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1.
FASEB J ; 33(1): 782-795, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30063438

RESUMO

Tissue repair is a highly dynamic process, and the immediate onset of acute inflammation has been considered necessary for repair. Pore-forming proteins are important, both in pathogen invasion and host immunity. However, their roles in wound healing and tissue repair are unclear. ßγ-crystallin fused aerolysin-like protein (α-subunit) and trefoil factor (ß-subunit) complex (ßγ-CAT) is a complex of a bacterial pore-forming toxin aerolysin-like protein and trefoil factor identified in the frog Bombina maxima. In this study, we established mouse cutaneous wound models to explore the effects of ßγ-CAT on skin wound healing. ßγ-CAT accelerated the healing of full-thickness wounds by improving re-epithelialization. This complex relieved dermal edema and promoted scarless healing. ßγ-CAT treatment resulted in a rapid release of IL-1ß, which initiated an acute inflammation response in the early stage of healing. Meanwhile, the expression levels of TGF-ß1, VEGF, and bFGF and the recruitment of M2 macrophages around the wound significantly increased after ßγ-CAT treatment. ßγ-CAT protected skin wounds against methicillin-resistant Staphylococcus aureus by improving neutrophil recruitment at the site of the wound. Overall, our results suggest that ßγ-CAT can promote tissue repair and protect skin wounds against antibiotic-resistant bacterial infection by triggering the acute inflammatory response. This is the first example that aerolysin-like pore-forming proteins widely existing in plants and animals may act in wound healing and tissue repair.-Gao, Z.-H., Deng, C.-J., Xie, Y.-Y., Guo, X.-L., Wang, Q.-Q., Liu, L.-Z., Lee, W.-H., Li, S.-A., Zhang, Y. Pore-forming toxin-like protein complex expressed by frog promotes tissue repair.


Assuntos
Proteínas Citotóxicas Formadoras de Poros/metabolismo , Toxinas Biológicas/metabolismo , Cicatrização , Animais , Anuros , Linhagem Celular , Colágeno/metabolismo , Cristalinas/metabolismo , Células Epiteliais/citologia , Fator 2 de Crescimento de Fibroblastos/metabolismo , Fibroblastos/citologia , Humanos , Interleucina-1beta/metabolismo , Macrófagos/citologia , Masculino , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Camundongos , Neutrófilos/citologia , Coelhos , Pele/lesões , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/prevenção & controle , Fator de Crescimento Transformador beta1/metabolismo , Fatores Trefoil/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
2.
J Synchrotron Radiat ; 26(Pt 6): 2075-2080, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31721753

RESUMO

The upgrade of the laser pump time-resolved X-ray probes, namely time-resolved X-ray absorption spectroscopy (TR-XAS) and X-ray diffraction (TR-XRD), implemented at the Beijing Synchrotron Radiation Facility, is described. The improvements include a superbunch fill, a high-efficiency fluorescence collection, an efficient spatial overlap protocol and a new data-acquisition scheme. After upgrade, the adequate TR-XAS signal is now obtained in a 0.3 mM solution, compared with a 6 mM solution in our previous report. Furthermore, to extend application in photophysics, the TR-XAS probe is applied on SrCoO2.5 thin film. And for the first time, TR-XAS is combined with TR-XRD to simultaneously detect the kinetic trace of structural changes in thin film.

3.
BMC Musculoskelet Disord ; 15: 330, 2014 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-25277133

RESUMO

BACKGROUND: Aggressive curettage has been well established for the treatment of giant cell tumors (GCTs) of the bone. The purpose of this study was to review our experience and evaluate the role of different implant materials in patients with GCTs of the extremities after aggressive curettage. METHODS: A total of 119 patients with GCTs of the long bone were treated at the First Affiliated Hospital of Sun Yat-Sen University between 2004 and 2009. We excluded patients presenting metastases, recurrent tumors, and soft tissue involvement and those with Jaffe pathological grade III. The remaining 65 patients were treated with aggressive curettage using a bone graft or bone cement to fill the cavity. The recurrence rates and functional scores associated with the different fillings were analyzed. RESULTS: Aggressive curettage and bone grafting was performed in 34 cases (52.3%), and aggressive curettage with bone cement was performed in 31 cases (47.7%). The overall recurrence rate after the aggressive intralesional procedures was 35.3% with bone grafting and 12.9% when bone cement was used as an adjuvant filling. The recurrence rate following aggressive curettage and bone grafting was higher than that following aggressive curettage with cement (p = 0.038). The Musculoskeletal Tumor Society (MSTS) score for bone graft patients was 91.1%, which was significantly lower than that for patients treated with bone cement (94.7%). CONCLUSIONS: The use of bone cement was associated with a significantly lower recurrence rate than bone grafting following aggressive intralesional curettage to treat benign giant cell tumors of the long bone. Better MSTS functional results were also observed in the bone cement group compared to the bone graft group.


Assuntos
Cimentos Ósseos/uso terapêutico , Neoplasias Ósseas/cirurgia , Curetagem/métodos , Tumor de Células Gigantes do Osso/cirurgia , Tíbia/cirurgia , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Intervalo Livre de Doença , Feminino , Seguimentos , Tumor de Células Gigantes do Osso/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Adulto Jovem
4.
Int J Biol Markers ; 39(3): 217-225, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38881381

RESUMO

PURPOSE: Gastric cancer is the most common malignancy worldwide and is the third leading cause of cancer-related deaths, urgently requiring an early and non-invasive diagnosis. Circulating extracellular vesicles may emerge as promising biomarkers for the rapid diagnosis in a non-invasive manner. METHODS: Using high-throughput small RNA sequencing, we profiled the small RNA population of serum-derived extracellular vesicles from healthy controls and gastric cancer patients. Differentially expressed microRNAs (miRNAs) were randomly selected and validated by reverse transcription-quantitative real-time polymerase chain reaction. Receiver operating characteristic curves were employed to assess the predictive value of miRNAs for gastric cancer. RESULTS: In this study, 193 differentially expressed miRNAs were identified, of which 152 were upregulated and 41 were significantly downregulated. Among the differently expressed miRNA, the expression levels of miR-21-5p, miR-26a-5p, and miR-27a-3p were significantly elevated in serum-derived extracellular vesicles of gastric cancer patients. The miR-21-5p and miR-27a-3p were closely correlated with the tumor size. Moreover, the expression levels of serum miR-21-5p and miR-26a-5p were significantly decreased in gastric cancer patients after surgery. CONCLUSIONS: The present study discovered the potential of serum miR-21-5p and miR-26a-5p as promising candidates for the diagnostic and prognostic markers of gastric cancer.


Assuntos
Biomarcadores Tumorais , Vesículas Extracelulares , MicroRNAs , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/genética , Neoplasias Gástricas/sangue , Neoplasias Gástricas/diagnóstico , MicroRNAs/sangue , MicroRNAs/genética , Vesículas Extracelulares/metabolismo , Vesículas Extracelulares/genética , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Regulação Neoplásica da Expressão Gênica
5.
Oper Neurosurg (Hagerstown) ; 24(3): 232-241, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36701567

RESUMO

BACKGROUND: Robotic surgery may be advantageous in neurogenic sacral tumor resection but only a few studies reported robotic-assisted neurogenic sacral tumor resection. OBJECTIVE: To propose a new surgical strategy for robotic-assisted benign sacral neurogenic tumor resection and introduce the ultrasonic osteotomy surgical system in robotic surgery. METHODS: Twelve patients who had robotic-assisted primary benign sacral neurogenic tumor resection between May 2015 and March 2021 were included. Our surgical strategy divides tumors into 4 types. Type I: Presacral tumors with diameter <10 cm. Type II: Narrow-base tumors involving the sacrum with diameter <10 cm. Type III: Broad-base tumors involving the sacrum with diameter <10 cm. Type IV: Tumors involving sacral nerve roots ≥2 levels and/or with diameter ≥10 cm. RESULTS: Five type I, 5 type II, and 1 type III patients underwent tumor resection via an anterior approach, and 1 type IV patient via a combined approach. The median operation time, blood loss, and postoperative hospital stay of type I and II were much less than those of type IV. The ultrasonic osteotomy surgical system facilitated osteotomy in 2 type II and 1 type III patients. Eleven patients had total resections, and 1 type III patient had a partial resection. During the follow-up period of 7.9 to 70.9 months (median: 28.5 months), no local recurrences or deaths were noted. CONCLUSION: With the largest single-center series to our knowledge, this surgical strategy helped to guide robotic-assisted benign sacral neurogenic tumor resection. The ultrasonic osteotomy surgical system was effective for type II and III.


Assuntos
Neoplasias , Procedimentos Cirúrgicos Robóticos , Humanos , Sacro/diagnóstico por imagem , Sacro/cirurgia , Sacro/patologia , Neoplasias/patologia , Pelve , Osteotomia
6.
World J Clin Cases ; 10(20): 7082-7089, 2022 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-36051112

RESUMO

BACKGROUND: Pyogenic liver abscesses are insidious in the early stage. Some cases progress rapidly, and the patient's condition can worsen and even become life-threatening if timely treatment is not provided. Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen. CASE SUMMARY: We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment, review the literature related to the use of platelet-rich plasma (PRP) in the treatment of hepatic impairment and partial hepatectomy in animals, and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses. This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans, providing new ideas for the treatment of this condition. CONCLUSION: This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically. PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.

7.
Neurosurgery ; 88(6): 1095-1102, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33556169

RESUMO

BACKGROUND: More effective therapies are needed to treat progressive desmoid tumors when active surveillance and systemic therapy fail. OBJECTIVE: To assess the efficacy and safety of sandwich isolation surgery on the local control of progressive desmoid tumors involving neurovascular bundles. METHODS: A total of 27 patients with progressive desmoid tumors at extremities involving neurovascular bundles who received surgery at our hospital between August 2014 and August 2018 were identified. A total of 13 patients received sandwich isolation surgery, in which R2 resection was performed in neurovasculature-involving regions, and a biomaterial patch was used to envelop involved neurovascular structures and isolate residual tumors. In non-neurovasculature-involving regions, wide resection was performed without isolation. A total of 14 patients received traditional surgery, which included tumor resection without isolation procedure. RESULTS: In sandwich isolation group, tumor progressions and local recurrences occurred in 3 patients outside the isolated neurovasculature-involving regions. However, no progressions or recurrences occurred in any patients in the isolated neurovasculature-involving regions where R2 resection was performed. Sandwich isolation surgery group and traditional surgery group shared similar baseline clinical characteristics. The estimated 3-yr event-free survival rate was 76.9% after sandwich isolation surgery, and 32.7% after traditional surgery (P = .025). Patients who received sandwich isolation surgery were less likely to have local recurrence (hazard ratio: 0.257, P = .040). No complications were noted except intermittent mild pain in operative regions (2 cases). CONCLUSION: Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles.


Assuntos
Fibromatose Agressiva/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Fibromatose Agressiva/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasia Residual/patologia , Intervalo Livre de Progressão , Radioterapia Adjuvante , Estudos Retrospectivos , Resultado do Tratamento
8.
Chin J Cancer ; 29(7): 703-8, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20591224

RESUMO

BACKGROUND AND OBJECTIVE: Elastofibroma dorsi has an extremely low incidence. At present, comparative study on imaging manifestations and pathologic findings of elastofibroma dorsi has not been reported in China. This study was to investigate clinical manifestations, computed tomography (CT) and magnetic resonance imaging (MRI) appearances, and pathologic features of elastofibroma dorsi and to improve preoperative imaging diagnosis of this disease. METHODS: The clinical manifestations, imaging findings, and pathologic appearances of 6 cases of elastofibroma dorsi were retrospectively analyzed and related literatures were reviewed. All patients were examined with MRI, and 4 of them were examined with CT scan. RESULTS: All patients were above 30 years old without obvious symptoms. The tumors presented as a lenticular soft-tissue mass in the deep subscapular region. The tumor's density on plain CT scan or signal intensity on MR T1-weighted image was approximately equal to that of muscle with some interlaced fat-like areas within mass suppressed by fat-suppression MR sequences, which corresponded to dense collagen tissue and interspersed mature adipose tissue observed microscopically. CONCLUSIONS: CT and MRI can reflect the histological features of elastofibroma dorsi. On the basis of their imaging characteristics, a correct preoperative diagnosis of elastofibroma dorsi can easily be made.


Assuntos
Fibroma/diagnóstico , Fibroma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Adulto , Idoso , Feminino , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Escápula/diagnóstico por imagem , Escápula/patologia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgia , Tomografia Computadorizada por Raios X
11.
R Soc Open Sci ; 5(5): 180015, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29892440

RESUMO

With an attempt to economically and efficiently improve the water resistance of defatted soya bean flour (DSF)-based wood adhesives, DSF was subjected to thermal treatment at various temperatures (65°C, 80°C, 95°C, 110°C and 125°C) for 30 min. The effects of thermal treatment temperature onto the chemical structure, crystalline degree, water-insoluble content and acetaldehyde value of the thermally treated DSF (T-DSF) were investigated. The thermal stabilities and bonding properties of soya bean adhesives prepared from T-DSF and cross-linker epichlorohydrin-modified polyamide (EMPA) were also investigated. Test results indicated that both the water-insoluble content and the acetaldehyde value of T-DSF increased after thermal treatment, reaching the highest values of 27.28% and 26.81 mg g-1, respectively. All plywood bonded with the T-DSF-based adhesive withstood a 28 h boiling-dry-boiling accelerated ageing treatment, while plywood bonded with the DSF-based adhesive delaminated after 4 h of water boiling, demonstrating the significantly improved water resistance of the T-DSF-based adhesives. Related analyses also confirmed that this improvement was due to: (i) the formation of insoluble cross-linked structures of T-DSF resulting from protein-protein self-cross-linking reactions and the protein-carbohydrate Maillard reaction and (ii) increased cross-linking efficiency between T-DSF and cross-linker EMPA owing to more T-DSF-reactive groups being released after thermal treatment.

12.
J Bone Oncol ; 11: 10-16, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29892520

RESUMO

BACKGROUND AND PURPOSE: Telangiectatic osteosarcoma (TOS), a rare variant of osteosarcoma, may be easily misdiagnosed as aneurysmal bone cyst (ABC). The aims of this study were to investigate the diagnostic and prognostic factors of TOS by reviewing our experience with TOS and to develop a diagnostic model that may distinguish TOS from ABC. MATERIALS AND METHODS: We identified 51 cases of TOS treated at the First Affiliated Hospital of Sun Yat-Sen University from March 2001 to January 2016 and reviewed their records, imaging information and pathological studies. A diagnostic model was developed to differentiate TOS and ABC by Bayes discriminant analysis and was evaluated. The log-rank test was used to analyze the prognostic factors of TOS and to compare the outcome differences between TOS and other high-grade osteosarcoma subtypes. RESULTS: The multi-disciplinary diagnostic method employed that combined clinical, imaging, and pathological studies enhanced the diagnostic accuracy. Age 18 years or younger and pathologic fracture were more common among the TOS patients than among the ABC patients (P = .004 and .005, respectively). The average white blood cell (WBC), platelet, lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) values of the TOS patients were higher than those of the ABC patients (P = .002, .003, .007, and .007, respectively). Our diagnostic model, including the aforementioned factors, accurately predicted 62% and 78% of the TOS patients in the training and validation sets, respectively. The 5-year estimates of event-free survival and overall survival of the TOS patients were 52.5 ± 9.4% and 54.9 ± 8.8%, respectively, which were similar to those of patients with other osteosarcoma subtypes (P = .950 and .615, respectively). Tumor volume and the LDH level were predictive prognostic factors (P = .040 and .044) but not the presence of pathologic fracture or misdiagnosis (P = .424 and .632, all respectively). CONCLUSIONS: The multi-disciplinary diagnostic method and diagnostic model based on predictive factors, i.e., age, the presence of pathologic fracture, and platelet, LDH, ALP and WBC levels, aided the differentiation of TOS and ABC. Smaller tumors and normal LDH levels were associated with better outcomes.

14.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 27(12): 1121-3, 2007 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-18198648

RESUMO

OBJECTIVE: To investigate the effect of integrative Chinese and Western medical therapy for radiative pneumonia (RP). METHODS: Eighty patients were randomly assigned to two groups. The treated group (48 patients) was treated by Shenqi Fuzheng Injection (SFI), antibiotics and short-term pulse therapy with high efficient hormone, while the control group (32 patients) was treated only by antibiotic and hormone pulse therapy. Changes of symptoms, signs, quality of life and subsets of T-lymphocytes (CD3+, CD4+, CD8+ and CD4+/CD8+ ratio) were observed before and after 20-day treatment. RESULTS: The chief symptom disappearance time was shorter (P < 0.05), Karnofsky performance score was better (P < 0.05) in the treated group after treatment as compared with those in the control group. Moreover, the immune function was improved in the treated group after treatment (P < 0.01). CONCLUSION: SFI combined with antibiotics and short-term pulse therapy with high efficient hormone has a good effect for radiative pneumonia, it could also increase patients' quality of life as well.


Assuntos
Antibacterianos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Metilprednisolona/uso terapêutico , Pneumonite por Radiação/tratamento farmacológico , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Fitoterapia , Qualidade de Vida , Resultado do Tratamento
16.
Oncol Lett ; 12(2): 928-932, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27446372

RESUMO

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign splenic vascular lesion. Since it was first defined in 2004, a total of 132 cases of SANT have been reported in ~50 studies in the English literature. However, it remains difficult to form a definitive pre-operative differential diagnosis of SANT compared with other splenic tumors or malignant lesions. The present study reports a pathologically proven case of SANT in a 29-year-old man who initially presented with left upper quadrant and back discomfort. The study also provides a review of the current knowledge on the condition, including the clinical profile, imaging features, cytological features, differential diagnosis and treatment of SANT. The most important distinguishing features of SANT are its typical vascular character and lack of other features that are typical of a granuloma. A splenectomy is required and the diagnosis is based on pathological analysis.

17.
Int J Clin Exp Med ; 8(6): 9758-64, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26309653

RESUMO

PURPOSE: (18)F-FLT-PET imaging was proposed as a tool for measuring in vivo tumor cell proliferation and detecting sub-volumes to propose escalation in radiotherapy. The aim of this study was to validate whether high FLT uptake areas in (18)F-FLT PET/CT are coincident with tumor cell proliferation distribution indicated by Ki-67 staining in non-small cell lung cancer, thus provide theoretical support for the application of dose painting guided by (18)F-FLT PET/CT. MATERIALS AND METHODS: Twelve treatment naive patients with biopsy proven NSCLC underwent (18)F-FLT PET/CT scans followed by lobectomy were enrolled. The surgical specimen was dissected into 4-7 µm sections at approximately 4-mm intervals. The best slice was sort out to complete Ki-67 staining. Maximum Ki-67 labelling Index and SUVmax of the corresponding PET image was calculated. The correlation between Ki-67 Labelling Index and SUVmax of FLT was determined using Spearman Correlation analysis. High uptake areas and high proliferating areas were delineated on the two images, respectively, and their location was compared. RESULTS: The maximal SUV was 3.26 ± 0.97 (1.96-5.05), maximal Ki-67 labeling index was 49% ± 27.56% (5%-90%). Statistical analysis didn't reveal a significant correlation between them (r = -0.157, P = 0.627, > 0.05). 9 patients can contour high proliferating area on Ki-67 staining slice, and eight can contour the high uptake areas. In 4 patients, we can observe a generally close distribution of high uptake areas and high proliferating areas, in one patient, both the uptake level and proliferation status was low, while the others didn't not find a significant co-localization. CONCLUSION: Noninvasive (18)F-FLT PET assessing the proliferative status may be a valuable aid to guide dose painting in NSCLC, but it needs to be confirmed further.

19.
Zhonghua Zhong Liu Za Zhi ; 25(1): 70-3, 2003 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-12678993

RESUMO

OBJECTIVE: To study MRI changes of vertebral metastasis and their value in differential diagnosis. METHODS: MR films of 103 patients with vertebral metastasis confirmed clinically or pathologically were reviewed with all features recorded and analyzed. RESULTS: 338 vertebrae were involved in 103 patients, including 82 in vertebral body only, 3 in appendix only and 253 in both. According to the shape of vertebral body and the characteristic abnormality, 335 vertebrae with body involved were divided into 4 types: Type I (97) with one single focus in the vertebral body, type II (102) with multiple foci with clear margin in the vertebral body, type III (16) with abnormal signal in the whole vertebral body and type IV (120) with abnormal signal in the whole or most part of vertebral body complicated with compression fracture. Among all these lesions, 114 showed concave superior and/or inferior edges and 116 protruding posterior and/or anterior borders. In 256 vertebrae with abnormal appendix, 238 showed abnormal pedicle of vertebral arch involving neighbouring part of vertebral body and 235 showed enlarged pedicle and other parts of the appendix. Soft tissue mass was showed around 133 vertebrae, with the center at the involved vertebrae on sagittal image. 130 pieces of these masses extended cranio-caudally within or a little beyond the width of a vertebral body. CONCLUSION: Vertebral metastasis is characterized by involving multiple vertebrae. Its diagnosis and differential diagnosis can be made definite in most patients according to the lesions distribution, change in vertebral shape and the characteristics of the soft tissue mass.


Assuntos
Neoplasias da Coluna Vertebral/diagnóstico , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias da Coluna Vertebral/secundário
20.
Cancer Imaging ; 13(4): 520-6, 2013 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-24334494

RESUMO

PURPOSE: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. MATERIALS AND METHODS: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9-32 years (mean age 15.9 years). RESULTS: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. CONCLUSION: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of TOS, and these features are helpful in making the correct preoperative diagnosis of TOS.


Assuntos
Neoplasias Ósseas/diagnóstico , Erros de Diagnóstico , Osteossarcoma/diagnóstico , Adolescente , Adulto , Biópsia , Neoplasias Ósseas/patologia , Criança , Feminino , Humanos , Angiografia por Ressonância Magnética , Masculino , Osteossarcoma/patologia , Estudos Retrospectivos
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