骨巨细胞瘤组织中p53和VEGF表达的意义

Expressions of p53, vascular endothelial growth factor in giant cell tumors of bone and their significance

目的:探讨p53、血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达与骨巨细胞瘤血管新生、肿瘤增殖、转移及复发的关系。方法:采用免疫组化法检测82例骨巨细胞瘤标本p53、VEGF、增殖细胞核抗原(proliferation cell muclear antigen, PCNA)、CD34表达,分析其与骨巨细胞瘤转移、复发的关系。结果: p53、VEGF 的阳性率分别为31 70%、57. 32%。VEGF阳性组p53阳性率为44. 68 %,增殖指数(proliferation index,PI)值、微血管密度(microvessel density, MVD)值分别为(55. 81±23 .42)%和(35. 17±12. 58)条,VEGF阴性组p53阳性率为14 .29 %, PI 值、MVD 值分别为(42 .41±25 .43)%和(24. 69±8 .66)条,不同VEGF表达组间p53表达、PI值、MVD值差异有统计学意义,P<0 .05(P值分别为0 .003、0 .016和0 .000),且MVD值、PI值与VEGF表达强度正相关,P<0 .05 (P值分别为0 .000和0 .004)。复发组VEGF、p53的阳性率分别为75 .86%和48. 28%,未复发组VEGF、p53的阳性率分别为47. 17%和22 .64%,两组间VEGF、p53的表达差异有统计学意义,P<0 .05(P值分别为0. 012和0. 017)。多因素logistic回归分析显示,VEGF、p53及手术方式对复发有显著影响,P<0 .05(P值分别为0 .027、0 .033和0 .009)。其中VEGF、p53为促进肿瘤?

OBJECTIVE: To evaluate the expressions of p53,vascular endothelial growth factor (VEGF) and their relationships with tumor angiogenesis and recurrence of giant cell tumors of bone (GCT).METHODS:The expressions of p53,VEGF,PI and CD34 in 82 cases of human GCT were detected by using immunohistochemical staining and intratumoral microvessel density was calculated. The expressions of p53, VEGF,PI value,MVD and other clinical factures were analyzed with the recurrence of the tumor.RESULTS:The expressions of p53,VEGF in GCT were 31.70% and 57.32%,respectively. The expression of p53 in VEGF positive group was 44.68 %, and PI value and MVD value were 55.81%±23.42% and 35.17±12.58. The expressions of p53 in VEGF negative group was 14.29 %, and the PI value and MVD value were 42.41%±25.43% and 24.69±8.66.The expressions of p53 ( P =0.003),PI value ( P =0.016) and MVD value ( P= 0.000 ) between VEGF positive and negative group were significantly different,and the expression of VEGF was found significantly associated with PI and MVD, P <0.05 ( P =0.000 , 0.004).The expression of VEGF and p53 in the recurrence group were 75.86% and 48.28%, the expressions of VEGF and p53 in the nonrecurrence group were 47.17% and 22.64%,and their expressions were statistically related to the recurrences of the tumor, P <0.05 ( P =0.012,0.017). Multiple logistic regression analysis revealed that the methods of operation, VEGF and p53 were significantly related to recurrence, P <0.05 ( P =0027 , 0.033, 0.009).VEGF and p53 were risk factors for recurrence.CONCLUSION:The expressions of p53,VEGF are highly related to the recurrence of GCT, and can be used to predict the recurrence of GCT and to guide the clinical therapy of GCT.