Necdin基因在人骨肉瘤中的表达及其临床意义  

Expression of Necdin gene in human osteosarcoma and its clinical significance

作　　者：武壮壮 申振 武太勇 王佳妮 李健[3] 陈士伟 靳文轩 杨美菊 吕智[1] WU Zhuang-zhuang;SHEN Zhen;WU Tai-yong;WANG Jia-ni;LI Jian;CHEN Shi-wei;JIN Wen-xuan;YANG Mei-ju;LüZhi(The Second Hospital,Shanxi Medical Universi-ty,Taiyuan 030001,China;Jincheng People's Hospital,Jincheng 048000,China;Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院,山西太原030001 [2]晋城市人民医院,山西晋城048000 [3]山西医科大学,山西太原030001

出　　处：《中国矫形外科杂志》2022年第9期769-774,共6页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81772867);山西省自然科学基金项目(编号:201801D121325);山西医科大学第二医院青年基金项目(编号:202002-4);山西省基础研究计划项目(自由探索类)(编号:20210302124419)。

摘　　要：[目的]观察Needin(NDN)基因在骨肉瘤中的表达,探讨其与骨肉瘤患者临床病理因素及预后的关系。[方法]回顾性研究2009年10月-2019年7月手术治疗的51例骨肉瘤患者的临床资料,活检术确认后行新辅助化疗,瘤段切除与假体重建术。评价临床效果和组织NDN的表达。[结果]本组51例患者均得到随访38个月以上,术后生存时间最长为78个月,最短者为16个月。随访过程中,局部复发16例,转移33例。末次随访时无瘤生存10例,带瘤生存5例,死亡36例。按末次随访结局分组比较。死亡组中Ⅱ_(B)、Ⅲ期所占比例明显高于无瘤生存组和带瘤生存组(P<0.05),死亡组中术前肺转移率明显高于生存组和带瘤生存组(P<0.05)。而三组间年龄、性别、肿瘤大小和NDN检测结果的差异均无统计学意义(P>0.05)。组织NDN免疫组化染色阳性率骨肉瘤组织为29.41%(15/51),而瘤旁正常骨组为80.00%(8/10),差异有统计学意义(P<0.05)。Kaplan-Meier生存期及对数等级比较表明,不同Enecking分期、是否肺转移、不同肿瘤大小、是否NDN阳性的患者平均生存时间的差异均有统计学意义(P<0.05)。Cox分析表明,Ennecking分期(HR=1.530)、肺转移(HR=4.662)、肿瘤大小(HR=3.398)是生存的危险因素,而NDN阳性(HR=0.207)是生存的保护性因素。[结论]瘤组织中NDN阳性表达显著低于瘤旁正常骨组织。术前Ennecking分期高、肺转移、肿瘤≥5 cm是骨肉瘤不良预后的危险因素,NDN阳性表达是保护因素。[Objective]To observe the expression of Necdin(NDN)gene in osteosarcoma,and to explore its relationship with clinico-pathological factors and prognosis of osteosarcoma.[Methods]A retrospective study was performed on 51 patients who received neoadju-vant chemotherapy,as well as tumor segment resection and prosthetic reconstruction after osteosarcoma was confirmed by biopsy in our hos-pital from October 2009 to July 2019.The clinical outcomes,NDN expression in tssue were evaluated.[Results]All the 51 patients were followed up for more than 38 months,with survival time of 78 months in the longest and 16 months in the shortest.During the fllow-up,16 patients got local recurrence and 33 patients had metastasis.At the latest follow-up,10 patients were of survival with tumor-free(STF),5 patients of survival with tumor(ST),and 36 patients died(death).In term of grouping comparison based on the outcome at the latest fllow-up,the proportion of stage Ⅱ_(B) and stage Ⅲ in the death group was significantly higher than that in the tumor-free survival group and the tu-mor-bearing survival group(P<0.05),and the death group had significantly higher ratio of lung metastasis than the STF and ST groups(P<0.05).However,there were no signifcant differences in terms of age,gender,tumor size and NDN expression among the three groups(P>0.05).The positive rate of NDN immunohistological staining was of 29.41%(15/51)in osteosarcoma tssues,whereas 80%(8/10)in normal bone tssues around the tumor,which was satistically significant(P<0.05).As results of Kaplan-Meier survival analysis and log-rank test,.the mean survival time proved significantly different in terms of different Ennecking stage,lung metastasis,tumor size and NDN(P<0.05)。With regarding to Cox analysis,the Ennecking stage(HR=1.530),lung metastasis(HR=4.662)and tumor size(HR=3.398)were risk factors for survival,while positive NDN(HR=0.207)were protective factors for survival.[Conclusion]The osteosarcoma tssue has significantly lower positive NDN expression than the adjacent no

关 键 词：骨肉瘤 NECDIN 生存 临床意义 

分 类 号：R738.1[医药卫生—肿瘤]