84例骨肉瘤生存分析  

Multivariate Survival Analysis for 84Osteosarcoma

作　　者：王晋[1] 沈靖南[1] 韩士英[1] 李佛保[1] 廖威明[1] 吴惠茜[2] 丘钜世[2] 郑迎东[3] 

机构地区：[1]中山医科大学附属第一医院骨科,广州市510080 [2]中山医科大学病理教研室 [3]中山医科大学统计教研室

出　　处：《中国肿瘤临床》2002年第4期245-248,251,共5页Chinese Journal of Clinical Oncology

基　　金：卫生部优秀人才基金(99Q-018);1995年度国家教委霍英东基金资助

摘　　要：目的:分析骨肉瘤预后的相关因素,评价骨肉瘤和多药耐药基因的关系。方法:检测骨肉瘤中MDR1/P-gp的表达,多因素统计生存分析。结果:84例骨肉瘤平均随访21.3个月,28.6%(24/84)1年内发生肺转移;3年生存率为42.9%;P-gp表达阳性率55.1%,等级相关分析显示P-gp表达与1年内肺转移率成等级正相关;COX模型分析显示:P-gp表达及扁骨部位骨肉瘤是无瘤生存期及生存时间的危险因素,年龄和病程是无瘤生存期及生存时间的保护因素。结论:骨肉瘤患者预后的高危因素是MDR1的表达及扁骨部位的骨肉瘤,保护因素是年龄和病程,大剂量新辅助化疗是改善骨肉瘤预后的关键。Objective:High-dose adjuvant chemotherapy is the most essential for successful treatment of osteosarcoma ,but MDR is the common reason for treatment failure.Objective:Discuss the outcome factors of related and risk of adverse events in osteosarcoma and evaluate the rela tion between osteosarcoma and MDR.Methods:Multiparameter assays:including assessments of P-gp by immunohistochemical.Result:The follow-up time for84patients is21.34months in the average,28.6%(24/84)for Lung metastasis in one year,Life-table showed that the survival rate is42.87%in three years;The positive percentage of P-gp is55.1%,Rank correlation are significant between P-glycoprotein expression and lung metastasis,with COX regression model ex pression of P-gp and osteosarcoma from flat bone are risk factors of survival time and event-free survival,but age and process of disease are protective factors.Conclusion:With the prognostic value of84osteosarcoma ,the risk factors is expression of MDR1and osteosarcoma from flat bone,but the protecting factors is age and process of disease;The high-dose adjuvant chemotherapy is the most essential for improving outcome of osteosarcoma.

关 键 词：骨肉瘤 多药耐药性 预后 生存质量 

分 类 号：R738.1[医药卫生—肿瘤]