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目的 :探讨受体相互作用蛋白激酶4(receptor interacting protein kinase 4,RIPK4)、β-catenin和P-糖蛋白(P-glycoprotein,P-gp)在骨肉瘤组织中的表达及其临床意义。方法:应用免疫组织化学法检测36例骨肉瘤和15例骨软骨瘤组织中RIPK4、β-catenin和P-gp的表达情况,分析三者的表达与骨肉瘤患者临床病理特征及预后之间的关系。结果:RIPK4、β-catenin和P-gp在骨肉瘤组织中的阳性表达率分别为63.9%、75.0%和61.1%,均高于这3个蛋白在骨软骨瘤组织中的阳性表达率(6.7%、20.0%和0.0%)(P值均<0.05)。RIPK4的表达与肿瘤大小以及Enneking分期相关(P值均<0.05);β-catenin的表达与Enneking分期相关(P<0.05);P-gp的表达与Enneking分期和转移相关(P值均<0.05)。RIPK4与β-catenin(γ=0.634,P<0.01)、β-catenin与P-gp(γ=0.461,P<0.01)、RIPK4与P-gp(γ=0.468,P<0.01)在骨肉瘤组织中的表达均呈正相关。Kaplan-Meier生存分析发现,RIPK4、β-catenin和P-gp阳性表达组患者的生存时间均短于阴性表达组(P值均<0.05)。单因素COX回归分析发现,年龄、Enneking分期、转移、RIPK4和P-gp蛋白的阳性表达与患者总生存时间相关(P值均<0.05);多因素COX回归分析证实,年龄、转移和P-gp蛋白的阳性表达可作为骨肉瘤患者独立的预后因素子(P值均<0.05)。结论:RIPK4、β-catenin和P-gp在骨肉瘤组织中高表达,且与骨肉瘤的病理特征相关;三者在骨肉瘤发生和发展的过程中起着重要作用,并能影响患者的预后。
Objective: To investigate the expression of receptor interacting protein kinase 4 (RIPK4), β-catenin and P-glycoprotein (P-gp) in osteosarcoma and its clinical significance. Methods: The expressions of RIPK4, β-catenin and P-gp in 36 specimens of osteosarcoma and 15 specimens of osteochondroma were detected by immunohistochemistry. The relationship between the expression of these three proteins and the clinicopathological characteristics and prognosis of osteosarcoma relationship. Results: The positive rates of RIPK4, β-catenin and P-gp in osteosarcoma tissues were 63.9%, 75.0% and 61.1%, respectively, which were higher than those of the three proteins in osteochondroma (6.7 %, 20.0% and 0.0% respectively) (P <0.05). The expression of RIPK4 was correlated with tumor size and Enneking staging (P <0.05). The expression of β-catenin was correlated with Enneking staging (P <0.05). The expression of P-gp was correlated with Enneking staging and metastasis ). The expressions of RIPK4 and P-gp (γ = 0.434, P <0.01) in the group of osteosarcoma In the expression were positively correlated. Kaplan-Meier survival analysis showed that the survival time of RIPK4, β-catenin and P-gp positive expression group were shorter than that of negative expression group (all P <0.05). Univariate COX regression analysis showed that age, Enneking staging, metastasis, RIPK4 and P-gp protein expression were positively correlated with overall survival (P <0.05). Multivariate Cox regression analysis confirmed that age, metastasis and P- The positive expression of gp protein could be an independent prognostic factor for osteosarcoma patients (all P <0.05). Conclusion: The expression of RIPK4, β-catenin and P-gp are highly expressed in osteosarcoma tissue and correlated with the pathological characteristics of osteosarcoma. All three play an important role in the development and progression of osteosarcoma and can affect the prognosis of patients.