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目的探讨朊蛋白PrPc(cellular prion protein)在EnnekingⅢ期骨肉瘤中的表达以及分析其与骨肉瘤转移和患者预后的相关性。方法采用免疫组织化学法(SP法)对初诊已发生肺转移的EnnekingⅢ期骨肉瘤15例以及相应瘤旁组织中朊蛋白PrPc的表达进行检测。同时,检测同期收治的初诊未转移骨肉瘤标本33例作为对照组。比较已有转移的骨肉瘤和未转移骨肉瘤中PrPc蛋白的表达水平。对2006年1月至2009年12月收住院的两组骨肉瘤患者的临床资料进行回顾性分析。收集年龄、性别、肿瘤部位、肿瘤大小、病理性骨折、生存时间等资料。应用Kaplan-Meier·法计算患者生存年率,应用Log-rank检验进行单因素分析,应用Cox回归模型进行多因素分析,探讨PrPc的表达和不同的临床特征与骨肉瘤患者预后生存率之间的关系。结果 PrPc蛋白在骨肉瘤组织中普遍表达,在瘤旁组织中不表达;EnnekingⅢ骨肉瘤中:PrPc的表达要显著高于EnnekingⅡ期对照组(P=0.006)。Kaplan-Meier生存分析和Log-rank检验显示PrPc的表达水平与骨肉瘤患者预后相关(P=0.010),Enneking分期与预后相关(P=0.025)。多因素分析显示,PrPc表达水平和肿瘤的Enneking分期可以作为骨肉瘤预后的独立影响因素。结论朊蛋白PrPc在已有转移的EnnekingⅢ骨肉瘤中的表达高于未转移患者。PrPc高表达的骨肉瘤患者预后较差。PrPc的高表达可能与骨肉瘤预后不良有一定相关性。
Objective To investigate the expression of prion protein PrPc in Enneking stage Ⅲ osteosarcoma and its relationship with metastasis and prognosis of osteosarcoma. Methods Immunohistochemical SP method was used to detect the expression of prion protein PrPc in 15 newly diagnosed Enneking stage Ⅲ osteosarcoma patients with lung metastases and corresponding adjacent tissues. At the same time, 33 cases of newly diagnosed non-metastatic osteosarcoma specimens admitted in the same period were detected as control group. PrPc protein expression was compared between osteosarcomas and non-metastatic osteosarcomas. The clinical data of two groups of patients with osteosarcoma admitted to hospital from January 2006 to December 2009 were analyzed retrospectively. Collect age, gender, tumor site, tumor size, pathological fracture, survival time and other data. The Kaplan-Meier method was used to calculate the annual survival rate. Log-rank test was used to perform univariate analysis. Cox regression model was used to analyze the relationship between PrPc expression and different clinical features and prognosis survival rate in osteosarcoma patients . Results PrPc protein was universally expressed in osteosarcoma tissues and not in tumor tissues. In Enneking Ⅲ osteosarcoma, PrPc expression was significantly higher than that in Enneking Ⅱ control group (P = 0.006). Kaplan-Meier survival analysis and Log-rank test showed that the expression of PrPc was correlated with the prognosis of osteosarcoma patients (P = 0.010). The Enneking staging correlated with the prognosis (P = 0.025). Multivariate analysis showed that PrPc expression and tumor Enneking staging can be used as independent prognostic factors of osteosarcoma. Conclusions PrPc is higher than that in non-metastatic Enneking Ⅲ osteosarcoma. PrPc high expression of osteosarcoma patients with poor prognosis. The high expression of PrPc may be related to the poor prognosis of osteosarcoma.