Determination Of Surgical Margin To Appendicular Osteosarcoma After Neoadjuvant Chemotherapy And Prognostic Analysis.

Part 1:TITLE: The comparision of image data and pathology for appendicular osteosarcoma after neoadjuvant chemotherapy.OBJECTIVE: To study the optimally surgical margin of appendicular osteosarcoma in bone marrow after neoadjuvant chemotherapy.MATERIAL AND METHODS: 1.Seventeen cases of appendicular osteosarcoma in bone marrow from September 2005 to December 2006 were included in our study. All cases were performed operation after three circle chemotherapy and image data of MRI just about one week before opreation and X-ray film and CT scan after operation were collected for further study. One half specimens of osteosarcoma were dissected along the coronal or anteroposterial axis and preserved in 10% formalin. Pathological examinations were studied and comparisoned with the above image data and observations in naked eyes.RESULTS: 1.The lengths of medullar invasion of osteosarcoma were statistically different between X-ray and pathalogical examinations (P=0.0031∠0.05), CT scan was same result (P=0.0250∠0.05). 2.MRI examinations (T1 and STIR) were almost same with the pathology (P=0.3403 and 0.1018 respectivly).CONCLUSIONS: 1.MRI examinations (T1 and STIR) were superior to X-ray or CT scan and more closed to the fact. 2.The measurement errors were smallest with T1-weighted MRI. 3.The optimal surgical margin was 2 to 3 cmacording to the measurement with MRI (T1 and STIR).Part 2:TITLE: The expression of Ki-67 and Bcl-2 in osteosarcoma and related analysisOBJECTIVE: To study the expressions of Ki-67 and Bcl-2 in osteosarcoma and whether they were related with tumor necrosis or pulmonary metastasis.MATERIAL AND METHODS: 25 cases were included in our sudy from September 2005 to December 2006, whose courses of disease must be at least one year and the original parffin block must be preserved in our pathological department. EnVision method of immunohistochemistry was used to analysis the expressions of Ki-67 and Bcl-2 in osteosarcoma.The ratio of tumor necrosis was also studied.RESULTS: The expressions of Ki-67 and Bcl-2 in osteosarcoma were 48% and 44% respectivly, and no statistical correlations to pulmonary metastasis, tumor necrosis and subgroup of osteosarcoma.(P<0.05). There was correlation between the expressions of Ki-67 and Bcl-2 in osteosarcoma (r=0.6056, P≤0.01).CONCLUSIONS: 1.The expressions of Ki-67 and Bcl-2 in osteosarcoma before chemotherapy were no index to the therapeutic effect. 2. There was correlation between the expressions of Ki-67 and Bcl-2 in osteosarcoma. 3. The expressions of Ki-67 and Bcl-2 in osteosarcoma before chemotherapy had nothing to do with pulmonary metastasis during one year.