基于血管生成拟态相关分子MIG-7的四肢骨肉瘤预后分析及风险预测模型构建  

Prognostic Analysis and Risk Prediction Model Establishment of ExtremityOsteosarcoma Based on Vasculogenic Mimicry-related Molecule MIG-7

作　　者：任可[1] 姚楠[2,3] 吴苏稼[4] 施鑫[4] 李超[1] 陆军[1] REN Ke;YAO Nan;WU Sujia;SHI Xin;LI Chao;LU Jun(Department of Orthopaedics,Zhongda Hospital,Southeast University,Nanjing 210009,China;Laboratory of Translational Medicine,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Laboratory of Translational Medicine,Jiangsu Province Academy of Traditional Chinese Medicine,Nanjing 210028,China;Department of Orthopedics,Jinling Hospital,Nanjing University,School of Medicine,Nanjing 210002,China)

机构地区：[1]东南大学附属中大医院骨科,南京210009 [2]南京中医药大学附属中西医结合医院转化医学实验室,南京210028 [3]江苏省中医药研究院转化医学实验室,南京210028 [4]东部战区总医院骨科(南京大学医学院金陵医院骨科),南京210002

出　　处：《肿瘤防治研究》2021年第1期31-37,共7页Cancer Research on Prevention and Treatment

基　　金：国家自然科学基金(81673017,31800843);江苏省自然科学基金(BK2012775)。

摘　　要：目的探讨血管生成拟态(VM)与MIG-7的关系及其在骨肉瘤预后中的作用,并构建骨肉瘤的预后预测模型。方法156例AJCCⅡ期的四肢骨肉瘤标本行MIG-7免疫组织化学染色,再行CD31/PAS双重染色观察VM,分析两者相关性。单因素和多因素Cox回归分析独立预后因素,并构建预测患者3年和5年生存率的列线图。通过一致性指数(C-index)和校正曲线验证列线图,检查预测精度。结果骨肉瘤MIG-7表达水平与VM显著相关,但MIG-7与性别、年龄、AJCCⅡA/ⅡB期、肿瘤部位、术式、术前化疗效果等临床病理参数均无相关性。生存分析显示,MIG-7表达、VM水平与术前化疗效果是预测四肢骨肉瘤患者生存时间和转移时间的独立预后因素。列线图中C-index大于0.7,校准曲线拟合良好。结论MIG-7通过促进VM形成加速骨肉瘤进展,还可能通过其他机制影响预后。列线图可为骨肉瘤患者提供较准确的预后评估和个性化诊疗决策。Objective To investigate the relation between vasculogenic mimicry(VM)and MIG-7 in osteosarcoma,as well as their roles in the prognosis,and to establish a model for predicting the prognosis of osteosarcoma.Methods VM was identified by CD31/PAS double-staining in 156 cases of AJCC stageⅡextremity osteosarcoma.Tumor samples were also immunohistochemically stained for MIG-7 to determine whether it was associated with the occurrence of VM.Univariate and multivariate Cox regression analyses were used to identify prognostic factors and a prognostic nomogram for predicting 3‑and 5‑year OS and MFS was constructed.C-index and calibration curves were used to verify the predictive accuracy of the model.Results The MIG-7 expression in osteosarcoma tissues was associated with VM formation,but MIG-7 expression was not associated with gender,age,AJCCⅡA/ⅡB stage,tumor location,surgical type or histological response to pre-operative chemotherapy.Survival analysis showed that MIG-7 expression,VM and pre-operative chemotherapy were identified as three independent prognostic factors.The value of C-index in nomogram was greater than 0.7.The predicted calibration curve was similar to the standard curve.Conclusion MIG-7 accelerates the progression of osteosarcoma by promoting VM formation,and may also affect prognosis through other mechanisms.The nomogram could afford accurate prognosis prediction and individualized diagnosis and treatment for osteosarcoma patients.

关 键 词：骨肉瘤 血管生成拟态 MIG-7 列线图 

分 类 号：R738.1[医药卫生—肿瘤]