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目的:探讨骨肉瘤保肢治疗中肿瘤大小、临床分期、手术方式、术前、术后化疗以及肿瘤多药耐药基因(mdr)表达产物P糖蛋白(P-170)对术后生存时间的影响。方法:统计分析近7年47例骨肉瘤保肢术患者的病理、临床资料及生存时间,并用链菌素生物素标记法(LSAB)免疫组织化学法回顾性检测肿瘤标本中P-170糖蛋白。结果:临床分期为ⅡB期患者1～5年生存率分别是974%,760%,463%,389%和340%;ⅡA期患者相应的生存率为100%,800%,800%,800%和800%;ⅠB期患者相应的生存率皆为100%;各临床分期间的生存率有统计学差异(P<01)。术前有化疗的患者1～5年生存率分别是975%,845%,674%,571%和530%;术前无化疗的患者相应的生存率分别为857%,429%和0%;两组生存率有统计学意义(P<001)。术后有化疗的患者1～5年生存率分别是971%,942%,727%,616%和572%;术后无化疗的患者相应的生存率分别是90%,200%和0%;差异有统计学意义(P<001)。P-糖蛋白阳性组1～5年生存率分别是974%,733%,471%,359%和307%;P-糖蛋白阴性组的相应值皆为100%,差异有统计学意义(P<001)。此外,在不同保肢术式中人工关节置换术患者1～5年生存率最高,分别是967%,930%,700%,631%和520%,差异有统计学意义(P<001)。结论:肿瘤临床分期、肿瘤大小、保肢术式、术前、术后化疗及P-17
Objective: To investigate the tumor size, clinical stage, surgical methods, preoperative and postoperative chemotherapy, and the multidrug resistance gene (mdr) expression product P-glycoprotein (P-170) for postoperative survival time in limb salvage treatment of osteosarcoma. influences. METHODS: The pathological, clinical data and survival time of 47 patients with osteosarcoma limb salvage surgery were analyzed statistically in the past 7 years. Streptocin biotinylated (LSAB) immunohistochemical method was used to retrospectively detect P-170 glycoprotein in tumor specimens. . Results: The 1- to 5-year survival rates of patients with stage IIB clinical stage were 974%, 760%, 463%, 389%, and 340%, respectively. The corresponding survival rates in stage IIA patients were 100%, 800%, 800%, and 800%. And 800%; the corresponding survival rate of patients with stage IB was 100%; the survival rate of each clinical period was statistically different (P<01). The 1- to 5-year survival rates of patients who had chemotherapy before surgery were 975%, 845%, 674%, 571%, and 530%, respectively. The corresponding survival rates of patients without chemotherapy before surgery were 857%, 429%, and 0%, respectively. The survival rate of the two groups was statistically significant (P < 001). The 1- to 5-year survival rates of patients who had chemotherapy after surgery were 971%, 942%, 727%, 616%, and 572%, respectively. The corresponding survival rates for patients without chemotherapy were 90%, 200%, and 0%, respectively. The difference was statistically significant (P < 001). The 1- to 5-year survival rates of the P-glycoprotein-positive group were 974%, 73%, 471%, 39%, and 307%, respectively; the corresponding values of the P-glycoprotein-negative group were all 100%, and the difference was statistically significant (P <001). In addition, the 1- to 5-year survival rate of patients undergoing artificial limb replacement in different salvage limbs was the highest, which was 967%, 930%, 700%, 631%, and 520%, respectively. The difference was statistically significant (P < 001). Conclusion: Tumor clinical staging, tumor size, limb salvage surgery, preoperative and postoperative chemotherapy, and P-17