Classification, imaging, biopsy and staging of osteosarcoma.
Classification, imaging, biopsy and staging of osteosarcoma.
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DOI：
10.4103/0019-5413.132491
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发表时间：
2014-05
影响因子：
1
通讯作者：
Kundu ZS
中科院分区：
文献类型：
--
作者：
Kundu ZS
骨肉瘤是除骨髓恶性肿瘤（骨髓瘤、淋巴瘤和白血病）外最常见的原发性骨恶性肿瘤，约占骨癌的20%。它主要影响20岁以下的患者，主要发生在四肢长骨，最常见的是膝关节周围的干骺端。这些骨肉瘤分为原发性（中央或表面）和继发性骨肉瘤。常规x线平片是最好的可能诊断，因为它描述了诸如太阳爆裂外观，Codman三角形，软组织新骨形成以及骨破坏的渗透性模式以及骨肉瘤特定亚型的其他特征。胸部x光片可以发现肺部的转移，但胸部的计算机断层扫描（CT）更有帮助。病变的磁共振成像（MRI）描绘了其进入软组织、髓管、关节、跳跃病变和肿瘤靠近神经血管结构的程度。Tc99骨扫描检测骨转移。正电子发射断层扫描（PET）用于转移性检查和/或切除后局部复发。碱性磷酸酶、乳酸脱氢酶等生化标志物的作用与预后和治疗反应有关。活检证实了诊断并显示了肿瘤的分级。恶性肌肉骨骼肿瘤分期的Enneking系统和美国癌症联合委员会（AJCC）分期系统最常用于四肢肉瘤。
Osteosarcoma is the most common primary osseous malignancy excluding malignant neoplasms of marrow origin (myeloma, lymphoma and leukemia) and accounts for approximately 20% of bone cancers. It predominantly affects patients younger than 20 years and mainly occurs in the long bones of the extremities, the most common being the metaphyseal area around the knee. These are classified as primary (central or surface) and secondary osteosarcomas arising in preexisting conditions. The conventional plain radiograph is the best for probable diagnosis as it describes features like sun burst appearance, Codman's triangle, new bone formation in soft tissues along with permeative pattern of destruction of the bone and other characteristics for specific subtypes of osteosarcomas. X-ray chest can detect metastasis in the lungs, but computerized tomography (CT) scan of the thorax is more helpful. Magnetic resonance imaging (MRI) of the lesion delineates its extent into the soft tissues, the medullary canal, the joint, skip lesions and the proximity of the tumor to the neurovascular structures. Tc99 bone scan detects the osseous metastases. Positron Emission Tomography (PET) is used for metastatic workup and/or local recurrence after resection. The role of biochemical markers like alkaline phosphatase and lactate dehydrogenase is pertinent for prognosis and treatment response. The biopsy confirms the diagnosis and reveals the grade of the tumor. Enneking system for staging malignant musculoskeletal tumors and American Joint Committee on Cancer (AJCC) staging systems are most commonly used for extremity sarcomas.
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DOI：
10.1001/jama.1920.02620100016007
发表时间：
1920-01-01
影响因子：
--
作者：
Broders, AC
通讯作者：
Broders, AC
影响因子：
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作者：
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通讯作者：
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作者：
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3.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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