瘤段灭活再植术与肿瘤假体置换术对四肢骨肉瘤患者血清IL-8、ERp29水平及预后的影响

Effect of Tumor Segment Devitalization and Replantation and Tumor Prosthesis Replacement on Serum IL-8 and ERp29 Levels and Prognosis in Patients with Osteosarcoma of Extremities

目的探讨瘤段灭活再植术、肿瘤假体置换术对四肢骨肉瘤患者血清白细胞介素-8(IL-8)、内质网蛋白29(ERp29)水平及预后的影响。方法选取河南大学第一附属医院、河南省人民医院、河南省肿瘤医院2016年8月至2018年8月收纳的四肢骨肉瘤患者50例,随机数表法将其分为A组与B组,A组进行瘤段灭活再植术,B组进行肿瘤假体置换术,进行比较。结果治疗前,两组患者血清IL-8水平经比较差异无统计学意义(P>0.05),治疗后,两组患者血清IL-8水平均显著下降,较治疗前差异有统计学意义(P<0.05);治疗后两组ERp29表达阳性率及免疫组化评分较治疗前均显著下降(P<0.05),但两组间比较差异无统计学意义(P>0.05);治疗前,两组患者肢体功能(Enneking)和生活质量(QOL)评分经比较差异无统计学意义(P>0.05),治疗后,两组患者Enneking和QOL评分较治疗前均显著上升,差异有统计学意义(P<0.05),两组患者QOL评分经比较差异无统计学意义(P>0.05),A组患者Enneking评分要显著低于B组,差异有统计学意义(P<0.05);A组患者有2人复发,B组有3人复发,两组复发人数经比较差异无统计学意义(P>0.05)。结论瘤段灭活再植术和肿瘤假体置换术都能够有效治疗四肢骨肉瘤患者,提高患者生存质量和肢体功能,其中肿瘤假体置换术能更好的恢复患者肢体功能。

Objective To explore the effect of tumor segment devitalization and replantation and tumor prosthesis replacement on serum interleukin-8(IL-8)and endoplasmic reticulum protein 29(ERp29)levels and prognosis in patients with osteosarcoma of extremities.Methods 50 patients with osteosarcoma of extremities admitted to the First Affiliated Hospital of Henan University,Henan People's Hospital and Henan Cancer Hospital from August 2016 to August 2018 were selected as the subjects and divided into Group A and Group B by the random number table method.Patients in Group A were treated with tumor segment devitalization and replantation,while those in Group B were treated with prosthesis replacement.Comparison was performed between the two groups.Results There was no significant difference in serum IL-8 level between the two groups before treatment(P>0.05);serum IL-8 levels in both groups were significantly decreased after treatment(P<0.05);the positive expression rates of ERp29 and immunohistochemistry score in both groups after treatment were significantly decreased(P<0.05),but there was no significant difference between the two groups(P>0.05).Before treatment,there were no significant differences in limb function(Enneking)scores or quality of life(QOL)scores between the two groups(P>0.05).After treatment,the above of both groups were significantly increased(P<0.05).There was no significant difference in QOL score between the two groups(P>0.05),but the Enneking score of Group A patients was significantly lower than that of Group B(P<0.05).There were 2 cases and 3 cases with recurrence in Group A and B respectively(P>0.05).Conclusion Both tumor segment devitalization and replantation and tumor prosthesis replacement can effectively treat osteosarcoma of extremities,and improve patients’quality of life and limb function.Tumor prosthesis replacement can better restore the patient's limb function.