骨桥蛋白在骨肉瘤中表达及其与侵袭转移关系

Expression of osteopontin in osteosarcoma and its correlation with metastasis

目的:探讨骨桥蛋白(OPN)在骨肉瘤组织中的表达情况及其与骨肉瘤远处转移的相关性,探索建立数学模型预测骨肉瘤远处转移的可行性。方法:免疫组化S-P法检测OPN在骨肉瘤及骨软骨瘤中的表达,单因素分析OPN表达与骨肉瘤临床病理特征之间的关系,并进一步利用多因素回归分析模型分析骨肉瘤远处转移相关因素,建立数学预测模型。结果:OPN在骨肉瘤中表达阳性率为76.7%,在骨软骨瘤中为22.2%,二者间有显著性差异。OPN与骨肉瘤临床病理特征的分析结果提示,OPN的表达与患者性别、年龄、病理分型无关,与临床分期和肺转移显著相关。随着临床分期程度的增高,肺转移的发生,OPN表达呈增高趋势,组间有显著性差异。单因素分析发现肿瘤体积、ALP水平、临床分期、新辅助化疗、OPN与骨肉瘤肺转移有相关性。而多因素回归分析筛选出2项有统计学意义的独立因素:临床分期和新辅助化疗,由此建立Logistic回归方程。结论:OPN可能是判断骨肉瘤恶性程度及预后的指标,多因素回归分析提示OPN作为肿瘤转移相关基因可能通过多种途径参与恶性肿瘤的转移。OPN可成为预测肿瘤预后的指标,用于监测肿瘤复发转移。

Objective：To investigate the expression of osteopontin（OPN） in osteosarcoma and study its correlation with metastasis.Explore the feasibility in establishing a mathematical model to predict metastasis in osteosarcoma.Methods： The expression of OPN in osteosarcoma and osteochondroma were detected by S-P immunohistology stain.The OPN expression and clinicopathological factors of osteosarcoma were evaluated by uni-variant analysis.A mathematical model was established by multivariant regression analysis to predict the relationship between clinicopathological factors and metastasis in osteosarcoma.Results： Positive expression rates of OPN were 76.7% in osteosarcoma,and 22.2% in osteochondroma.The difference was statistically significant.The expression of OPN was significantly correlated with clinical stage and lung metastasis,but not related with sex,age or pathological type.Univariate analysis showed that tumor size,ALP level,clinical stage,neoadjuvant chemotherapy and OPN were statistically correlated with the metastasis in osteosarcoma.Multivariate analysis indicated 2 independent factors,which were clinical staging and neoadjuvant chemotherapy.A formula was established by logistic regression.Conclusion： OPN might be useful in predicting the biological characteristics and prognosis in osteosarcoma.Multivariate analysis indicated that OPN,as a tumor metastasis relating gene,might contribute to tumor metastasis by multiple pathways.OPN could be a practical factor of prognosis for the monitoring of tumor recurrence and metastasis.