骨肉瘤组织中血管生成拟态的表现及预后意义  

Manifestation of vasculogenic mimicry in osteosarcoma and its prognostic significance

作　　者：任可[1] 陆晓 黄伟谦 施鑫[3] 吴苏稼[3] 孙晓亮[1] 

机构地区：[1]常州市第一人民医院骨一科,江苏常州213003 [2]解放军八一医院肿瘤生物治疗中心实验室,210002 [3]南京军区南京总医院骨科,210002

出　　处：《临床肿瘤学杂志》2015年第3期238-243,共6页Chinese Clinical Oncology

基　　金：江苏省自然科学基金资助项目(BK2012775);常州市卫生局重大科技项目(ZD201404)

摘　　要：目的探讨骨肉瘤组织中血管生成拟态(VM)的存在情况及其与临床病理特征和预后的关系。方法收集骨肉瘤标本66例,采用CD34和PAS双重染色方法检测骨肉瘤组织中VM存在情况,探讨骨肉瘤VM与临床病理特征和预后的相关性以及VM与黏着斑激酶(FAK)、迁移诱导基因(Mig)-7表达的关系。结果 66例骨肉瘤中存在15例VM,阳性率为22.7%。骨肉瘤VM与患者性别、年龄、肿瘤直径、肿瘤部位、术式及术前化疗坏死率无关。VM(+)组FAK及Mig-7的阳性表达率均高于VM(-)组。VM(+)组患者的总生存期和无转移生存期均短于VM(-)组患者(P<0.05),Cox风险比例回归模型显示VM和术前化疗效果是预测骨肉瘤生存期和发生转移的两个独立预后因素。结论 VM存在于骨肉瘤组织中并且是其重要的预后指标,FAK及Mig-7与骨肉瘤VM的形成有密切关系。Objective To investigate whether vasculogenic mimicry（VM） was present in osteosarcoma and its relevance with patients＇ elinicopathologic features and prognosis. Methods VM was assessed in osteosarcoma by CD34/PAS double-staining of speci- mens from 66 patients. VM channels were verified to be of osteoblastic origin by staining for osteonectin and osteocalcin, and tumors were also immunohistochemically stained for focal adhesion kinase（FAK） and migration inducing gene-7（Mig-7） to determine whether these markers are associated with the occurrence of VM. The relevance of VM with the prognosis was also investigated. Results VM was observed in 15 of the 66 osteosarcoma samples（ 22. 7% ）, and the incidence of VM didn＇t differ with respect to patient sex, age, tumor size, tumor site, surgical type or histological response to pre-operative chemotherapy. However, Kaplan-Meier survival analysis determined that the presence of VM and the tumor necrosis rate after pre-operative chemotherapy were associated with both the overall survival （ P = 0. 011 and 0. 040, respectively） and metastasis-free survival （ P = 0. 002 and 0. 045, respectively）. Furthermore, Cox pro- portional hazards analysis showed that the presence of VM and the histological response to pre-operative chemotherapy were independent indicators for both poor overall survival（ P = 0. 007 and 0. 024, respectively） and poor metastasis-free survival （P = 0. 002 and 0. 027, respectively）. The expression level of FAK and Mig-7 were higher in VM group than non-VM group （P = 0. 017 and 0. 021, respective- ly）. Conclusion These results demonstrate the presence of VM in osteosarcoma and suggest that VM is an unfavorable prognostic fac- tor with FAK and Mig-7 expression as a potential associated mechanism of VM formation in osteosarcoma.

关 键 词：血管生成拟态 骨肉瘤 黏着斑激酶(FAK) 迁移诱导基因-7(Mig-7) 预后 

分 类 号：R738.1[医药卫生—肿瘤]