成血管因子和溶骨因子在皂泡型和溶骨型骨巨细胞瘤中表达差异的分析

Comparison of expression levels of the angiogenic and osteolytic factors between osteolytic and soap-bubble types of giant cell tumor

[目的]比较骨巨细胞瘤(giant cell tumor of bone,GCT)标本在各临床分级以及溶骨型和皂泡型中成血管和溶骨因子表达水平的差异,为GCT的临床治疗研究提供理论基础。[方法]选取2000年6月~2015年2月来自天津医院、济南军区总医院及河北省第三医院的GCT病例40例,其中典型皂泡征组20例,溶骨型组20例。利用免疫组化的方法检测所有标本VEGF(vascular endothelial growth factor)、CD34、PCNA(proliferating cell nuclear antigen)及RANKL(receptor activator of nuclear factor ligand)的表达,分别按照Campanacci和Ennecking临床分级以及皂泡型和溶骨型分组进行统计分析。[结果]VEGF和PCNA表达在Ennecking和Campanacci不同分级中差异无统计学意义(P>0.05);CD34和RANKL在Campanacci不同分级中差异无统计学意义(P>0.05),而在Ennecking分级中差异有统计学意义(χ~2=11.552,11.979;P=0.021,0.018);PCNA、RANKL及CD34表达在皂泡型组和溶骨型组之间差异无统计学意义(P>0.05);VEGF在皂泡型组表达多于溶骨组,差异有统计学意义(χ~2=11.882;P=0.003)。[结论]VEGF、CD34、PCNA和RANKL在GCT的表达水平与其临床分级无完全平行的对应关系,皂泡型与溶骨型GCT在肿瘤细胞增殖和肿瘤对骨破坏情况上无明显区别,皂泡型与溶骨型GCT在肿瘤血管形成情况上有明显区别,皂泡征型GCT血管形成多于溶骨型GCT。

[Objective] To compare the expression levels of immunological biomarkers including VEGF, CD34, PC- NA and RANKL in patients with osteolytic and soap-bubble giant cell tumor （GCT） respectively, providing new ideas for clinical research of GCT. [Methods] Histological samples obtained from 40 patients with GCT were immunohistochemically investigated.The patients were collected from Tianjin Hospital, Jinan General Mititary Hospital and the Third Hospital of Hebei province from June 2000 to February 2015, including 20 cases of typical soap-bubble GCT and 20 cases of osteolytic GCT. Expression levels of VEGF, CD34, PCNA and RANKL were individually compared according to the Campanacci grades, Ennecking grades, as well as the soap-bubble orosteolytictypes of GCT. [Results] VEGF and PCNA expressed in similar level among the differcent Ennecking and Campanacci grades （P〉0.05）, while CD34 and RANKL levels were statisti- cally different among the Ermecking grades （x2=11.552, 11.979; P=0.021, 0.018）, by contrast, the quantities were grossly equivalent among the Campanacci grades （P〉0.05） . As for soap-bubble orosteolytic types of GCT, CD34, PCNA and RANKL were detected in comparable level （P〉0.05）, however VEGF was significantly higher in the soap-bubble type of GCT （X%11.882; P=0.003） . [Conclusions] There is no totally corresponding relationship between the expression levels of VEGF, CD34, PCNA as well as RANKL and the clinical grading Of GCT respectively. Additionally, there is no significant difference in factors related to tumor cell multiplication and bone destruction between the osteolytie and soap-bubble types of GCT. However, vaseularization feature in the soap-bubble type is superior to the osteolytic type of GCT.