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目的 :分析长骨骨巨细胞瘤相关复发因素 ,为其临床治疗及降低复发率提供参考依据。方法 :分析 2 1例长骨复发性骨巨细胞瘤一般资料、影像学检查资料、首次手术方式、肿瘤所在部位、病理骨折与否、Jaffe’s病理分级、Campan icci’s放射线分级等 ,总结相关的复发因素。结果 :本组 41例肿瘤中复发者 2 1例。 2 1例中Jaffe’s病理诊断与首次比较 ,17例无变化 ;按Campanicci’s放射诊断标准 ,首次 19例为Ⅱ、Ⅲ级。 12例位于胫骨近端 ;11例首次术前即伴局部病理性骨折 ,占 5 2 .4%。所有病例均被施予单纯瘤内刮除术 ,7例肿瘤残腔经烧灼等辅助处理。结论 :长骨骨巨细胞瘤复发相关因素复杂多样 ,肿瘤复发与Jaffe’s病理分级无明显相关 ;但Campanicci’s分级越高 ,则复发率越高 ;局部病理性骨折是导致复发的重要原因 ;单纯瘤内刮除术可致较高比例的肿瘤复发 ,而相关的烧灼瘤壁等辅助治疗措施 ,不能替代彻底的肿瘤切除术。
Objective: To analyze the related recurrence factors of giant cell tumor of long bone, and provide reference for clinical treatment and reduce the recurrence rate. METHODS: A total of 21 cases of recurrent giant bone cell tumors of the long bone were analyzed for general information, imaging data, the first surgical approach, the location of the tumor, pathological fractures, Jaffe’s pathological grade, and Campanic Icci’s radiographic classification, and relevant recurrence factors were summarized. Results: There were 41 cases of recurrence in 21 cases in this group. In 21 cases, Jaffe’s pathological diagnosis and first comparison showed no change in 17 cases. According to the Campanicci’s diagnostic criteria, the first 19 cases were grade II and III. Twelve cases were located in the proximal humerus; 11 cases had local pathological fractures before surgery for the first time, accounting for 52.4%. All patients were treated with simple intralesional curettage, and 7 cases were treated with cauterization and other auxiliary treatments. Conclusion: The factors associated with the recurrence of giant cell tumor of long bone are complex and diverse. There is no significant correlation between tumor recurrence and Jaffe’s pathological grade, but the higher the Campanicci’s grade, the higher the recurrence rate; Local pathological fracture is an important cause of recurrence; Debridement may result in a higher proportion of tumor recurrences, and associated analgesic measures such as cauterizing tumor walls may not be a substitute for thorough tumor resection.