CyclinE和p27蛋白在骨肉瘤中的表达及临床意义

Expression and clinical significance of CyclinE and p27 proteins in osteosarcoma

目的探讨CyclinE和p27在骨肉瘤中表达及临床意义。方法检测108例骨肉瘤石蜡包埋组织中CyclinE和p27蛋白表达水平,统计分析其与患者临床病理因素和预后之间的关系。结果骨肉瘤组织中CyclinE的阳性率为68.52%,p27的阳性率为26.85%;CyclinE和p27蛋白表达水平与骨肉瘤病理分级、软组织浸润、远处转移、Enneking分期及患者整体生存期有关(P<0.05);CyclinE蛋白阳性组骨肉瘤患者5年存活率显著低于阴性组;而p27蛋白阳性组患者5年存活率显著高于阴性组(P<0.05)。Cox多因素分析提示软组织浸润及远处转移状态、病理分级、Enneking外科分期、CyclinE和p27蛋白表达水平是影响骨肉瘤患者预后的独立危险因素(P<0.05)。结论 CyclinE和p27蛋白表达水平是判断骨肉瘤患者预后的新指标,联合检测CyclinE和p27蛋白表达水平对骨肉瘤的进展、预后判断有重要意义。

Objective To investigate the expression level of CyclinE and p27 proteins in osteosarcoma and their clinical significance. Methods The expression of CyclinE and p27 proteins were detected with ElivisionTM immunohistochemical method in 108 osteosarcoma specimens. The relation between the expression level of CyclinE or p27 proteins and clinicopathological characteristics of osteosarcoma was statis- tically analyzed with Chi-square test. The relation between clinicopathological characteristics or the expression level of CyclinE, p27 proteins and the postoperative survival time of osteosarcoma patients was analyzed with Cox regression analysis. Results In osteosarcoma, the positive rates of CyclinE and p27 proteins were 68.52% and 26.85M respectively （P〈0.05）. A significant correlation was found between the expression level of CyclinE or p27 protein and such clinicopathological characteristics as parenchyma infiltration, distant metastasis, pathology degree, and Enneking stage of patients with osteosarcoma （P〈0.05 for all） ; but age, gender, primary tumor site, diameter and histologic type were not correlated with the expression level of CyclinE or p27 protein （P〉0.05 for all）. A positive association was found between CyclinE and p27 （P〈0.05）. The overall 5-year-survival rate of osteosarcoma patients in the CyclinE positive group was much lower than that in the negative group, and much higher in the p27 positive group than in the negative group （P〈0.05 for all）. Cox multifactor regression analysis indicated that parenchyma infiltration, distant metastasis, pathology degree, Enneking stage, expression level of CyclinE or p27 proteins were independent risk factors of osteosarcoma （P%0.05）. Conclusion CyclinE and p27 may be new markers for predicting the prognosis of osteosarcoma, and it is very important to detect CyclinE and p27 during the development and invasion/ metastasis of osteosarcoma simultaneously.