Ezrin表达变化及其对原发性骨肉瘤预后的意义  

Prognostic Significance of Changes in Ezrin Expression in Primary Osteosarcoma

作　　者：尚希福[1] 王姚斐[1] 李旭[1] 吴科荣[1] 凌晓冬[1] 沈靖南[2] 王晋[2] 

机构地区：[1]安徽医科大学附属安徽省立医院骨科,合肥市230001 [2]中山大学附属第一医院骨肿瘤科

出　　处：《中国肿瘤临床》2012年第24期2080-2084,共5页Chinese Journal of Clinical Oncology

基　　金：安徽省自然科学基金项目(编号:1208085QH161)资助~~

摘　　要：目的:了解Ezrin在术前新辅助化疗前、后表达的变化情况以及其对骨肉瘤预后的意义。方法:收集25例Ezrin表达阳性的原发性无转移骨肉瘤患者在新辅助化疗前的活检标本及化疗后的手术标本,用RT-PCR检测同一患者在化疗前、后标本中Ezrin表达的变化情况,分析Ezrin表达变化与各临床病理指标之间的关系,再对所有患者进行生存分析,找出与骨肉瘤患者生存相关的独立预后因素。结果:25例原发性骨肉瘤患者中有64%在术前化疗后Ezrin表达发生显著下调,另有36%未见明显变化。Ezrin表达变化显著者与骨肉瘤的病理类型(P=0.037)、恶性程度(P=0.006)、对化疗反应(P=0.017)及转移或复发(P=0.041)密切相关。单因素分析显示总生存率、无病生存率与Ezrin表达变化(P=0.001、P=0.002)及对术前化疗反应有统计学相关性(P=0.001、P=0.002),多因素分析显示Ezrin表达变化是骨肉瘤患者无病生存率的独立预后因素(P=0.014)。结论:Ezrin在术前新辅助化疗前、后的表达变化与骨肉瘤预后密切相关,可据此将患者分为复发和转移的高危患者和低危患者,从而采取相应的治疗方案。Objective： This work aims to investigate the changes in ezrin expression after preoperative chemotherapy and to analyze the prognostic value of ezrin in patients with primary osteosarcoma. Methods： The mRNA expression levels of ezrin in prechemotherapy primary biopsy specimens and postchemotherapy surgical specimens in 25 patients with primary osteosarcoma were determined by semi-quantitative reverse transcription polymerase chain reaction to evaluate the changes in ezrin expression. Related prognostic factors, as well as the relationship between clinical characteristics and changes in ezrin expression, were analyzed. Results： Decreased ezrin expression was observed in 16 patients （64%）, whereas no change in ezrin expression was identified in 6 patients （36%）. The changes in ezrin expression have close correlations with histology （P=0.037）, grading （P=0.006）, chemotherapeutic response （P=0.017）, and metastasis or recurrence （P=-0,041）. Two-year overall survival and event-free survival rates are associated with changes in ezrin expression （P=- 0.001 and P=-0.002, respectively） and with responses to preoperative chemotherapy （P=-0.001 and P=0.012, respectively）. Multivariate analysis denotes ezrin as an independent prognostic factor for event-free survival in non-metastatic osteosarcoma （P=0.014）. Conclusions： A close relationship exists between ezrin expression and prognosis of osteosarcoma. Osteosarcoma patients can be categorized into high- and low-risk groups on the basis of the potential metastasis and recurrence of the disease, thereby providing proper homologous treatments to osteosarcoma patients.

关 键 词：骨肉瘤 预后 EZRIN 生存 转移 

分 类 号：R738[医药卫生—肿瘤]