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目的探讨骨肉瘤组织中p21WAF1基因的表达与骨肉瘤生物学特性及预后的关系。方法采用原位杂交及免疫组织化学(LSAB法)检测p21WAF1mRNA及p21蛋白在45例骨肉瘤、10例骨纤维结构不良实体瘤组织标本的表达。结果(1)p21蛋白阳性表达率在骨肉瘤中为17.7%(8/45);(2)骨肉瘤组织高分化组与低分化组的p21蛋白阳性表达率之间的差异有统计学意义(40.0%,11.4%,χ2=4.34,P<0.05);(3)p21WAF1mRNA表达阳性率在骨肉瘤中为42.2%(19/45),骨肉瘤组织高分化组与低分化组的p21WAF1mRNA阳性表达率之间的差异有统计学意义(60.0%,37.1%,χ2=20.6,P<0.01);(4)p21WAF1mRNA表达阳性者术后生存时间高于表达阴性者术后生存时间(P<0.05)。结论(1)随着骨肉瘤恶性度的升高,p21WAF1基因mRNA及p21蛋白的表达下降。(2)p21WAF1基因mRNA在骨肉瘤中的表达对评价患者的预后有一定价值。
Objective To investigate the relationship between the expression of p21WAF1 gene and the biological characteristics and prognosis of osteosarcoma in osteosarcoma. Methods The expression of p21WAF1mRNA and p21 protein in 45 osteosarcoma and 10 fibrous dysplasia tissues were detected by in situ hybridization and immunohistochemistry (LSAB). Results (1) The positive rate of p21 protein in osteosarcoma was 17.7% (8/45). (2) There was a significant difference in the positive rate of p21 protein expression between osteosarcoma group and poorly differentiated group (3) The positive rate of p21WAF1mRNA in osteosarcoma was 42.2% (19/45). The positive rate of p21WAF1mRNA in well-differentiated and poorly differentiated osteosarcoma tissues was higher than that in osteosarcoma (40.0%, 11.4%, χ2 = 4.34, P < (60.0%, 37.1%, χ2 = 20.6, P <0.01). (4) The positive expression rate of p21WAF1mRNA in postoperative patients was significantly higher than that in negative patients (P <0.05). Conclusions (1) With the malignant degree of osteosarcoma, the expression of p21WAF1 mRNA and p21 protein decreased. (2) The expression of p21WAF1 mRNA in osteosarcoma has some value in evaluating the prognosis of patients.