Biomarkers in Osteosarcoma.
Biomarkers in Osteosarcoma.
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DOI：
10.1517/17530050802608496
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发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Hansen MF
中科院分区：
文献类型：
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作者：
Kong C;Hansen MF
骨肉瘤是最常见的骨原发肿瘤，约占所有骨恶性肿瘤的19%。它是青少年中第三常见的恶性肿瘤。二十多年前，结合多药化疗和保肢手术的多学科治疗方法的出现极大地提高了骨肉瘤患者的生存率。不幸的是，从那时起，存活率并没有显着提高。迄今为止，最有力的结果预测因素仍然是在诊断时检测转移性疾病的能力以及肿瘤对术前化疗的组织病理学反应。目前，80%初次诊断时没有远处转移的患者将成为长期幸存者。不幸的是，这意味着大约 20% 诊断时未出现转移的患者将无法生存。这组患者似乎对当前的治疗有抵抗力，因为对组织病理学反应较差的患者进行手术后强化治疗的尝试并没有显着提高生存率。这些患者最需要额外的临床相关标志物来预测预后，并且分子分析可以为他们提供最大的帮助。虽然在骨肉瘤遗传改变的鉴定方面取得了稳步进展，但迄今为止，还没有任何单个分子标记被证明在骨肉瘤治疗中比目前的临床标记具有更好的预后意义。因此，显然需要采用新的综合分析技术来开发信息更丰富的分类系统并确定新的治疗靶点。
Osteosarcoma is the most common primary tumor of bone and accounts for approximately 19% of all malignant tumors of bone. It is the third most common malignant tumor in teenagers. More than twenty years ago, the advent of a multidisciplinary approach that combined multi-agent chemotherapy and limb-sparing surgery greatly improved the survival rate of patients with osteosarcoma. Unfortunately, since that time, survival rates have not dramatically improved. To date, the most powerful predictors of outcome have remained the ability to detect metastatic disease at diagnosis and the histopathologic response of the tumor to preoperative chemotherapy. Presently, 80% of patients who do not have distant metastases at initial diagnosis will become long-term survivors. Unfortunately, this means that approximately 20% of patients who do not present with metastases at diagnosis will not survive. This group of patients appears to be resistant to current treatment as attempts to intensify therapy after surgery for patients with a poor histopathologic response has not significantly improved survival rates. It is these patients that are in the greatest need of additional clinically relevant markers for prognosis and who can be most helped by molecular analysis. While steady progress has been made in the identification of genetic alterations in osteosarcoma, no individual molecular marker has thus far been demonstrated to have a better prognostic significance in the treatment of osteosarcomas than the current clinical markers. Thus there is clearly a need to employ new comprehensive analysis technologies to develop significantly more informative classification systems and to identify new therapeutic targets.