| ObjectiveAmputation has been the main method of surgical treatment of osteosarcoma.In recent years,with the development of comprehensive treatment methods such as limb salvage surgery and neoadjuvant chemotherapy,the clinical cure rate has increased,but the disability and mortality of malignant osteosarcoma have been reduced.Still high.Osteosarcoma belongs to the category of “bone neoplasm” and “bone spasm” in traditional Chinese medicine.Traditional Chinese medicine therapy can enhance the body's immunity to enhance the body's ability to fight cancer and kill tumor cells.At the same time,Chinese medicine can reduce the complications of surgery.Minimize the adverse effects of chemotherapy to improve the quality of life and prolong life.In this study,we analyzed the clinical data of osteosarcoma patients diagnosed and treated in our hospital through clinical research to explore the clinical efficacy of neoadjuvant chemotherapy combined with limb salvage surgery for osteosarcoma.At present,clinical treatment methods are mainly comprehensive treatment based on limb salvage surgery.The prognosis depends on whether or not the surgery can completely remove the tumor tissue.However,only the experience of the surgeon can be used to remove the tumor during surgery,and normal tissues and tumors can be distinguished throughthe naked eye.Organization makes surgical treatment difficult.Therefore,it is a hotspot to find a rapid and effective method to identify the tumor tissue during surgery,assist the surgeon to completely remove the tumor and increase the cure rate of osteosarcoma.In recent years,with the deepening of people's research on electromagnetic spectrum,terahertz technology has been rapidly developed as a new emerging spectroscopic technology,and it has been gradually recognized and applied in the biomedical field.In this study,we further studied the fast imaging of terahertz waves in vivo in BALB/c nude mice and human osteosarcoma cell line MG-63-bearing mice.Whether terahertz waves can be performed on MG-63 tumor-bearing mice Live tissue tumor specific imaging,and to explore the guiding role of terahertz wave technology in malignant osteosarcoma tissue resection,for the application of terahertz technology in the detection of clinical malignant bone tumors and provide guidance for surgical guidance during surgery.MethodsPart ?: Using retrospective analysis,eight patients with osteosarcoma diagnosed and treated at Wuhan General Hospital of the Chinese People's Liberation Army from January 2013 to January 2016 were randomly divided into two groups according to the treatment methods.The group was treated with neoadjuvant chemotherapy combined with limb salvage surgery and the group B was treated with limb salvage surgery combined with postoperative adjuvant chemotherapy.The data of the two groups were analyzed statistically,and the clinical efficacy of neoadjuvant chemotherapy combined with limb salvage surgery for osteosarcomawas explored..Part ?: 1.Establishment of a mouse model of human osteogenic sarcoma cell line MG-63 bearing osteosarcoma in BALB/c nude mice;2.Using continuous terahertz imaging system at Wuhan National Laboratory for Optoelectronics,Huazhong University of Science and Technology,8 BALB/c nude mice(normal mouse group)and 16 human osteosarcoma cell line MG-63 tumor-bearing mice(tumor-bearing mice group)were subjected to continuous terahertz imaging after intraperitoneal injection of combined anesthesia in vivo.The system experiment test station was used for terahertz wave imaging to verify the feasibility of the preoperative design.3.Sixteen human osteosarcoma cell line MG-63 tumor-bearing mice were randomly divided into two groups of 8 mice each.Under the guidance of terahertz imaging,tumor resection was performed(experimental group)and conventional macroscopic tumor resection(control group)was performed.The resectioned tumor tissue and the boundary tissue after the tumor resection were sent for pathological section;Week,observe the growth condition of the mice in the two groups and whether there is tumor recurrence in situ.ResultsPart ?: the effect of recent clinical chemotherapy: After the preoperative chemotherapy in group A,it was completely effective in 1 case,partially effective in 2 cases,invalid in 1 case,and the overall effective rate was 75%,showing that the preoperative chemotherapy has a significant immediate effect.Long-term clinical effect comparison: Follow-up results showed that the1-year and 2-year survival rates in group A were all 100%.One patient had recurrence and metastasis in situ;the 1-year and 2-yearsurvival rates in group B were 100% and 50%.Among them,there were3 patients with recurrence and metastasis in situ.The 1-year survival rate was similar between the two groups,and the 2-year survival rate was significantly different(P<0.05).Postoperative recurrence occurred in A group.The rate of metastasis was significantly lower than that of group B(P<0.05).Part ?: 1.Human osteosarcoma MG-63 cell line was implanted into the right forelimbs of 16 BALB/c nude mice for subcutaneous tumorigenesis.Small masses were seen around four weeks and slowly increased.The growth of tumors was counted by SPSS software(Long Diameter×short diameter): The experimental group 42.3 ± 6.8(mm×mm),the control group 43.1 ± 7.1(mm×mm)no significant difference(P> 0.05).The terahertz fast imaging assay showed a strong absorption signal in the cardiac region of the normal mouse group,and a strong signal-absorbing region appeared in the tumor tissue and heart parts of the right forelimb in the tumor-bearing mouse group.The tumor tissue imaging of tumor-bearing mice was approximately 8mm × 7mm,and the signal intensity was 17 ± 3dB,which was significantly higher than that of the surrounding tissue(43 ± 7)d B.ImageJ software was used to calculate the area of preoperative terahertz wave imaging.After SPSS software statistics,the experimental group was 57.7±8.3mm×mm and the control group was 55.4 ± 7.5mm × mm.There was no significant difference(P>0.05).2.In the experimental group,following the tumor resection under the guidance of the magnetic imaging of terahertz,the terahertz magnetic wave rapid imaging system showed that the strong absorption signal of the right forelimb part disappeared after the removal of the tumor;the control groupunderwent the tumor removal after the naked eye.The terahertz magnetic rapid imaging system showed that the strong absorption signal at the tumor site was significantly weaker than before surgery,but the surrounding area remained scattered in the strong absorption area and the signal intensity was(16±4)dB.The pathological section of the edge tissue of the tumor was confirmed during operation.It was confirmed that there was no tumor tissue around the tumor in the experimental group and the tumor was completely resected.The tumor tissue was found in the peripheral tissues around the control group and the tumor was not completely removed.After the tumors were removed from the two groups,the edges of the tumor tissue were removed at 12 o'clock,4 o'clock,and 8 o'clock,and the size of the tissue blocks were taken for HE staining.The positive rate of osteosarcoma obtained from the edge of the tissue was removed.The experimental group was 8.3%.The control group was 37.5%,and there was a significant difference between the two groups(P<0.05).3.The MG-63 tumor-bearing mice were reared for two weeks.One MG-63 tumor-bearing mice died in the experimental group(1/8,12.5%).The remaining mice had no obvious in situ right forelimbs.In the block organization,no strong absorption signal was observed in the corresponding region of the terahertz wave imaging again;whereas in the control group,2 mice(2/8,25.0%)and 4 mice(4/8,50%)of the right forelimb died.Reappeared mass,re-recurrence of terahertz wave imaging showed that the corresponding area again showed a strong absorption signal,pathological examination confirmed the in situ reproduction of osteosarcoma.The recurrence rate(0% vs.50%)was significantly different between the two groups(P<0.05),but the differencebetween the experimental group and the control group(12.5% vs.25.0%)was not statistically significant(P>0.05).Conclusions1.Effective neoadjuvant chemotherapy combined with complete resection of tumor margin may be an ideal treatment for osteosarcoma of the extremities.It can ensure survival rate and well preserved limb function,and reduce the incidence of in situ recurrence and metastasis of osteosarcoma.The clinical effect is better.Chinese medicine treatment of osteosarcoma through the regulation of the body to achieve the purpose of overall treatment,has its own unique advantages,not only can be adjusted as a whole,but also to ease the side effects of Western medicine,in recent years more and more people's attention,and gradually become the focus of attention at home and abroad,pending further in-depth research.2.Terahertz wave technique can specifically image osteosarcoma in living human osteogenic sarcoma cell line MG-63 tumor-bearing mice;and through tumor resection and macroscopic tumor resection under the guidance of in vivo imaging.After the comparison,it was found that terahertz wave technology can guide the complete surgical removal of malignant tumor tissue,providing support for the application of terahertz technology in the detection of malignant bone tumors,and has good clinical application prospects. |
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