中国现代医学杂志2025，Vol.35Issue(5)：39-45,7.DOI:10.3969/j.issn.1005-8982.2025.05.007
骨肉瘤肺转移的作用机制及其临床治疗策略
Mechanisms and clinical therapeutic strategies for pulmonary metastasis in osteosarcoma
摘要
Abstract
Osteosarcoma,the most common primary malignant bone tumor,is characterized by aggressive local invasion and a high propensity for distant metastasis,particularly to the lungs.Pulmonary metastasis is a critical determinant of poor prognosis,with 5-year survival rates plummeting below 20％in metastatic cases.Despite advances in primary tumor resection,the molecular and microenvironmental mechanisms driving post-surgical pulmonary recurrence and metastasis remain insufficiently elucidated.This review synthesizes recent advances in understanding the multifactorial pathogenesis of osteosarcoma pulmonary metastasis,emphasizing the roles of surgical trauma-induced inflammatory cascades,immune evasion(PD-1/PD-L1 axis dysregulation),angiogenic reprogramming,oncogenic drivers(e.g.,MYLK overexpression),and pre-metastatic niche formation in promoting tumor cell migration,invasion,and pulmonary colonization.Furthermore,we critically evaluate current clinical strategies,including immune checkpoint inhibitors,tyrosine kinase inhibitors,and metastasis-targeted therapies,while highlighting emerging approaches such as microenvironment modulation and epigenetic therapeutics.By integrating mechanistic insights with translational evidence,this review proposes a framework for developing combinatorial therapies to suppress metastatic progression and improve patient outcomes.关键词
骨肉瘤/肺转移/肿瘤免疫治疗/肿瘤免疫微环境/PD-1/PD-L1/MYLK/癌基因Key words
osteosarcoma/pulmonary metastasis/cancer immunotherapy/tumor immune microenvironment/PD-1/PD-L1/MYLK/oncogene分类
临床医学引用本文复制引用
郭芸,陈后平..骨肉瘤肺转移的作用机制及其临床治疗策略[J].中国现代医学杂志,2025,35(5):39-45,7.基金项目
国家自然科学基金(No:82160543) （No:82160543）
贵州省卫生健康委科学技术基金(No:gzwkj2021-290) （No:gzwkj2021-290）
