Background: Although the tumor coagulome interacts with the tumor immune microenvironment (TME) in solid tumors, its role in osteosarcoma (OS) remains uncharacterized. This study aimed to delineate this transcriptomic interplay and identify potential prognostic targets. Methods: This study was performed with bulk RNA sequencing (RNA-seq), single-cell RNA sequencing (scRNA-seq), and clinical phenotype data. Bioinformatic approaches were employed at the transcriptomic level to investigate the impact of the tumor coagulome on the TME and prognosis in OS. We validated the above findings using immunohistochemistry and immunofluorescence. Results: The activity of a coagulation-related transcriptional signature was found to correlate with the degree of malignancy in OS. Its activity score demonstrated predictive value for OS prognosis, with a maximum area under the curve (AUC) of 0.802. scRNA-seq analysis indicated that inflammatory cancer-associated fibroblasts (iCAFs) and APOE+ macrophages were predominantly enriched in the high coagulation score subgroup. Our data further suggest that iCAFs may facilitate the M2 polarization of APOE+ macrophages via the C3–C3AR1 axis, potentially contributing to poorer clinical outcomes in patients with OS. Conclusions: These findings imply that within a high coagulation-related transcriptional score group, the interaction between iCAFs and APOE+ macrophages, likely mediated by the C3–C3AR1 axis, could facilitate OS progression. Consequently, the C3–C3AR1 signaling pathway might represent a promising target for future therapeutic strategies and coagulome monitoring in OS.
Jianhua Mu, Yi-Tian Wang, Han Liu et al.· Biomedicines· 0 citations
Unicameral bone cysts (UBCs) are fluid-filled, osteolytic lesions commonly affecting children and adolescents. Minimally invasive treatments such as percutaneous injection have become increasingly popular. Calcium phosphate cement (CPC), a biocompatible artificial bone substitute with mechanical strength and osteoconductivity, and may be suitable for such applications. This study aimed to evaluate the mid- to long-term clinical and radiographic outcomes of percutaneous calcium phosphate cement injection for UBCs, with particular emphasis on late recurrence, repeat injection, cortical remodeling, and cavity filling.
A retrospective review was conducted on 31 patients with UBC treated by CPC injection between January 2013 and January 2025, with at least 1 year of follow-up. Postoperative outcomes were assessed radiographically, functionally, and for complications. We recorded the patients’ age, sex, preoperative and postoperative visual analog scale (VAS) scores, Musculoskeletal Tumor Society (MSTS) scores, modified Neer classification and Capanna classification, cortical thickness ratio, cavity filling, recurrence, repeat intervention, and complications.
The mean follow-up duration was 61.1 months (range, 13–149 months). Among them, 14 patients experienced pathological fractures. Postoperatively, pain and functional outcomes improved significantly, with the median VAS score decreasing to 0 and the median MSTS score improving to 30 at final follow-up (
P
< 0.001). Recurrence after the first injection occurred in four patients (12.9%). Among them, three patients underwent repeat percutaneous CPC injection, and one patient was managed with observation because of adequate cortical thickness and clinical stability. At final follow-up after all treatments, all patients achieved modified Neer grade I or II outcomes, and most patients achieved Capanna grade I or II healing. One patient experienced delayed wound healing, and no severe complications were observed.
Percutaneous CPC injection was associated with pain relief, functional improvement, and radiographic stabilization in patients with UBCs. Repeat CPC injection appeared to provide stable outcomes in recurrent cases, whereas observation was considered reasonable for one clinically stable lesion with adequate cortical thickness. The observed cortical remodeling and cavity filling suggest that CPC injection may represent a potential minimally invasive strategy for reconstruction of UBC-related bone defects.
Meng-Zhang Xie, Zhengxiao Lai, Yi Luo et al.· Frontiers in Surgery· 0 citations
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