CD133和CD44在骨肉瘤中的表达及其临床意义

Expression and Clinical Significance of CD133 and CD44 in Osteosarcoma

目的探讨CD133和CD44在骨肉瘤中的表达情况及其与骨肉瘤患者预后的关系。方法应用免疫组织化学方法检测CD133和CD44在79例骨肉瘤患者石蜡切片标本中的表达情况,应用卡方检验比较CD133、CD44表达与患者临床病理资料的相互关系,Kaplan-Meier法计算患者生存率,Log rank检验比较CD133、CD44阴性低表达组与高表达组患者之间的生存差异,并以性别、年龄、肿瘤部位、肿瘤大小、Ennecking分期、CD133和CD44表达水平、局部复发及肺转移为变量指标,应用Cox回归模型进行多因素分析,研究这些因素与骨肉瘤患者生存率之间的关系。结果 CD133和CD44的表达水平与患者性别、年龄、肿瘤部位、肿瘤大小、Ennecking分期及局部复发无关,发生肺转移的骨肉瘤患者其CD133和CD44的表达明显高于未发生转移的骨肉瘤患者,差异有统计学意义(P值分别为0.00014和0.0008)。经单因素生存分析表明,影响骨肉瘤患者预后的因素有:肿瘤大小,局部复发,肺转移,CD44和CD133表达水平。多因素分析显示CD133和CD44表达水平及肿瘤大小是影响患者预后的独立影响因素。结论 CD133和CD44表达水平与骨肉瘤肺转移密切相关,检测CD133和CD44的表达可以作为骨肉瘤患者肺转移及预后预测的指标。

Objective To investigate the expressions of CD133 and CD44 in osteosarcoma tissue and their relationship with the prognosis of osteosarcoma.Methods Expressions of CD133 and CD44 were examined by immuno-histochemical MaxVision method in 79 specimens of human osteosarcoma tissues.The relationship between expression of CD133/CD44 and clinicopathological parameters was calculated by Chi-square test.Kaplan-Meier method was used to calculate the overall survival rate.The factors of gender,age,tumor-size,tumor location,Ennecking stage,local recurrence and lung metastasis were included in univariate analysis.The univariate analysis was used to determine the prognostic factors related with survival rate by Log rank test.The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and survival.Results No correlations were found between expression of CD133/CD44 and clinicopathological parameters including gender,age,tumor location,tumor size,Ennecking stage and local recurrence,but occurrence of pulmonary metastasis was significantly associated with the expression levels of CD133/CD44（P value was 0.00014 and 0.0008,respectively）.Univariate survival analysis showed that the significant prognostic factors were tumor size,local recurrence,lung metastasis,expression levels of CD133 and CD44.Multivariate analysis showed that CD133 and CD44 expression and tumor size were independent prognostic factors of patients with osteosarcoma.Conclusion The positive expressions of CD133 and CD44 closely correlate with the lung metastasis of osteosarcoma,detection of CD133 and CD44 may be used as an indicator for lung metastasis and prognosis of osteosarcoma.