关键词: 骨肉瘤;危重病;综合治疗

    摘 要:目的 通过分析61例骨肉瘤预后因素及生存率，探讨高危骨肉瘤临床特点及治疗对策，报告16例高危骨肉瘤治疗经验. 方法 以经肢体挽救手术治疗有完整随访资料的61例骨肉瘤为基础，寿命表法计算生存率，采用图像分析技术对肿瘤预后相关因素包括肿瘤的绝对长度、绝对宽度、绝对深度、绝对面积、软组织肿块最大横径进行分析. 结果 61例骨肉瘤随访1～10a，5a生存率57.5%，外科分期III期;骨肉瘤与宿主骨面积比≥2/3;软组织肿块最大横径≥6cm;病理骨折;活检标本PCNA阳性细胞检出占平均视野2/3以上均属高危骨肉瘤.采用术前多次化疗，深静脉持续给药;高选择骨肉瘤原发灶和转移灶滋养动脉化疗并栓塞;术前放疗和肢体挽救术处理高危骨肉瘤16例，随访1.5a，死亡2例，带病存活5例，无病存活9例，保肢率68.7%. 结论 本研究使一些高危骨肉瘤得到了积极救治，更具备综合性和肿瘤针对性.

    Characteristics of high┐risk osteosarcoma and treat┐ment countermeasure

    WANG Zhen HUANG Yao-Tian HUANG Lu-Yu ZHAO Jin-Kang YU Hui-Dong LIU Ji-Zhong DU Xiao-Chuan LI Jing-Bang YAN Pei-Song WANG Zhi-Xiang

    1 Institute of Orthopeadics of Chinese PLA，

    2 Department of Radiodiagnosis，

    3 Department of Pathology，

    4 Center of Radiotherapy，Xijing Hospi-tal，Fourth Military Medical University，Xi'an710033，China

    Keywords:osteosarcoma;critical illness;comprehensive treatment

    Abstract:AIM We discussed the characteristics and treat-ment of high-risk osteosarcoma by analyzing prognostic factor and survival rate of61osteosarcoma patients ......