骨肉瘤中血管生成拟态现象的初步研究和预后相关性分析  

Pilot Study and Prognostic Correlation Analysis of Vascularization Mimicry in Osteosarcoma

作　　者：黄永明[1] 黄启明 徐逸生[1] 石宇雄[1] 张宗富[1] 练文兴[1] 苏海涛[1] 刘军[1] 

机构地区：[1]广东省中医院大学城医院骨科,广东广州510006 [2]北京弘润天源生物技术有限公司,北京100085

出　　处：《广州中医药大学学报》2013年第2期165-168,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技厅社会发展领域科技计划项目(编号:83031);广东省中医药管理局科研基金资助课题(编号:2070091)

摘　　要：【目的】通过检测临床骨肉瘤患者手术后组织石蜡标本,观察骨肉瘤中是否存在血管生成拟态现象,探讨骨肉瘤血管生成拟态的临床意义。【方法】收集广东省中医院2000-2009年间病理科石蜡包埋的骨肉瘤组织切片57例,其中44例骨肉瘤患者临床和预后资料完整,并以此44例骨肉瘤组织切片和相关信息做为研究对象,复习切片明确诊断后,通过免疫组化方法进行CD31和过碘酸雪夫(PAS)双重染色,检测骨肉瘤组织中血管生成拟态存在与结构,结合患者临床和预后信息统计分析与血管生成拟态相关性,阐述血管生成拟态的临床意义。【结果】免疫组化检测发现临床44例骨肉瘤中16例(36.36%)具有血管生成拟态发生,统计分析发现血管生成拟态发生与患者年龄、肿瘤发生的部位之间无相关性(P﹥0.05),但是发现有转移患者与无转移患者血管生成拟态发生之间比较差异具有统计学意义(P<0.05),而且肿瘤的大小与血管生成拟态发生之间也有明显的相关性(P<0.01)。【结论】骨肉瘤中存在血管生成拟态现象,血管生成拟态发生与骨肉瘤患者发生转移和肿瘤的大小密切相关。血管生成拟态发生可能是骨肉瘤患者预后的不利因素,有血管生成拟态的患者易发生转移和肿瘤不断增殖,影响骨肉瘤患者预后的改善,其预后比无血管生成拟态的患者差。Objective To explore the existence and the clinical significance of osteosarcoma vascularization mimicry （VM） through the observation of Paraffin sections of tumor tissues of postoperative osteosarcoma patients. Methods We have collected 57 osteosarcoma biopsy slices from the department of pathology of Guangdong Provincial Hospital of Traditional Chinese Medicine from the year of 2000 to 2009. Of the 57 cases, we picked out 44 cases which had whole clinical and prognostic data as the study object. The osteosarcoma biopsy slices and clinic information of 44 cases were studied. These tissues slices were stained by CD31 and PAS, and were examined by immunohistochemistry method. The existence and structure of VM were analyzed. We investigated the correlation of VM with clinical and prognostic information, and evaluated clinical significance of VM after statistical analysis. Results The immunohistochemical results showed that VM was shown in 16 （36.36%） among 44 cases. There was no correlation of VM with the age of patients, or tumor focus （P 〉 0. 05 ） . However, there were significant statistical differences of VM between metastasis osteosarcoma patients and non-metastasis osteosarcoma patients （ P 〈 0. 05 ） , and obvious correlation was found between the tumor mass size and VM （ P 〈 0.01 ）. Conclusion VM occurs in osteosarcoma patients, and is closely related with the metastasis and tumor mass size in osteosarcoma patients. VM is the possible factor of bad prognosis for osteosarcoma patients. The osteosarcoma patients with VM are apt to have metastasis and tumor proliferation, and has worse prognosis than the patients without VM.

关 键 词：骨肉瘤 临床预后因素 血管生成拟态 转移 

分 类 号：R738.1[医药卫生—肿瘤]