裸角质膜同源蛋白在骨肉瘤组织中表达及其患者临床意义

Expression of naked cuticle drosophila 1 in osteosarcoma and its relationship with clinicopathological features and prognosis

目的探讨裸角质膜同源蛋白(NKD1)在骨肉瘤组织中表达及与患者临床病理特征和预后的关系。方法选取2014年1月到2019年1月信阳职业技术学院附属医院保存的骨肉瘤组织样本和周围正常骨组织样本各63例作为研究对象。采用免疫组织化学检测骨肉瘤和正常组织NKD1蛋白表达, 分析NKD1表达水平与患者临床病理特征和预后的关系。组间计量数据比较采用t检验, NKD1与临床病理特征的关系采用χ^(2)检验, NKD1与生存时间和预后的关系采用Kaplan-Meier分析。结果 NKD1主要表达于细胞质, 呈黄色或棕黄色。癌旁组织NKD1表达阳性率[95.20%(60/63)]明显高于骨肉瘤组织[14.29%(9/63)], 差异有统计学意义(χ^(2)=12.091, P<0.05)。不同性别骨肉瘤患者NKD1表达阳性率比较(11.90%比19.05%), 差异无统计学意义(χ^(2)=0.517, P>0.05)。<20岁和≥20岁骨肉瘤患者NKD1表达阳性率比较(11.90%比19.05%), 差异无统计学意义(χ^(2)=0.489, P>0.05)。膝关节周围和其他部位发病的患者NKD1表达阳性率比较(11.63%比20.00%), 差异无统计学意义(χ^(2)=0.367, P>0.05)。Enneking分期Ⅱ期患者NKD1表达阳性率(23.33%)明显高于Ⅲ期患者(6.06%), 差异有统计学意义(χ^(2)=7.109, P<0.05)。无肺转移患者肿瘤组织NKD1表达阳性率(29.63%)明显高于肺转移患者肿瘤组织(2.78%), 差异有统计学意义(χ^(2)=12.722, P<0.05)。不同组织类型患者NKD1表达阳性率比较(13.79%比14.29%比15.38%)差异无统计学意义(χ^(2)=0.732, P<0.05)。NKD1表达阳性者的中位生存时间(29个月)明显高于NKD1表达阴性者(13个月), 差异有统计学意义(χ^(2)=7.271, P<0.05)。生存曲线显示, NKD1表达阳性者的3年生存率[77.78%(7/9)]明显高于NKD1表达阴性者[25.93%(14/54)], 差异有统计学意义(Log-rank=4.901, P<0.05)。NKD1表达水平、Enneking分期和肺转移均是骨肉瘤患者独立预后因素(P<0.05)。结论 NKD1蛋白在骨肉瘤组织表达下调, 与肿瘤恶性程度和患者预后明显相关。

Objective To investigate the expression of naked cuticle drosophila 1(NKD1)in osteosarcoma and its relationship with clinicopathological features and prognosis.Methods Totally,63 osteosarcoma tissue samples and 63 surrounding normal bone tissue samples stored in Affiliated Hospital of Xinyang Vocational and Technical College from January 2014 to January 2019 were selected as the research objects.The expression of NKD1 protein in osteosarcoma and normal tissues was detected by immunohistochemistry,and the relationship between NKD1 expression level and clinicopathological features and prognosis was analyzed.The measurement data between groups were compared by t-test,the relationship between NKD1 and clinicopathological features was analyzed by chi square test,and the relationship between NKD1 and survival time and prognosis was analyzed by Kaplan Meier.Results NKD1 was mainly expressed in cytoplasm.The positive rate of NKD1 expression in adjacent tissues[95.20%(60/63)]was significantly higher than that in osteosarcoma tissues[14.29%(9/63),χ^(2)=12.091,P<0.05].There was no significant difference in the positive rate of NKD1 expression between different gender osteosarcoma patients(11.90%vs.19.05%,χ^(2)=0.517,P>0.05).There was no significant difference in the positive rate of NKD1 expression between patients aged<20 and≥20 years(11.90%vs.19.05%,χ^(2)=0.489,P>0.05).There was no significant difference in the positive rate of NKD1 expression between patients around the knee and other parts(11.63%vs.20.00%)(χ^(2)=0.367,P>0.05).The positive rate of NKD1 expression in Enneking stageⅡpatients(23.33%)was significantly higher than that in stageⅢpatients(6.06%)(χ^(2)=7.109,P<0.05).The positive rate of NKD1 expression in tumor tissues of patients without lung metastasis(29.63%)was significantly higher than that of patients with lung metastasis(2.78%)(χ^(2)=12.722,P<0.05).The positive rate of NKD1 expression in patients with different tissue types(13.79%vs.14.29%vs.15.38%)was not statistically significant(χ^(2)=0.732,P<0.05).The median survival time of NKD1 positive patients(29 months)was significantly longer than that of NKD1 negative patients(13 months,χ^(2)=7.271,P<0.05).The survival curve showed that the 3-year survival rate of NKD1 positive patients[77.78%(7/9)]was significantly higher than that of NKD1 negative patients[25.93%(14/54),Log-rank=4.901,P<0.05].The Nkd1 expression,Enneking stage and lung metastasis were independent prognostic factors in patients with osteosarcoma(P<0.05).Conclusion The expression of NKD1 protein in osteosarcoma is down-regulated,which is closely related to the degree of malignancy and prognosis of patients.