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目的探讨术前化疗对体内骨肉瘤细胞超微结构的改变。方法男女各4例,年龄平均19.5岁。股骨远端6例,胫骨近段和股骨近段各1例。ⅡB7例,ⅢB1例。术前应用DIA方案化疗2疗程后行保肢手术。对本组骨肉瘤标本,应用透射电镜观察细胞超微结构的变化。结果本组患者均完成术前化疗,并获得平均术后18个月的随访。1例复发,6例肺转移,4例死亡,2例带瘤生存。透射电镜观察发现,7例化疗后的骨肉瘤细胞超微结构表现为不同程度的细胞毒性损伤。仅1例可见相对完整的骨肉瘤细胞结构。结论化疗药物在体内能诱导骨肉瘤细胞凋亡,最终导致细胞坏死。
Objective To investigate the ultrastructural changes of osteosarcoma cells in vivo by preoperative chemotherapy. Methods Male and female 4 cases each with an average age of 19.5 years. 6 cases of distal femur, proximal tibia and proximal femur in 1 case. Ⅱ B7 cases, Ⅲ B1 cases. Preoperative application of DIA regimen of chemotherapy after 2 courses of limb salvage surgery. In this group of osteosarcoma specimens, transmission electron microscopy was used to observe the ultrastructural changes. Results All patients underwent preoperative chemotherapy and were followed up for an average of 18 months. One patient relapsed, six patients had lung metastases, four patients died and two patients survived. Transmission electron microscopy showed that the ultrastructures of osteosarcoma cells after 7 chemotherapy showed different degree of cytotoxicity. Only one case showed relatively complete osteosarcoma cell structure. Conclusion Chemotherapy can induce osteosarcoma cell apoptosis in vivo and eventually lead to cell necrosis.