淋巴结转移在原发恶性骨肿瘤中的研究进展  

Advances in lymph node metastasis in primary malignant bone tumors

作　　者：罗恺 谢天裕 韦庆军[2] 刘云[1] LUO Kai;XIE Tianyu;WEI Qingjun;LIU Yun(Department of Spinal Bone Disease,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Autonomous Region,China;Department of Trauma Orthopaedic and Hand Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Autonomous Region,China)

机构地区：[1]广西医科大学第一附属医院脊柱骨病外科,广西壮族自治区南宁530021 [2]广西医科大学第一附属医院创伤骨科手外科,广西壮族自治区南宁530021

出　　处：《肿瘤》2024年第10期1051-1060,共10页Tumor

基　　金：国家自然科学基金(82260814);广西重点研发计划项目(2021AB11095);广西医科大学第一附属医院“优秀医学英才”科研创新能力培养项目

摘　　要：目前临床上常见的原发恶性骨肿瘤类型包括骨肉瘤、软骨肉瘤、尤文氏肉瘤、脊索瘤和多发性骨髓瘤等。恶性骨肿瘤通常以血行途径转移至肺部较为多见,但也可发生淋巴结转移,且一旦患者出现淋巴结转移,其预后相较于肺转移更差。因此,原发恶性骨肿瘤的淋巴结转移问题逐渐成为了近年来的研究热点。根据现有研究,原发恶性骨肿瘤发生淋巴结转移主要通过以下2种途径:一是骨肿瘤细胞突破骨膜侵入周围的淋巴组织;二是通过分泌WISP-3、CCL5和BDNF等相关因子调控VEGF-C的表达,进而诱导恶性骨肿瘤淋巴管的新生。既往关于原发恶性骨肿瘤淋巴结转移的研究,多局限于单一类型恶性骨肿瘤的临床观察,缺乏系统性的基础研究和综述,且其转移机制尚未完全阐明。同时,不同类型的恶性骨肿瘤在淋巴结转移率和转移部位上存在差异。鉴于此,本文特针对淋巴结转移在5种常见恶性骨肿瘤中的转移率、转移部位、诊断方法、潜在机制以及治疗方式等方面进行了全面综述,旨在加深人们对原发恶性骨肿瘤淋巴结转移现象的认知,并为其临床治疗和药物研发提供新的思路。Currently,common primary malignant bone tumors in clinical practice include osteosarcoma,chondrosarcoma,Ewing's sarcoma,chordoma,and multiple myeloma.Malignant bone tumors often metastasize to the lungs through the bloodstream,but lymph node metastasis can also occur.Once lymph node metastasis occurs,the prognosis for patients is worse than with lung metastasis,making the study of lymph node metastasis in malignant bone tumors a growing research focus in recent years.According to current research,primary malignant bone tumors mainly metastasize to lymph nodes through two pathways:firstly,bone tumor cells break through the periosteum into the surrounding lymphatic tissue;secondly,they regulate the expression of VEGF-C by secreting factors like WISP-3,CCL5,BDNF,thus inducing the neogenesis of lymphatic vessels in malignant bone tumors.Past research on lymph node metastasis of primary malignant bone tumors has mostly focused on clinical studies of a single type of malignant bone tumor,lacking systematic basic research and reviews,and the mechanisms of metastasis are not yet fully elucidated.Moreover,different types of malignant bone tumors vary in their rates and sites of lymph node metastasis.Therefore,this article mainly reviews the rates,sites,diagnostic methods,potential mechanisms,and treatment methods of lymph node metastasis in these five common types of malignant bone tumors,aiming to deepen understanding of lymph node metastasis in primary malignant bone tumors and to provide new ideas for clinical treatment and drug development.

关 键 词：恶性骨肿瘤 原发性 淋巴结转移 转移途径 

分 类 号：R738.1[医药卫生—肿瘤]