局部及转移骨肉瘤中VEGF、p53表达及微血管生成的对照研究

Comparison of VEGF,MVD and p53 Expression in Patients with Localized and Metastatic Osteosarcoma

目的 :探讨血管内皮生长因子 (VEGF)和p5 3在骨肉瘤微血管新生中的作用及对骨肉瘤侵袭性转移性的影响。方法 :采用免疫组织化学方法 ,检测 5 7例局部原发性骨肉瘤和 2 7例转移骨肉瘤原发灶标本中VEGF、p5 3的表达 ,计算MVD值。对比两骨肉瘤组中VEGF、p5 3表达、MVD值以及其它临床病理因子的差别。结果 :转移骨肉瘤组VEGF阳性表达率和MVD高于局部骨肉瘤组 (P =0 .0 494,P =0 .0 3 0 2 ) ;p 5 3蛋白表达在两组肿瘤中无显著差别 (P >0 .0 5 ) ;转移骨肉瘤组中肿瘤平均直径大于局部骨肉瘤组的平均直径 (P =0 .0 3 5 0 ;VEGF和 p5 3表达阳性组与阴性组相比 ,MVD值高 (P =0 .0 12 5 ,P =0 .0 0 3 6) ;VEGF与p5 3表达阴阳性一致率为 5 1.2 %。VEGF和 p5 3共同阳性表达组MVD值最高 ( 4 2 .7+-2 2 .4) ,而VEGF和 p5 3共同阴性表达组MVD值为最低 ( 2 3 .3 +-2 0 .1) ,差别显著 (P =0 .0 0 77)。结论 :p5 3和VEGF共同参与骨肉瘤血管生成并有协同作用。多血管质骨肉瘤侵袭性强并易发早期转移。

Objective:To investigate VEGF,p53 expression and MVD in osteosarcoma and address the effect of VEGF and p53 mutation in the progression and metastases of osteosarcoma.Methods:The specimens from 57 patients with primary localized osteosarcoma and 27 patients with osteosarcoma that were metastatic at the time of diagnosis were stained immunohistochemically for VEGF and p53,MVD and counted,the results were comparatively analyzed.Results:The positive expression rates of VEGF and MVD in group of patients who presented with metastases were higher than in group of those who presented with a localized osteosarcoma( P =0.0494, P =0.0302);p53 expression did not differentiate in the two groups ( P >0.05);The tumors in the metastatic group tend to be larger than those in the local group ( P =0.0350);MVD was significantly higher in the VEGF or p53 positive tumors than in the negative ones( P =0.0125, P =0.0036);The conformable rate of VEGF and p53 expression was 51.2%; MVD was the highest in VEGF and p53 positive co expression tumors,and was lowest in those VEGF and p53 negative tumors,differences were significant( P =0.0077).Conclusion:Both VEGF and p53 mutation irritate angiogenesis in osteosarcoma.Osteosarcomas with more angiogenesis are more aggressive and earlier to metastasis.