Prognostic relevance of cell biologic and biochemical features in conventional chondrosarcomas
Open Access
- 15 April 2002
- Vol. 94 (8) , 2273-2281
- https://doi.org/10.1002/cncr.10461
Abstract
BACKGROUND: Conventional chondrosarcoma is the second most common malignant solid tumor of bone, and its management still poses a challenge for the orthopedic surgeon. Currently, tumor grade is the only parameter of prognostic significance besides stage and, possibly, resection margins. Additional independent prognostic markers therefore would be highly valuable for patient management.METHODS: In the current study, the authors evaluated biologic markers for various chondrocytic phenotypes by histochemical and immunohistochemical technology in a large series of clinically well defined cases of enchondromas and conventional chondrosarcomas, each with at least 5 years of clinical follow‐up.RESULTS: The authors' results confirm the strong correlation between clinical behavior and cell differentiation as expressed by marker genes. The phenotypes of the tumor cells are the biologic substrate of the histopathologic appearance of the neoplasms and, thus, the biologic basis for classic tumor grading. Collagen Types II and X, as well as the proteoglycan aggrecan, suggest a mature neoplastic phenotype and good prognosis, i.e., low recurrence rate, rare metastasis, and long survival. Conversely, collagen Type I, together with cell spindling, indicates a transition to a more proliferative, so‐called “dedifferentiated” phenotype, which clearly is associated with a poorer prognosis. The changes in cellular phenotypes are accompanied by changes in proliferative activity. Thus, low‐grade neoplasms showing mainly mature and terminally differentiated (hypertrophic) chondrocytes display only scant proliferation whereas less differentiated chondrosarcomas with biologically dedifferentiated chondrocytes show significantly higher proliferative activity, a feature that is also highly correlated with prognosis.CONCLUSIONS: These data indicate that molecular markers are to a large extent the biologic basis of the conventional grading, rather than representing independent prognostic markers. The authors' results further indicate that COL1 has significant value in the distinction between enchondromas and low‐grade chondrosarcomas including these that are histologically similar. Further understanding of chondrocytic phenotypes will be a promising way to provide new tumor markers for better understanding, diagnosis, and treatment of chondroid neoplasms. Cancer 2002;94:2273–81. © 2002 American Cancer Society.DOI 10.1002/cncr.10461Keywords
Funding Information
- Wilhelm-Sander-Stiftung (Munich, Germany) (96.050.2)
This publication has 22 references indexed in Scilit:
- Presalvage prostate‐specific antigen (PSA) and PSA doubling time as predictors of biochemical failure of salvage cryotherapy in patients with locally recurrent prostate cancer after radiotherapyCancer, 2006
- Cell Differentiation and Matrix Gene Expression in Mesenchymal ChondrosarcomasThe American Journal of Pathology, 2000
- Immunolocalization of type X collagen in normal fetal and adult osteoarthritic cartilage with monoclonal antibodiesMatrix Biology, 1996
- Monoclonal antibodies against recombinant parts of the Ki‐67 antigen (MIB 1 and MIB 3) detect proliferating cells in microwave‐processed formalin‐fixed paraffin sectionsThe Journal of Pathology, 1992
- Production of collagens, collagenase and collagenase inhibitor during the dedifferentiation of articular chondrocytes by serial subculturesBiochimica et Biophysica Acta (BBA) - Molecular Cell Research, 1990
- Effect of insulin-like growth factor on collagen and glycosaminoglycan synthesis by rabbit articular chondrocytes in cultureCellular and Molecular Life Sciences, 1982
- Relationship between cell shape and type of collagen synthesised as chondrocytes lose their cartilage phenotype in cultureNature, 1977
- Simultaneous localization of proteoglycan by light and electron microscopy using toluidine blue O. A study of epiphyseal cartilage.Journal of Histochemistry & Cytochemistry, 1976
- Asymptotically Efficient Rank Invariant Test ProceduresJournal of the Royal Statistical Society. Series A (General), 1972
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958