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目的：探讨骨巨细胞瘤（ＧＣＴ）的细胞学性质、肿瘤发生以及生物学行为。方法：用免疫组化法检测了５１例ＧＣＴ中ＰＣＮＡ、ｐ１６、Ｒｂ和ｂｃｌ－２蛋白的表达及用ＴＵＮＥＬ法检测其凋亡细胞。结果：全部标本ＰＣＮＡ阳性表达，其中典型多核巨细胞未见着色；ｐ１６、Ｒｂ和ｂｃｌ－２在ＧＣＴ中的阳性率分别为９２２％、９６１％和３３３％。Ｊａｆｅ分级间ＰＣＮＡ的表达具有显著性差异；ｐ１６和Ｒｂ在ＧＣＴ中的表达具有一定的负相关；ｂｃｌ－２在Ⅰ与Ⅲ级及Ⅰ与Ⅱ＋Ⅲ级间表达差异有显著性。ＧＣＴ的凋亡率（ＡＩ）为０８６％，多核巨细胞凋亡偶见。ＧＣＴ的ＡＩ与ｂｃｌ－２的表达呈显著负相关，ｂｃｌ－２表达与否的ＡＩ之间有显著的差异。结论：Ｊａｆｅ分级可以反映出ＧＣＴ内的增殖状态；多核巨细胞是一种静息细胞；ｂｃｌ－２在ＧＣＴ发展中可能起一定的作用；联合检测ＰＣＮＡ和ｂｃｌ－２可以作为判断其生物学行为的指标。
Objective: To investigate the cytological properties, tumorigenesis and biological behavior of giant cell tumor of bone (GCT). METHODS: The expressions of PCNA, p16, Rb and bcl-2 proteins in 51 cases of GCT were detected by immunohistochemistry and the apoptotic cells were detected by TUNEL method. Results: The expression of PCNA was positive in all specimens. There was no staining in typical multinucleated giant cells. The positive rates of p16, Rb and bcl-2 in GCT were 92. 2%, 96.1% and 33. 3%, respectively. There was a significant difference in the expression of PCNA between Jafe grades; the expression of p16 and Rb in GCT had a certain negative correlation; the expression of bcl-2 in grades I and III and I and II+III had significant differences. The apoptotic rate (AI) of GCT was 0. 86%, and multinucleated giant cell apoptosis was occasionally observed. The AI of GCT was significantly negatively correlated with the expression of bcl-2, and there was a significant difference between AI with or without bcl-2 expression. Conclusion: Jafe classification can reflect the proliferation status in GCT; multinucleated giant cells are a kind of resting cells; bcl-2 may play a role in the development of GCT; combined detection of PCNA and bcl-2 can be used as a judgement of biological behavior. index of.