Histological examination of frozen autograft treated by liquid nitrogen removed after implantation
Histological examination of frozen autograft treated by liquid nitrogen removed after implantation
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DOI：
10.1007/s00776-009-1392-1
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发表时间：
2009-11-01
影响因子：
1.7
通讯作者：
Tomita, Katsuro
中科院分区：
文献类型：
--
作者：
Tanzawa, Yoshikazu;Tsuchiya, Hiroyuki;Tomita, Katsuro
几种肿瘤学灭菌方法，包括高压灭菌、照射或巴氏灭菌，已被开发用于肿瘤切除后大型骨缺损的肢体重建。涉及这些自体移植物的组织学检查的研究都发现，成骨发生得很慢。我们使用液氮处理的冷冻自体移植物进行肢体重建，取得了良好的骨愈合效果。为了确定冷冻自体移植物是否存在早期骨重建，我们研究了冷冻自体移植物的修复过程。我们分析了冷冻自体移植物经液氮处理后，因并发症或局部肿瘤复发而平均在植入后19.1个月(2-75个月)取材的情况。标本取自6例患者，平均年龄36.2岁(8~68岁)。这6个移植物包括3个骨关节移植物、2个间质移植物和1个关节移植物。我们复习了含有肿瘤细胞坏死的自体移植切片、皮质修复的证据、皮质连接和关节软骨。所有病例的冷冻骨中的肿瘤细胞都被完全清除。在植入后5个月取材的标本中，一小部分骨显示活跃的骨细胞和成骨细胞。3例术后1年以上取材，在冻骨的大片部位可见成骨细胞和成骨细胞，说明冻骨在早期即开始成骨。皮质宿主-移植物交界处随着骨小梁的延续而融合。此外，我们能够在关节表面发现正常的软骨细胞。因此，本研究中的冰冻骨标本显示出新形成的骨和比先前报道的更早的成骨。我们的结果表明，冷冻自体移植物可能被认为是最有用的生物重建再生材料之一。
Several oncological sterilization methods involving autoclaving, irradiation, or pasteurization have been developed for limb reconstruction of large bone defects following tumor excision. Studies involving histological examinations of these autografts have all found that osteogenesis occurs slowly. We have used frozen autografts treated by liquid nitrogen for limb reconstruction and have achieved excellent results for bone union. To determine if frozen autografts exhibit early bone remodeling, we investigated the repair processes of the frozen bones.We analyzed frozen autografts treated by liquid nitrogen, retrieved at a mean of 19.1 months (2-75 months) after implantation because of complications or local tumor recurrence. The specimens were obtained from six patients with a mean age of 36.2 years (8-68 years). The six grafts comprised three osteoarticular grafts, two intercalary grafts, and one joint graft. We histologically reviewed the autograft-containing sections for tumor cell necrosis, evidence of cortical repair, the cortical junction, and joint cartilage.Tumor cells were completely eradicated from the frozen bone in all cases. In a specimen retrieved 5 months after implantation, a small area of the bone showed active osteocytes and osteoblasts. In three cases retrieved more than 1 year after implantation, osteocytes and osteoblasts were observed in broad portions of the frozen bones, indicating the onset of osteogenesis in the frozen bone at an early stage. The cortical host-graft junction showed incorporation along with continuity of bone trabeculae. In addition, we were able to fi nd normal chondrocytes on the articular surface.The frozen bone specimens in this study thus showed evidence of newly formed bone and earlier osteogenesis than has been previously reported. Our results suggest that frozen autografts may be considered one of the most useful recycled materials for biological reconstruction.