title: [Factors related to biologic behavior in giant cell tumor of bone].
abstract: OBJECTIVE
  To study the histogenesis of giant cell tumor (GCT) and factors related to tumor recurrence, invasiveness and malignant transformation.
  
  
  METHODS
  The clinical features, radiologic classification, surgical approach, pathologic findings, immunophenotypes and follow-up data of 123 cases of GCT were analyzed.
  
  
  RESULTS
  There was a significant correlation between tumor recurrence and radiographic classification (P = 0.032), over-expression of CD147 (P = 0.034) and p53 (P = 0.005), and surgical approach (P = 0.0048) in GCT. The biologic behavior showed no correlation with intramedullary infiltration, cortical bone involvement, parosteal soft tissue extension, tumor thrombi, fusiform changes of mononuclear tumor cells, mitotic count, Ki-67 index, coagulative tumor necrosis, secondary aneurysmal bone cyst formation, and adjoining bony reaction. The positive rate of p63 in stromal cells of GCT (79.7%, 94/118) was significantly higher than that in chondroblastoma (44.7%, 21/47), osteosarcoma (22.2%, 10/45) and other giant cell-rich tumors.
  
  
  CONCLUSIONS
  GCT is a bone tumor of low malignant potential. It is sometimes characterized by locally invasive growth, active proliferation, coagulative necrosis, secondary aneurysmal bone cyst and surrounding bony reaction. It is difficult to predict the biologic behavior of GCT. Over-expression of p53 in the tumor cells and CD147 in all components of GCT correlate with tumor invasiveness, recurrence and malignant transformation. Selection of suitable surgical approach with reference to radiologic classification is considered as an important factor in reducing the recurrence rate.
authors.affiliation: Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Xiang-ying
authors.initials: XY
authors.lastname: Ran
authors.affiliation: Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China. E-mail: liuyuanblz@aliyun.com.
authors.forename: Hui-zhen
authors.initials: HZ
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Zhi-ming
authors.initials: ZM
authors.lastname: Jiang
authors.affiliation: Department of Pathology, Shanghai Jiaotong University Affiliated the Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D051926:Basigin / Q000378:metabolism; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000473:pathology; D010733:Phosphoglucomutase / Q000378:metabolism; D011859:Radiography; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D055815:Young Adult
chemical_list: C497886:BSG protein, human; C081876:CKAP4 protein, human; D008565:Membrane Proteins; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D051926:Basigin; C488050:PGM1 protein, human; D010733:Phosphoglucomutase