Various diagnostic methods for osteosarcoma

In addition to affecting the patient's physical and mental health, osteosarcoma can also threaten life safety in severe cases. In order to completely cure osteosarcoma, scientific medical diagnosis and treatment methods are very important. Currently, there are many diagnostic methods for osteosarcoma in clinical practice. Below I will give you a detailed introduction to the various diagnostic methods of osteosarcoma.

Osteosarcoma is a primary malignant bone tumor originating from mesenchymal tissue, and its incidence ranks second among primary bone tumors. The most common age is 10 to 25 years old, and males are slightly more likely to be diagnosed than females. Its most common sites are the epiphyses of long bones, with the distal femur and proximal tibia being the most common. Osteosarcoma is highly malignant, prone to early lung metastasis, and has a poor prognosis. Common diagnostic methods are as follows:

1. Diagnostic methods of clinical manifestations of osteosarcoma

1. Pain: caused by the traction of the periosteum. Characteristics: mild to severe; intermittent to continuous; pain at night; pain at rest.

2. Lumps: There may be local lumps with varying hardness. The affected area may have increased skin temperature and venous distension.

3. Functional impairment: limited joint movement.

4. Pathological fracture

5. Symptoms of cachexia such as anemia, weight loss, and loss of appetite.

2. Diagnostic methods of laboratory tests

It is reported that laboratory tests such as alkaline phosphatase are closely related to the diagnosis and prognosis of osteosarcoma. Some patients may have elevated alkaline phosphatase, increased erythrocyte sedimentation rate, and increased white blood cell count. Patients should be examined before receiving neoadjuvant chemotherapy, and blood routine, liver and kidney function, and alkaline phosphatase should be regularly monitored during chemotherapy. In recent years, many studies have shown that the levels of miRNAs in peripheral blood or tissues can effectively predict the stage, severity, and prognosis of osteosarcoma, such as miR-21, miR-199a-3p, and miR-29.

2. Diagnostic methods of imaging examination

1. X-ray examination (the most important imaging examination method) lateral osteolysis or osteogenesis, or both changes in the epiphyseal ends of long bones, with different shapes and unclear shapes; cortical bone destruction and tumor bone formation; periosteal reaction: Codman triangle, "sunlight radiation", etc.; chest X-ray: helps to detect lung metastasis at an early stage.

2. CT can show the condition of bone destruction and the degree of ossification inside the tumor. After enhancement, it can also show the blood supply of the tumor, the relationship between the tumor and adjacent blood vessels, and the range in the bone and soft tissue.

3. MRI has clear display of soft tissues and is of great significance in the evaluation of the effect of preoperative chemotherapy. It can show the extent of tumor invasion in soft tissues, the extent of tumor invasion in the bone marrow cavity, and the detection of skip lesions.

4.DSA provides a reference for identifying tumor blood supply and performing interventional treatment.

5.ECT and PET-CT can determine the size of the tumor and metastatic lesions. If conditions permit, PET-CT can be considered for auxiliary tumor staging, disease diagnosis and efficacy evaluation.

Patients with the above clinical manifestations, abnormal laboratory test results, and abnormal imaging changes should be referred to a professional bone tumor diagnosis and treatment center. The standard diagnostic steps for all suspected osteosarcoma patients should include: clinical manifestations, physical examination, laboratory tests (blood routine, alkaline phosphatase, etc.), imaging examination of the primary lesion (X-ray film, MRI and CT scan of the lesion), bone scan, and the final diagnosis still requires pathological diagnosis.