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目的探讨骨膜蛋白基因表达在骨肉瘤中的特征及其相关性。方法原发性骨肉瘤患者69例,取其骨肉瘤标本和瘤旁正常组织各69份,采用反转录-PCR法检测标本中mRNA表达量,比较骨肉瘤组织和瘤旁组织骨膜蛋白mRNA表达水平,以骨肉瘤组织中骨膜蛋白mRNA表达量中位数(2.68)为界分为高表达组(≥2.68)44例和低表达组(<2.68)25例,分析骨膜蛋白mRNA表达水平与骨肉瘤临床特征的关系,采用Kaplan-Meier法分析生存率,采用Cox回归模型分析骨肉瘤发生的危险因素。结果骨肉瘤组织骨膜蛋白mRNA表达量(3.06±0.87)高于瘤旁组织(0.90±0.35),转移者骨膜蛋白mRNA表达量(5.04±1.47)高于未转移者(2.39±0.65),高恶性程度者骨膜蛋白mRNA表达量(4.59±1.39)高于低恶性程度者(2.52±0.76)(P<0.05);高表达组高恶性程度发生率(86.96%)、复发率(87.50%)和转移率(83.33%)高于低表达组(13.04%、12.50%、16.67%)(P<0.05),生存时间[(42.8±8.9)个月]短于低表达组[(53.3±10.9)个月](P<0.05),年龄、性别、肿瘤直径、侵袭部位与低表达组比较差异无统计学意义(P>0.05);Cox回归模型分析显示骨肉瘤的高恶性程度(OR=2.103,95%CI:1.060~4.175,P=0.034)、复发(OR=2.224,95%CI:1.029~4.808,P=0.042)、术前转移(OR=3.040,95%CI:1.307~7.072,P=0.010)及骨膜蛋白mRNA高表达(OR=6.478,95%CI:2.463~17.039,P=0.001)是骨肉瘤患者不良预后的独立危险因素。结论骨膜蛋白与骨肉瘤恶性程度、转移情况和预后密切相关。
Objective To investigate the characteristics of periostin gene expression in osteosarcoma and its correlation. Methods Sixty-nine patients with primary osteosarcoma were enrolled in this study. Sixty-nine osteosarcoma specimens and 69 normal para-tumor tissues were obtained. The mRNA expression of osteosarcoma and peritumoral tissue were detected by RT-PCR. (44 cases of high expression group (≥2.68) and 25 cases of low expression group (<2.68)). The expression of periostin mRNA was compared with that of flesh and blood Tumor characteristics of the relationship between the use of Kaplan-Meier analysis of survival rate, the use of Cox regression model analysis of osteosarcoma risk factors. Results The expression of periostin mRNA in osteosarcoma was (3.06 ± 0.87) higher than that in peritumoral tissue (0.90 ± 0.35), and the expression of periostin mRNA in metastatic osteosarcoma was 5.04 ± 1.47 (2.39 ± 0.65) (4.59 ± 1.39) were higher than those with low malignancy (2.52 ± 0.76) (P <0.05). The high malignant degree (86.96%), recurrence rate (87.50%) and metastasis (83.33%) were higher than those in the low expression group (13.04%, 12.50%, 16.67%, P <0.05), and the survival time was (42.8 ± 8.9) months shorter than the low expression group (53.3 ± 10.9 months There was no significant difference in age, sex, tumor diameter and invasion site between the two groups (P> 0.05). Cox regression analysis showed that the malignant degree of osteosarcoma (OR = 2.103, 95% (OR = 3.040, 95% CI: 1.307-7.072, P = 0.010), recurrence (OR = 2.224, 95% CI: 1.029-4.0880, P = 0.042) (OR = 6.478, 95% CI: 2.463-17.039, P = 0.001) were the independent risk factors of poor prognosis in patients with osteosarcoma. Conclusion Periosteum protein is closely related to the malignant degree, metastasis and prognosis of osteosarcoma.