成骨性肿瘤中Ⅰ、Ⅱ和Ⅲ型胶原蛋白的表达

Expression of type Ⅰ,Ⅱand Ⅲcollagen in bone forming tumor

目的：研究成骨性肿瘤组织中Ⅰ、Ⅱ和Ⅲ型胶原蛋白的表达及与肿瘤分类、分化的关系。方法：用饱和苦味酸天狼星红偏振光镜和免疫组化ＬＳＡＢ 法，检测６９ 例成骨性肿瘤组织中Ⅰ、Ⅱ、和Ⅲ型胶原的表达情况，并用ＥＭＡＬ２００ 真彩图像分析系统进行分析和半定量测定。结果：骨瘤和骨样骨瘤中只有Ⅰ型胶原的表达（ 阳性率均为１００ ％ ，灰度值分别为１３３－１３ ±７－４７ 和１３６－４９ ±１４－２１） ，而骨肉瘤不仅Ⅰ型胶原阳性率和强度均明显低于前二者（ 阳性率８７ ％ ，４０／４６，灰度值１７１－９９ ±１４－７４） ，且出现了Ⅱ型和Ⅲ型胶原，Ⅱ型胶原在软骨母细胞型和混合型的表达明显高于其它型骨肉瘤（ Ｐ＜ ０－０１） ，而Ⅰ、Ⅲ型胶原的表达在各型骨肉瘤间无显著差别；在高中低３ 组不同分化程度的骨肉瘤间，Ⅰ型胶原表达差异显著（ Ｐ＜ ０－０１） ，分化越低表达越少；天狼星红与免疫组化染色结果基本一致。结论：Ⅱ型胶原可作为软骨母细胞型和混合型骨肉瘤的分型参考指标，Ⅰ型胶原的表达可作为骨肉瘤分化的参考指标。天狼星红是鉴别Ⅰ、Ⅲ型胶原简便、经济的方法之一。

Objective:To investigate expression of type Ⅰ, Ⅱand Ⅲcollagen in bone forming tumors and their relationship with classification and differentiation of tumor. Methods:Type Ⅰ,Ⅱand Ⅲcollagen in 69 cases of osteogenous tumor (including 15 cases of osteoma, 8 osteoid osteoma and 46 osteosarcoma)were detected using picric acid sirius red polariscope and immunohistochemistry,the EMAL 200 image software was used to analyse the staining result. Results:Only type I collagen was positive in osteoma and osteoid osteoma (positive rates of type I collagen in both tumors were all 100%,grey values were 133 13±7 47 and 136 49±14 21 respectively), expression of type I collagen in osteosarcoma (positive rate 87%,grey value 171 99±14 74) was significantly weaker than that in osteoma and osteoid osteoma.Besides type Ⅰ, type Ⅱand Ⅲcollagen were also detected in osteosarcomas.Type Ⅱcollagen stain was significantly stronger in chondroblastic and mixed than other type osteosarcomas.Among the three groups of osteosarcomas of high,moderate and low degree,the difference of type Ⅰcollagen was statistically significant demonstrating that the lower the osteosarcoma differentiate,the weaker the expression of type Ⅰcollagen was. Conclusion:Type Ⅱcollagen can be utilized as one of the indicators to diagnose chondroblastic and mixed osteosarcomas.Type Ⅰcollagen can be used as one of the markers to determine the differentiation of ostecosarcoma. Picric acid sirius red polariscope is a simple and ecnomic method to identify type Ⅰand type Ⅲcollagen.