年龄与脊柱骨巨细胞瘤预后关系的研究进展

骨巨细胞瘤（GCT）是一种有局部侵袭性的良性骨肿瘤。女性较男性多见，并且好发于20～40岁的青壮年1-3]。骨巨细胞瘤的生物学行为较特殊，术后易复发。目前临床实践中常从肿瘤影像或病理等方面来分析其生物学行为，并对其预后进行判断。而以往骨巨细胞瘤的研究报道，不同年龄段患者术后复发率存在差异4-5]，提示年龄可能是影响骨巨细胞瘤生物学行为及预后的因素。但由于以往的研究多为全身骨骼骨巨细胞瘤的病例，并未明确反映出年龄与脊柱骨巨细胞瘤复发之间的关系。

Research progress of the relationship between age and prognosis of giant cell tumors of the spine

Giant cell tumors （ GCT ） are benign but locally aggressive with a relatively high recurrence rate. Some previous literatures about GCT reported that the postoperative recurrence rate varied in different age groups of patients and indicated that age might be an important factor affecting the biological behaviour and prognosis of GCT. However, the previous studies mainly focused on the cases of GCT of the whole body, and the relationship between age and prognosis of GCT of the spine was not clearly illustrated. GCT of the spine are relatively rare. So far, there has been no large series of cases documented. The existing small series of cases report about GCT of the spine at home and abroad were reviewed in this article and the effects of age on the prognosis of GCT of the spine were analyzed, including the postoperative recurrence rate, iconography, pathology and micro cytokines. According to the existing literatures, the recurrence rate in young patients is relatively low. Tumors in young patients are less likely to invade more than one vertebral level or to involve both the anterior and posterior structures of the vertebral body. Histologically, cellular atypia and mitosis are less common in spindle-like stromal cells of youth patients. As to the cytokines, the ratios of serum ligand of receptor activator of NF-κB （ RANKL ） and osteoprotegerin （ OPG ） are lower in young patients. It is indicated that age appears to be associated with the recurrence rate of GCT of the spine. Young patients tend to have a better prognosis. However, larger series of cases report are needed to demonstrate this conclusion in the future.