Application of BMP for reconstruction of bone defect after the removable of malignant bone tumor

在恶性骨肿瘤的治疗中，肿瘤广泛切除会造成巨大的骨丢失。骨移植作为一种填充指骨小肿瘤等微小缺损的有效方法。但对于因骨盆骨切除而造成的巨大骨缺损，以往的方法均未能成功修复。此外，患有恶性肿瘤的患者进行化疗或放射治疗，处于不利状态，因为这些治疗对骨形成或修复造成负面影响。本研究旨在探讨抗癌药物对骨形成反应的影响，以及对肿瘤尤其是骨盆肿瘤切除后骨缺损的理想填充方法的改进。首先，我们通过植入由骨形态发生蛋白（BMP）和胶原载体组成的具有皮下成骨能力的颗粒来检查抗癌药物对骨形成反应的影响。接受抗癌药物治疗的人群 ...更多信息 成骨能力明显优于对照组，对照组在2 ~ 3周内以软骨内成骨方式成功成骨，而抗癌药物组未见成熟骨形成，仅见软骨样形成。接下来，我们使用大鼠股骨骨折模型检查抗癌药物对骨折修复的影响。抗肿瘤药物组骨折修复能力较差。通过使用抗VEGF抗体的免疫组织化学研究，在抗癌药物组中观察到BMP颗粒周围的阳性染色较少，这表明药物对新血管形成产生了负面影响，而新血管形成是新骨形成所必需的。最后制作兔骨盆巨大骨缺损模型。作为一种治疗方法，我们应用三磷酸钙骨水泥糊剂填充缺损。单纯糊剂不能引起充分愈合，但钛丝和糊剂的组合可成功和有力地替代骨缺损。少

In a treatment of malignant bone tumor, huge loss of bone is caused by tumor wide resection. As a filling up the small defect such as small tumor of digital bone, bone transplant is a useful method. But huge bone defect caused by removal of the pelvic bone has not been successfully reconstructed by previous method. Furthermore, the patient suffering from malignant tumor has chemotherapy or radiation therapy, is in a disadvantage state because these treatment cause a negative affect for bone formation or repair. This study focused on the effect of the anti-cancer drug for bone forming reaction, and improvement of the ideal method for filling up the defect caused by tumor resection, especially pelvic bone tumor. First, we examined the influence of anti-cancer drug for bone-forming reaction by means of the implantation of pellet consisted of bone morphogenetic protein (BMP) and collagen carrier, which has an ability of forming subcutaneous bone. Anti cancer drug receiving group has less a … More bility of bone formation than control group; successful bone formation has been achieved in control group in 2 or 3 weeks by means of enchondral bone formation, on the other hand no mature bone formation but chondroid formation was seen in anti-cancer drug group. Next, we examined the influence of anti-cancer drug for fracture repair using rat femoral bone fracture model. Less ability for fracture repair was revealed in anti-cancer drug group. By an immunohistochemical study using anti-VEGF antibody, less positive staining around BMP pellet was seen in anti-cancer drug group, that indicates the drug had influenced a negative effect for new vascular formation which had been needed for new bone formation. Finally, we made the rabbit model bearing huge bone defect in pelvis. As a treatment of filling up the defect, we applied the triphosphate calcium cement paste. The paste alone did not cause the sufficient healing, but the combination of titanium wire and the paste caused successful and powerful replacement for the bone defect. Less