骨肉瘤凋亡与耐药相关机制的研究进展  

Research progress of apoptosis and drug resistance mechanism of osteosarcoma

作　　者：陈楷[1] 吕书军[1] 付东[2] 李国东[2] 蔡郑东[3] 

机构地区：[1]南通大学附属海安县人民医院骨科,江苏226600 [2]同济大学附属上海第十人民医院骨科,上海200072 [3]上海市第一人民医院骨科

出　　处：《中国骨与关节杂志》2015年第1期45-49,共5页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金(81202116);教育部博士点基金(20100072120056)

摘　　要：骨肉瘤是骨科临床最常见的一种严重危害人类健康的恶性骨肿瘤，好发于青少年。常伴随截肢、肺转移、死亡等后果，其单纯手术治愈率仅15%～20%[1]。随着新辅助化疗的发展，骨肉瘤患者5年生存率已提高至70%左右[2]。凋亡异常以及耐药性的产生（尤其是多重耐药性）导致肿瘤迅速进展是骨肉瘤治疗失败的主要原因[3-4]。调控细胞凋亡异常，降低骨肉瘤的耐药性，从而提高骨肉瘤治疗效果，是降低骨肉瘤死亡率，改善患者远期预后的重要途径。笔者对近年来有关骨肉瘤凋亡以及耐药机制的研究现状进行综述，试图为探索骨肉瘤凋亡、耐药的发生机理提供新思路。Osteosarcoma is one of the most common malignant bone tumors. The cure rate of the traditional surgery is low and amputation, lung metastases and death often occur. Currently, the neoadjuvant therapy with the combination of chemotherapy and surgery is an important method in the treatment of osteosarcoma. Abnormal apoptosis and drug resistance of osteosarcoma are major causes of clinical treatment failure. The changes of various genes and protein pathways are noticed with the appearance of abnormal apoptosis and drug resistance of osteosarcoma. The most common apoptosis-related genes include B-cell lymphoma-2 （ Bcl-2 ） family （ Bcl-2, Bax et al. ）, Fas / Fas Ligand （ FasL ） family, Caspases, p53 family and so on. The drug resistance genes / proteins cover multidrug resistance-1 （ MDR-1 ）, P-glycoprotein （ P-gp ）, multi-drug resistance protein （ MRP ）, high mobility group box 1 protein （ HMGB1 ） and others. The research on these molecular pathways may help to reveal the mechanism of abnormal apoptosis and drug resistance of osteosarcoma. And we could understand the mechanism of malignant biological behaviors of osteosarcoma better. Through further studies, new targets of gene therapy for osteosarcoma may be found in the related pathways, which could bring revolutionary progress in reversing drug resistance, regulating abnormal apoptosis and improving the clinical effects in the treatment of osteosarcoma.

关 键 词：骨肉瘤 细胞凋亡 抗药性 肿瘤 药理作用分子作用机制 

分 类 号：R738.1[医药卫生—肿瘤]