组织蛋白酶水平与骨肉瘤患者临床特征及预后的关系

Level of cathepsin in osteosarcoma and its relationship with clinical characteristics and prognosis

目的探讨组织蛋白酶水平与骨肉瘤患者临床特征及预后的关系。方法选取112例骨肉瘤患者和100例健康体检者,检测两组受试者血清组织蛋白酶(Cath)B、Cath D水平,并分析其与患者临床特征的关系。对所有骨肉瘤患者随访7~60个月,记录患者的生存情况,骨肉瘤患者预后的影响因素采用Cox回归模型分析。结果骨肉瘤组患者入院即刻血清Cath B、Cath D水平均明显高于健康对照者(P﹤0.01)。临床分期为Ⅲ期、分化程度为低分化、存在远处转移骨肉瘤患者血清Cath B、Cath D水平分别高于临床分期为Ⅰ~Ⅱ期、分化程度为中高分化、无远处转移的患者(P﹤0.05)。随访7~60个月,病死81例,生存31例,病死患者的入院即刻血清Cath B、Cath D水平均明显高于生存患者(P﹤0.01)。Cox回归模型分析结果显示,临床分期为Ⅲ期、分化程度为低分化、存在远处转移、血清Cath B和Cath D水平较高均为骨肉瘤患者生存的独立危险因素(P﹤0.05)。结论血清Cath B、Cath D水平在骨肉瘤患者中明显升高,生存预后较不理想,可能为后续患者的术后治疗方案制订等提供依据。

Objective To explore the relationship between the level of cathepsin with clinical characteristics and prognosis of osteosarcoma patients.Method A total of 112 patients with osteosarcoma and 100 healthy subjects were selected to detect the serum cathepsin(Cath)B and Cath D levels of the two groups of subjects,and analyze the relationship between them and the clinical characteristics of the patients.All patients with osteosarcoma were followed up for 7-60 months,and their survival was recorded.The factors affecting the prognosis of patients with osteosarcoma were analyzed by Cox regression model.Result The serum Cath B and Cath D levels of patients in the osteosarcoma group were significantly higher than those in healthy controls(P<0.01).The serum Cath B and Cath D levels of patients with clinical stage Ⅲ,poorly differentiated,and distant metastasis osteosarcoma were higher than those of clinical stage I-Ⅱ,moderately differentiated,and without distant metastasis(P<0.05).During a follow-up of 7-60 months,81 cases died and 31 cases survived,the serum Cath B and Cath D levels of the patients who died of the disease were significantly higher than those of the surviving patients immediately after admission(P<0.01).Cox regression model analysis showed that the clinical stage of stage Ⅲ,poorly differentiated,distant metastasis,and high serum Cath B and Cath D levels were independent risk factors for survival in patients with osteosarcoma(P<0.05).Conclusion Serum Cath B and Cath D levels are significantly higher in patients with osteosarcoma,and the survival prognosis is not ideal,which may provide a basis for the subsequent formulation of postoperative treatment plans for patients.