骨肉瘤化疗后bcl-2表达与影像学改变及预后的相关性研究

Bcl-2 expression in osteosarcoma after chemotherapy: correlation with radiographic change and prognosis

目的:探讨骨肉瘤化疗后bcl-2表达与影像学改变及预后的相关性。方法:23例病人均经穿刺活检病理证实为骨肉瘤,术前均按大剂量甲氨蝶呤(MMIA)方案化疗。免疫组化检测bcl-2,评价其与影像学改变及预后的相关性。结果:化疗前73.9%(17H23)患者bcl-2表达呈阳性,化疗后39.1%(9H23)呈阳性,差异具有显著统计学意义(χ2=15.36,P<0.05)。化疗前平均5.96分,化疗后平均8.65分,化疗后评分显著高于化疗前(t=4.236,P=0.000)。12例预后良好者,化疗前33.3%表达阳性,化疗后bcl-2阳性者8.3%;预后差者化疗前44.4%、化疗后33.3%表达阳性。结论:化疗后骨肉瘤bcl-2表达低于化疗前。化疗后bcl-2阳性表达率低者影像学评分高、预后好。

Objective： To correlate bcl-2 expression after chemotherapy in osteosareoma with radiographic change and prognosis. Methods： Large dose of MMIA chemotherapy was given to 23 patients with pathologically proved osteosareoma preoperatively. Bcl-2 was examined using immunohistology chemistry before and after chemotherapy. Expression of bcl-2 was correlated with change of radiography and prognosis. Results： Bcl-2 was positive in 73.9% and 39.1% of patients before and after chemotherapy respectively. There was a statistically difference between the two groups. Mean score of radiography before chemotherapy was statistically higher than that after chemotherapy, which was 5.96 scores and 8.65 scores respectively. In 12 patients with good prognosis, bcl-2 was positive in 33.3% and 8.3% before and after chemotherapy respectively. While that in patients with bad prognosis was 44.4% and 33.3% respectively. Conclusion： Expression of bcl-2 after chemotherapy decreased compared to that before chemotherapy. Osteosarcoma with less expression of bcl-2 had a higher score of radiograph and better prognosis.