan N, Hu Y. Giant cell tumour of bone: a new evaluating system is necessary.Int Orthop.2012,36(12):2521-2527.
6. Junming M, Cheng Y, Dong C, et al. Giant cell tumor of the cervical spine: a series of22cases and outcomes. Spine.2008,33(3):280-288.
7. Klenke FM, Wenger DE, Inwards CY, et al. Giant cell tumor of bone. Risk factors forRecurrence. Clin Orthop Relat Res.2011,469:591-599.
8. van der Heijden L, van de Sande MAJ, Dijkstra PDS. Soft tissue extension increases therisk of local recurrence after curettage with adjuvants for giant-cell tumor of the longbones. A retrospective study of93patients. Acta Orthop.2012,83(4):401-405.
9. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging ofmusculoskeletal sarcoma. Clin Orthop Relat Res.1980,153:106-120.
10. Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res.1986,204:9-24.
11. Li DW, Yan DW, Tang HM, et al. IMP3is a novel prognostic marker that correlateswith colon cancer progression and pathogenesis. Ann Surg Oncol.2009,16(12):3499-3506.
12. Boriani S, Bandiera S, Casadei R, et al. Giant cell tumor of the mobile spine: a reviewof49cases. Spine.2012,37(1): E37-45.
13. Komiya S, Zenmyo M, Inoue A. Bone tumors in the pelvis presenting growth duringpregnancy. Arch Orthop Trauma Surg.1999,119(1-2):22-29.
14. Ross AE, Bojescul JA, Kuklo TR. Giant cell tumor: a case report of recurrence duringpregnancy. Spine.2005,30(12): E332-335.
15. Balke M, Schremper L, Gebert C, et al. Giant cell tumor of bone: treatment andoutcome of214cases. J Cancer Res Clin Oncol.2008,134(9):969-978.
16. Errani C, Ruggieri P, Asenzio MAN, et al. Giant cell tumor of the extremity: A reviewof349cases from a single institution. Cancer Treat Rev.2010,36(1):1-7.
17. Su YP, Chen WM, Chen TH. Giant-cell tumors of bone: an analysis of87cases. IntOrthop.2004,28(4):239-243.
18. Jeys LM, Suneja R, Chami G, et al. Impending fractures in giant cell tumours of thedistal femur: incidence and outcome. Int Orthop.2006,30(2):135-138.
19. Kivioja AH, Blomqvist C, Hietaniemi K, et al. Cement is recommended in intralesionalsurgery of giant cell tumors-A Scandinavian Sarcoma Group study of294patientsfollowed for a median time of5years. Acta Orthop.2008,79(1):86-93.
20. Miszczyk L, Wydmanski J, Spindel J. Efficacy of radiotherapy for giant cell tumor ofbone: Given either postoperatively or as sole treatment. Int J Radiat Oncol Biol Phys.2001,49(5):1239-1242.
21. Becker WT, Dohle J, Bernd L, et al. Local recurrence of giant cell tumor of bone afterintralesional treatment with and without adjuvant therapy. J Bone Joint Surg Am.2008,90(5):1060-1067.
22. Dahlin DC, Cupps RE, Johnson EW. Giant-cell tumor: a study of195cases. Cancer.1970,25(5):1061-1070.
23. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis oftwo hundred and eighteen cases. J Bone Joint Surg Am.1970,52(4):619-664.
24. McGrath PJ. Giant-cell tumour of bone: an analysis of fifty-two cases. J Bone JointSurg Am.1972,54(2):216-229.
25. Larsson SE, Lorentzon R, Boquist L. Giant-cell tumors of thespine and sacrum causing neurological symptoms. Clin Orthop Relat Res.1975,111:201-211.
26. Nair MK, Jyothirmayi R. Radiation therapy in the treatment of giant cell tumor of bone.Int J Radiat Oncol Biol Phys.1999,43(5):1065-1069.
27. Rock JP, Ryu S, Shukairy MS, et al. Postoperative radiosurgery for malignant spinaltumors. Neurosurgery.2006,58(5):891-897.
28. Kriz J, Eich HT, Mucke R, et al. Radiotherapy for giant cell tumors of the bone: a safeand effective treatment modality. Anticancer Res.2012,32(5):2069-2073.
29. Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases:clinical experience in500cases from a single institution. Spine.2007,32(2):193-199.
30. Roeder F, Timke C, Zwicker F, et al. Intensity modulated radiotherapy (IMRT) inbenign giant cell tumors-a single institution case series and a short review of theliterature. Radiat Oncol.2010,5:18.
31. Nielsen J, Christiansen J, Lykke-Andersen J, et al. A family of insulin-like growthfactor II mRNA-binding proteins represses translation in late development. Mol CellBiol.1999,19(2):1262-1270.
32. Mueller-Pillasch F, Pohl B, Wilda M, et al. Expression of the highly conserved RNAbinding protein KOC in embryogenesis. Mech Dev.1999,88(1):95-99.
33. Monk D, Bentley L, Beechey C, et al. Characterisation of the growth regulating geneIMP3, a candidate for Silver-Russell syndrome. J Med Genet.2002,39(8):575-581.
34. Mueller-Pillasch F, Lacher U, Wallrapp C, et al. Cloning of a gene highlyoverexpressed in cancer coding for a novel KH-domain containing protein. Oncogene.1997,14(22):2729-2733.
35. Liao B, Hu Y, Herrick DJ, Brewer G. The RNA-binding protein IMP-3is a translationalactivator of insulin-like growth factor II leader-3mRNA during proliferation of humanK562leukemia cells. J Biol Chem.2005,280(18):18517-18524.
36. Findeis-Hosey JJ, Xu HD. The use of insulin like-growth factor II messenger RNAbinding protein-3in diagnostic pathology. Hum Pathol.2011,42(3):303-314.
37.李康华,黄跃平,张俊,李国军,李思鸿. IMP3蛋白在骨肉瘤组织中的表达与临床意义.细胞与分子免疫学杂志.2009,5:426-427.
38. Do SI, Kim YW, Park HR, Park YK. Expression of insulin-like growth factor-II mRNAbinding protein3(IMP3) in osteosarcoma. Oncol Res.2008,17(6):269-272.
39. Jiang Z, Chu PG, Woda BA, et al. Analysis of RNA-binding protein IMP3to predictmetastasis and prognosis of renal-cell carcinoma: a retrospective study. Lancet Oncol.2006,7(7):556-564.
40. Szarvas T, vom Dorp F, Niedworok C, et al. High insulin-like growth factormRNA-binding protein3(IMP3) protein expression is associated with poor survival inmuscle-invasive bladder cancer. BJU Int.2012,110(6): E308-317.
41. Jeng YM, Chang CC, Hu FC, et al. RNA-binding protein insulin-like growth factor IImRNA-binding protein3expression promotes tumor invasion and predicts earlyrecurrence and poor prognosis in hepatocellular carcinoma. Hepatology.2008,48(4):1118-1127.
42. Chen YL, Jeng YM, Hsu HC, et al. Expression of insulin-like growth factor IImRNA-binding protein3predicts early recurrence and poor prognosis in intrahepaticcholangiocarcinoma. Int J Surg.2013,11(1):85-91.
43. Muller S, Zirkel D, Westphal M, Zumkeller W. Genomic imprinting of IGF2and H19in human meningiomas. Eur J Cancer.2000,36(5):651-655.
44. Cui H, Cruz-Correa M, Giardiello FM, et al. Loss of IGF2imprinting: a potentialmarker of colorectal cancer risk. Science.2003,299(5613):1753-1755.
45.张锋锐,何小兵,杨玉华,谢维.大肠癌中胰岛素样生长因子2基因的印迹状态和表达.中华医学遗传学杂志.2003,20(1):31-34.
46. Kohda M, Hoshiya H, Katoh M, et al. Frequent loss of imprinting of IGF2and MESTin lung adenocarcinoma. Mol Carcinog.2001,31(4):184-191.
47. Hernando E, Charytonowicz E, Dudas ME, et al. The AKT-mTOR pathway plays acritical role in the development of leiomyosarcomas. Nat Med.2007,13(6):748-753.
48. Lennartsson J, Blume-Jensen P, Hermanson M, et al. Phosphorylation of Shc by Srcfamily kinases is necessary for stem cell factor receptor/c-kit mediated activation of theRas/MAP kinase pathway and c-fos induction. Oncogene.1999,18(40):5546-5553.
49. Duensing A, Medeiros F, McConarty B, et al. Mechanisms of oncogenic KIT signaltransduction in primary gastrointestinal stromal tumors (GISTs). Oncogene.2004,23(22):3999-4006.
50. Goddard NC, McIntyre A, Summersgill B, et al. KIT and RAS signalling pathways intesticular germ cell tumours: new data and a review of the literature. Int J Androl.2007,30(4):337-348.
51. Braconi C, Bracci R, Bearzi I, et al. Insulin-like growth factor (IGF)1and2help topredict disease outcome in GIST patients. Ann Oncol.2008,19(7):1293-1298.
1. Szendroi M. Giant-cell tumour of bone. J Bone Joint Surg Br.2004,86B(1):5-12.
2. Sung HW, Kuo DP, Shu WP, et al. Giant-cell tumor of bone: analysis of208cases inChinese patients. J Bone Joint Surg Am.1982,64(5):755-761.
3. Unni KK. Dahlin’s Bone Tumors. General Aspects and Data on11,087Cases.5th edn.Philadelphia: Lippincoot-Raven.1996:263–283.
4. Leggon RE, Zlotecki R, Reith J, et al. Giant Cell Tumor of the Pelvis and sacrum:17cases and analysis of the literature. Clin Orthop Relat Res.2004,423:196-207.
5.杜联军，丁晓毅，江浩，陈克敏.脊柱骨巨细胞瘤的影像学表现及临床意义.实用放射学杂志,2006,22(3):300-303.
6. Enneking WF. Musculoskeletal Tumor Surgery. New York: Churchill Livingstone.1983,69-122.
7. Sanjay BK, Sim FH, Unni KK, et al. Giant-cell tumours of the spine. J Bone Joint SurgBr.1993,75(1):148-154.
8. Fidler MW. Surgical treatment of giant cell tumours of the thoracic and lumbar spine:report of nine patients. Eur Spine J.2001,10(1):69-77.
9. Boriani S, Weinstein JN, Biagini R. Spine update–Primary bone tumors of the spine–Terminology and surgical staging. Spine.1997,22(9):1036-1044.
10. Tomita K, Kawahara N, Baba H, et al. Total en bloc spondylectomy–A new surgicaltechnique for primary malignant vertebral tumors. Spine.1997,22(3):324-333.
11. Cloyd JM, Acosta FL, Polley MY, et al. En bloc resection for primary and metastatictumors of the spine: a systematic review of the literature. Neurosurgery.2010,67(2):435-444.
12. Marcove RC, Sheth DS, Brien EW, Huvos, et al. Conservative surgery for giantcell tumors of the sacrum. The role of cyosurgery as a supplement to curettage andpartial excision. Cancer.1994,74(4):1253-1260.
13. Takeda N, Kobayashi T, Tandai S, et al. Treatment of giant cell tumors in the sacrumand spine with curettage and argon beam coagulator. J Orthop Sci.2009,14(2):210-214.
14. Boriani S, Bandiera S, Casadei R, et al. Giant cell tumor of the mobile spine: a reviewof49cases. Spine.2012,37(1): E37-45.
15. Gille O, Soderlund C, Berge J, et al. Triple total cervical vertebrectomy for a giant celltumor–Case report. Spine.2005,30(10): E272-E275,.
16. Ma JM, Yang C, Cao D, et al. Giant cell tumor of the cervical spine–A series of22cases and outcomes. Spine.2008,33(3):280-288.
17. Shimizu K, Ido K, Fujio K, et al. Total spondylectomy and spinal shortening forgiant-cell tumour of spine. Lancet.1996,348(9023):342-342.
18. Ozaki T, Liljenqvist U, Halm H, et al. Giant Cell Tumor of the Spine. Clin OrthopRelat Res.2002,401:194-201.
19. Guo W, Ji T, Tang XD, et al. Outcome of Conservative Surgery for Giant Cell Tumor ofthe Sacrum. Spine.2009,34(10):1025-1031.
20.彭晓新,程志远,范志斌,等.术前经动脉栓塞脊柱骨巨细胞瘤.中国介入影像与治疗学.2011,8(1):10-12.
21. Finstein JL, Chin KR, Alvandi F, et al. Postembolization paralysis in a man with athoracolumbar giant cell tumor. Clin Orthop Relat Res.2006,453:335-340.
22. Wilson MA, Cooke DL, Ghodke B, et al. Retrospective analysis of preoperativeembolization of spinal tumors. Am J Neuroradiol.2010,31(4):656-660.
23. Martin C, McCarthy EF. Giant cell tumor of the sacrum and spine: series of23casesand a review of the literature. Iowa Orthop J.2010,30:69-75.
24. Hosalkar HS, Jones KJ, King JJ, et al. Serial arterial embolization for large sacralgiant-cell tumors–Mid-to long-term results. Spine.2007,32(10):1107-1115.
25. Balke M, Henrichs MP, Gosheger G, et al. Giant cell tumors of the axial skeleton.Sarcoma.2012,2012:410973.
26. Nair MK, Jyothirmayi R. Radiation therapy in the treatment of giant cell tumor of bone.Int J Radiat Oncol Biol Phys.1999,43(5):1065-1069.
27. Feigenberg SJ, Marcus RB, Zlotecki RA, et al. Radiation therapy for giant cell tumorsof bone. Clin Orthop Relat Res.2003,411:207-216.
28. Rock JP, Ryu S, Shukairy MS, et al. Postoperative radiosurgery for malignant spinaltumors. Neurosurgery.2006,58(5):891-897.
29. Gerszten PC, Burton SA, Ozhasoglu C, et al. Radiosurgery for spinal metastases–Clinical experience in500cases from a single institution. Spine.2007,32(2):193-199.
30. Roeder F, Timke C, Zwicker F, et al. Intensity modulated radiotherapy (IMRT) inbenign giant cell tumors–a single institution case series and a short review of theliterature. Radiat Oncol.2010,5:18.
31. Mendenhall WM, Zlotecki RA, Scarborough MT, et al. Giant cell tumor of bone. Am JClin Oncol.2006,29(1):96-99.
32. Kriz J, Eich HT, Muecke R, et al. Radiotherapy for Giant Cell Tumors of the Bone: ASafe and Effective Treatment Modality. Anticancer Res.2012,32(5):2069-2073.
33. Cheng YY, Huang L, Lee KM, et al. Bisphosphonates induce apoptosis of stromaltumor cells in giant cell tumor of bone. Calcif Tissue Int.2004,75(1):71-77.
34. Chang SS, Suratwala SJ, Jung KM, et al. Bisphosphonates may reduce recurrence ingiant cell tumor by inducing apoptosis. Clin Orthop Relat Res.2004,426:103-109.
35. Tse LF, Wong KC, Kumta SM, et al. Bisphosphonates reduce local recurrence inextremity giant cell tumor of bone: a case-control study. Bone.2008,42(1):68-73.
36. Gille O, Oliveira BA, Guerin P, et al. Regression of Giant Cell Tumor of the CervicalSpine With Bisphosphonate as Single Therapy. Spine.2012,37(6): E396-E399.
37. Morgan T, Atkins GJ, Trivett MK, et al. Molecular profiling of giant cell tumor of boneand the osteoclastic localization of ligand for receptor activator of nuclear factor kappaB. Am J Pathol.2005,167(1):117-128.
38. Kim N, Odgren PR, Kim DK, et al. Diverse roles of the tumor necrosis factor familymember TRANCE in skeletal physiology revealed by TRANCE deficiency and partialrescue by a lymphocyte-expressed TRANCE transgene. Proc Natl Acad Sci U S A.2000,97(20):10905-10910.
39. Thomas D, Henshaw R, Skubitz K, et al. Denosumab in patients with giant-cell tumourof bone: an open-label, phase2study. Lancet Oncol.2010,11(3):275-280.
40. Branstetter DG., Nelson SD, Manivel JC, et al. Denosumab induces tumor reductionand bone formation in patients with giant-cell tumor of bone. Clin Cancer Res.2012,18(16):4415-4424.
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