The etiology and pathogenesis of osteosarcoma in traditional Chinese medicine and western medicine

With the development of medicine, the survival rate of osteosarcoma has been greatly improved. However, many problems of osteosarcoma have not been solved, which has become a bottleneck in the treatment of this disease. Only by finding the cause can we treat the disease accordingly. Today, let's take a look at the etiology and pathogenesis of osteosarcoma in traditional Chinese medicine and Western medicine:

Bone tumors are the same as other tumors. Their etiology is very complex. Generally speaking, the internal factors are present first, and the external factors occur through the internal factors. The internal factors include the quality theory, the gene theory, the endocrine theory, etc.; the external factors include the chemical elements, the slow stimulation theory of internal and external radiation, the virus infection theory, etc. Multiple osteochondromas and fibroid hyperplasia are both related to the family. Bone tumors often occur between the ages of 10 and 30, indicating that the vigorous development and growth of bones is related to the occurrence of tumors. Therefore, it can be considered that during the growth and maturation of bones, the body is more sensitive to the stimulation of the above factors, so that it is easy to become a tumor or tumor-like lesions. Benign bone tumors can become malignant: for example, chondroma, osteochondroma, osteoblastoma, etc. can all become malignant sarcomas, and fibroid dysplasia in tumor-like lesions can also become malignant sarcomas. Some patients with bone tumors often recall a history of trauma to the affected part, such as sprains, bruises, etc. In fact, this type of trauma will not cause bone changes, and osteosarcoma occurring at the fracture site is extremely rare. It is likely that when the tumor develops to a certain extent, the trauma causes obvious symptoms and attracts attention.

Since the first record of bone tumor in Huangdi Neijing, doctors of successive dynasties have further explored and supplemented the understanding and treatment of bone tumor from different aspects, which has gradually deepened the understanding of bone tumor. According to the theories of various doctors, the occurrence of bone tumor is always caused by insufficient kidney qi, imbalance of yin and yang, and dysfunction of viscera, which leads to cold, dampness and toxic evil taking advantage of the opportunity to enter the bones, and blood stasis and accumulation in the bones. For example, the invasion of external evil from the surface to the inside, deep into the bones, and accumulation for a long time; the injury caused by falling and hitting, the blood vessels are damaged, and the blood stasis accumulates and does not disperse into tumors; insufficient endowment, or excessive labor, excessive sexual intercourse, depletion of kidney qi, kidney is responsible for bone and marrow production, and kidney qi depletion leads to bone lesions; excessive eating, damage to spleen and stomach, spleen failure, dampness and phlegm, accumulation into tumors; mental stimulation, emotional depression, excessive five emotions, resulting in imbalance of yin and yang, disharmony of qi and blood, and blockage of meridians, leading to bone tumors.

It is more common in adolescents and is prone to occur in the long bones of the limbs, especially the lower end of the femur and the tibia or upper end of the tibia. The tumor is located at the end of the bone marrow, can involve the bone marrow cavity and the bone cortex, and even extend to the soft tissue outside the periosteum, forming a spindle-shaped mass, where the periosteum is lifted up, accompanied by a large amount of reactive new bone formation, which accumulates at the tumor site, forming a triangular protrusion, called Codman's triangle.

The new bone expands outward from the bone cortex to form a radial structure, which is perpendicular to the longitudinal axis of the bone shaft, forming a solar radial shadow. These two phenomena are the characteristics of X-ray diagnosis of osteosarcoma.

Osteosarcoma has various appearances, which are related to the bone content in the tumor, the presence or absence of bleeding, necrosis and cyst formation.

Microscopically, the tumor cells are highly atyptic, mainly spindle-shaped or polygonal, with varying sizes and shapes, and pathological nuclear division is easy to be seen. The formation of tumorous osteoid tissue and bone tissue is the most important histological basis for diagnosing osteosarcoma. Its shape is extremely irregular, and tumorous osteoblasts can be seen around it.

1. Clinically, it is not very clear what causes osteosarcoma. Some patients develop symptoms of osteosarcoma, and the main inducing factors are trauma and stimulation, as well as viral infection, which will directly lead to osteosarcoma.

2. The occurrence of osteosarcoma also includes some genetic factors, as well as the patient's exposure to some radioactive substances, or viral infection, etc. When osteosarcoma occurs, patients are often prone to secondary symptoms, because this is caused by the malignant transformation of benign tumors. Primary osteosarcoma is related to genetics: ① The risk of osteosarcoma in patients with retinoblastoma is about 2,000 times higher than that of the normal population. This is because the retinoblastoma gene (Rb gene) is a tumor suppressor gene located on the long arm of chromosome 13 (13q14). The deletion or inactivation of this gene is the direct cause of retinoblastoma. In cases of sporadic or associated osteosarcoma with retinoblastoma, there is often a deletion of the Rb gene. In cases of bilateral retinoblastoma, about 12% develop osteosarcoma, and more than 70% of osteosarcoma cases have inactivated Rb gene products. ② In many sporadic cases, there is often a mutation in another tumor suppressor gene p53, which is located on the short arm of chromosome 17. The incidence of osteosarcoma is significantly increased in families with Li-Fraumeni syndrome who have p53 gene mutations. 45% of osteosarcomas have p53 gene mutations.

3. The pathogenesis of osteosarcoma is not yet very clear, but the symptoms of osteosarcoma are mainly a type of primitive group of cells. Clinically, patients can further diagnose the disease through some examination methods. Once diagnosed, we must seize the time to treat it.

Osteosarcoma, like other human tumors, has unclear etiology and mechanism. Its pathogenic factors are very complex. The internal factors include the diathesis theory, the genetic theory, the endocrine theory, etc.; the external factors include chemical substances, internal and external radiation, the chronic inflammatory stimulation theory, the viral infection theory, etc. Some other benign bone tumors such as Paget's disease, giant cell tumor of bone, and dysplastic bone fibrous tissue structure can cause osteosarcoma, which is more common in patients after middle age.

Note: The above mentioned are the causes of osteosarcoma. It is recommended that everyone must prevent the occurrence of osteosarcoma as early as possible in life. At the same time, patients should not worry too much and should maintain an optimistic attitude to actively treat the disease.