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目的 探讨p21w afl/cip1 基因在人骨肉瘤中的作用, 了解其在骨肉瘤、骨软骨瘤和正常骨组织中的表达。方法 应用免疫组化LSAB 法和原位杂交方法, 检测了p21wafl/cip 1 蛋白及p21w afl/cip1 基因在40 例骨肉瘤、20 例骨软骨瘤和20 例正常骨组织中的表达。并通过近4 年的临床随访,观察了骨肉瘤患者p21w afl/cip1 表达水平与临床预后之间的关系。结果 骨肉瘤组织中p21w afl/cip1 蛋白的阳性反应率和阳性反应强度均明显高于骨软骨瘤和正常骨组织,其差异有显著性意义( P< 0-05) 。骨肉瘤组织中p21w afl/cip1 基因的总体表达趋势与免疫组化基本一致,其阳性反应的41-2 % 为中度和强阳性表达,二者的阳性反应存在显著相关性( P< 0-01) 。骨软骨瘤和正常骨组织在p21 基因水平的阳性率比蛋白水平明显增高, 但全部是弱或微弱的阳性表达, 说明正常p21w afl/cip1 蛋白受多途径和多种因素的修饰。临床随访中,p21 基因高表达型患者与低表达型患者之间,在复发转移和生存时间方面差异有显著性意义( P< 0-05) ,高表达患者的生存时间短。结论 人骨肉瘤中存在p21w afl/cip1 蛋白的积聚和p21w afl/cip1 基因的过表达,并且这种蛋白的积聚和过表达与临床预后可能有关
Objective To investigate the role of p21w afl/cip1 gene in human osteosarcoma and to understand its expression in osteosarcoma, osteochondroma and normal bone tissue. Methods The expression of p21wafl/cip 1 protein and p21w afl/cip1 gene in 40 cases of osteosarcoma, 20 cases of osteochondroma and 20 cases of normal bone tissue were detected by immunohistochemical LSAB method and in situ hybridization. After 4 years of clinical follow-up, the relationship between the expression level of p21w afl/cip1 and clinical prognosis in osteosarcoma patients was observed. Results The positive reaction rate and positive reaction intensity of p21w afl/cip1 protein in osteosarcoma tissue were significantly higher than that of osteochondroma and normal bone tissue, and the difference was significant (P < 0-05). The overall expression pattern of p21w afl/cip1 gene in osteosarcoma tissues was basically consistent with that of immunohistochemistry. 41-2% of the positive reactions were positive and moderately positive. There was significant correlation between the positive responses of the two genes (P<0- 01). The positive rate of osteochondroma and normal bone tissue at the p21 gene level was significantly higher than that at the protein level, but all were weak or weakly positive, indicating that the normal p21w afl/cip1 protein was modified by multiple pathways and various factors. During clinical follow-up, there was a significant difference in recurrence metastasis and survival time between patients with high expression of p21 gene and patients with low expression (P < 0-05). The survival time of patients with high expression was short. Conclusion There is accumulation of p21w afl/cip1 protein and overexpression of p21w afl/cip1 gene in human osteosarcoma, and the accumulation and overexpression of this protein may be related to clinical prognosis.