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目的：探讨p21(WAF1/CIP1)基因mRNA及p21WAF1蛋白、PCNA（增殖细胞核抗原）与骨肉瘤的发生、发展之间的关系及其对预后的评价。方法：采用原位杂交及免疫组化法（LSAB法）检测p21(WAF1/CIP1)基因mRNA及p21WAF1蛋白、PCNA在骨肉瘤中的表达。结果：原位杂交结果显示，p21(WAF1/CIP1)mRNA在45例骨肉瘤中有19例阳性表达，阳性率为42％；在10例骨纤维结构不良中有8例阳性表达，阳性率为80％。免疫组化结果显示，p21(WAF1)蛋白在45例骨肉瘤中有8例阳性表达，阳性率为17.7％；在10例骨纤维结构不良有5例阳性表达，阳性率为50％。PCNA在45例骨肉瘤中均有表达，阳性率为100％。p21(WAF1/CIP1)mRNA表达阳性者术后生存时间与p21(WAF1/CIP1)mRNA表达阴性者术后生存时间之间的差异有显著性（P<0.05）。结论：①随着骨肿瘤恶性度的升高，p21(WAF1/CIP1)mRNA及p21WAF1蛋白的表达下降；②p21(WAF1/CIP1)mRNA及p21WAF1蛋白表达的数量和水平的下降是导致人类骨组织发生恶性骨肿瘤的可能原因之一；③随访结果显示，p21(WAF1/CIP1)mRNA在骨肉瘤中的表达对预后有影响。
Objective: To investigate the relationship between p21 (WAF1/CIP1) mRNA and p21WAF1 protein, PCNA (proliferating cell nuclear antigen), and the occurrence and development of osteosarcoma and its evaluation of prognosis. Methods: The expression of p21(WAF1/CIP1) mRNA and p21WAF1 protein and PCNA in osteosarcoma were detected by in situ hybridization and immunohistochemistry (LSAB). RESULTS: The results of in situ hybridization showed that the expression of p21(WAF1/CIP1) mRNA was positive in 19 of 45 cases of osteosarcoma, with a positive rate of 42%. In 10 cases of structural defects of bone fibers, there were 8 cases of positive expression. 80%. The results of immunohistochemistry showed that the expression of p21(WAF1) protein was positive in 8 out of 45 cases of osteosarcoma, and the positive rate was 17.7%. In 10 cases of structural dysplasia of bone, there were 5 cases of positive expression, and the positive rate was 50%. PCNA was expressed in 45 cases of osteosarcoma, and the positive rate was 100%. There was a significant difference between the survival time of p21 (WAF1/CIP1) mRNA expression and postoperative survival time of p21 (WAF1/CIP1) mRNA negative patients (P<0.05). Conclusions:1 With the increase of the malignant degree of bone tumors, the expression of p21 (WAF1/CIP1) mRNA and p21WAF1 protein decreased; the decrease of the number and level of 2p21 (WAF1/CIP1) mRNA and p21WAF1 protein expression resulted in human bone tissue formation. One of the possible causes of malignant bone tumors; 3 Follow-up results showed that the expression of p21 (WAF1/CIP1) mRNA in osteosarcoma has an impact on prognosis.