髓内型骨肉瘤患者预后的多因素COX模型分析

Prognostic factors for intramedullary osteosarcoma: a multivariate analysis using COX proportion hazard model in 80 cases

目的：研究病理多因素对骨肉瘤预后的影响。方法：通过计算机ＣＯＸ多因素分析模型，利用累积生存率，对８０例有随访的长骨髓内型骨肉瘤进行预后研究。结果：８０例骨肉瘤患者２年、５年生存率分别为３３．８％和１８．３％。在选取的１４个因素中，对预后影响最大的因素依次为：骨样组织分型（ＲＲ＝２．３５）、ｐ５３（ＲＲ＝２．２７）、血管内皮生长因子（ＶＥＧＦ）表达（ＲＲ＝２．０７）、ＷＨＯ分型（ＲＲ＝１．８７）、增殖细胞核抗原（ＰＣ－ＮＡ）（ＲＲ＝１．７４）、微血管密度（ＭＶＤ）（ＲＲ＝１．０１）。治疗方法和转移抑制基因ｎｍ２３－Ｈ１蛋白表达对预后影响不大。结论：该结果对综合评估骨肉瘤预后有重要意义。

Objective: To investigate the prognostic significance of pathological parameters in osteosarcoma. Methods: Fourteen individual variables were statistically evaluated using the cumulative survival rate by the computerized COX multivariate analysis model in 80 patients with intramedullary osteosarcoma of long bone. Results: The 2 and 5 year cumulative survival rates were 33.8% and 18.3% respectively. The most important prognostic variables for predicting overall survival included the neoplastic osteoid classification, p53 protein, expression of vascular endothelial growth factor, the type according to WHO classification in 1993, proliferating nuclear antigen and intratumoral microvessel density. The methods of treatment and the expression of nm23 H1 protein did not strongly influence the prognosis of the disease. Conclusion: The results are important for comprehensive evaluation of the prognosis of osteosarcoma.