MDM2与VEGF在骨肉瘤组织中的表达及临床意义

Expressions of MDM2 and VEGF in osteosarcoma tissue and clinical significances

目的:探讨MDM2、VEGF在骨肉瘤组织中的表达与骨肉瘤病理分级、转移及预后的关系。方法:采用免疫组织化学(S-P)法检测56例骨肉瘤标本中MDM2、VEGF的表达情况,并分析MDM2、VEGF的表达与病理分级、转移及预后的关联性。同时设8例骨纤维结构不良为阴性对照组。结果:骨肉瘤组织中MDM2表达总阳性率为64.3%(36/56),VEGF表达总阳性率为67.9%(38/56)。骨纤维结构不良组MDM2、VEGF呈阴性表达。骨肉瘤组织中MDM2、VEGF表达与病理分级无关联(P>0.05),而与骨肉瘤的转移和预后相关联(P<0.05)。MDM2和(或)VEGF阳性表达者5年生存率均明显低于阴性表达组(P<0.05);MDM2和VEGF均阳性表达者生存率最低,而二者均阴性表达者生存率最高,MDM2和VEGF均阳性和均阴性表达两组生存率比较,差异具有显著性(P<0.01)。结论:骨肉瘤组织MDM2异常表达者肿瘤的恶性程度增高、预后差,MDM2可能与VEGF共同参与骨肉瘤血管生成并起协同作用。检测骨肉瘤中MDM2和VEGF的表达水平对评价患者的预后有一定价值。

Objective To explore the relation of the expressions of MDM2 and VEGF in osteosarcoma with the pathological parameters and prognosis of the tumor. Methods The expressions of MDM2 and VEGF were detected with immunohistochemical （SP） method in specimens from 56 cases of osteosarcoma. The correlation between the expressions of MDM2, VEGF and pathological grade, metastasis and prognosis was analyzed statistically, while 8 cases of fibrous dysplasia of bone were used as negative control group. Results The positive rates of MDM2 and VEGF in osteosarcoma were 64.3% （36/56） and 67.9% （38/56）, respectively . MDM2 and VEGF didn＇t express in negative control group. The expression of MDM2 and VEGF were not significantly correlated to the pathological grades of the osteosarcoma, but which were significantly correlated with tumor metastasis and prognosis （P〈0.05）. The five-year survial rate in patients with positive expression of MDM2 and （or） positive expression of VEGF was significantly lower than that in negative control group （P〈0. 05）. The patients with positive reaction for both MDM2 and VEGF had the lowest survival rate, but the patients with negative reaction for both MDM2 and VEGF had the highest survival rate, the difference was significant （P〈0.01）. Conclusion There is an intimate correlation between the overexpression of MDM2 and VEGF in osteosarcoma and its unfavorable prognosis. MDM2 cooperating with VEGF probably plays a role in angiogenesis of osteosarcoma and is an useful parameter to evaluate prognosis of osteosarcoma.