经典型骨肉瘤中Hes1蛋白的表达及其临床意义

Expression of Hes1 protein in conventional osteosarcoma and its clinical significance

目的研究发状分裂相关增强子1(hairy and enhancer of split 1,Hes1)蛋白在经典型骨肉瘤中的表达及其与临床特征和预后的关系。方法收集本院2007年4月至2016年10月初诊初治并明确诊断的经典型骨肉瘤患者标本56例,运用免疫组织化学检测Hes1蛋白的表达,分析其表达与临床病理特征及术后转归的关系。对患者总生存和无进展生存情况进行随访,随访至术后5年,采用Kaplan-Meier法和log-rank检验进行生存分析。结果56例患者中,Hes1高表达22例(39.3%),低表达34例(60.7%)。与Hes1低表达患者比较,Hes1高表达患者的肿瘤直径更大(P=0.018),术后复发率及转移率均更高(均P<0.05)。Hes1低表达和高表达患者5年内平均总生存期为52.7个月和38.4个月(P=0.001),5年内平均无进展生存期为48.3个月和22.6个月(P<0.01)。Cox多因素回归分析提示,Hes1表达水平是患者总生存和无进展生存的预后独立风险因素(均P<0.01)。结论经典型骨肉瘤中Hes1蛋白的高表达与术后复发、转移及生存时间缩短相关。

Objective To investigate the expression of hairy and enhancer of split 1(Hes1)protein in conventional osteosarcoma,and to explore the relationship between the expression and the clinical features and prognosis of conventional osteosarcoma.Methods From April 2007 to October 2016,56 patients with conventional osteosarcoma who were initially diagnosed and treated in our hospital were collected.Immunohistochemistry was used to detect the expression of Hes1 protein,and the relationship between the expression and the clinicopathological parameters of patients and their prognosis were analyzed.The overall survival and progression-free survival of the patients were followed up until 5 years after surgery,and the Kaplan-Meier method and log-rank test were used for survival analysis.Results Hes1 was highly expressed in 22 cases(39.3%),and lowly expressed in 34 cases(60.7%).Compared with patients with low expression of Hes1,patients with high expression of Hes1 had larger tumor diameters(P=0.018),higher tumor relapse and metastasis rates(both P<0.05).Within the 5-year follow-up,the mean overall survival time of patients with low and high Hes1 expression was 52.7 months and 38.4 months(P=0.001),and the mean progression-free survival time was 48.3 months and 22.6 months(P<0.01).Cox multivariate regression analysis showed that Hes1 expression was an independent risk factor of osteosarcoma prognosis for overall survival and progression-free survival(both P<0.01).Conclusions The high expression of Hes1 protein in conventional osteosarcoma is associated with tumor relapse,metastasis and shortened survival time.