骨巨细胞瘤的表达因子及相关性研究

目的评价凋亡抑制蛋白Survivin和环氧化酶-2（cyclooxygenase-2,COX-2）在骨巨细胞瘤（giant cell tumor of bone,GCT）发生、发展中的作用,探讨影响GCT预后的因素。方法采用免疫组织化学链霉菌抗生素蛋白-过氧化酶（streptavidin-peroxidase,S-P）染色法对39例GCT组织和4例正常骨组织的Survivin与COX-2蛋白表达进行检测,并结合临床、病理资料进行分析。结果 GCT JaffeⅠ、Ⅱ、Ⅲ级中Survivin蛋白的阳性表达率分别为18.2%、68.8%和83.3%,COX-2蛋白的阳性表达率分别为36.4%、81.3%和100.0%,正常对照组均未见Survivin蛋白和COX-2蛋白表达。Survivin蛋白和COX-2蛋白的表达分别与Jaffe病理分级呈正相关,而与患者性别、年龄无关。两种蛋白表达具有中度一致性。Logistic回归分析显示瘤段截除植骨术明显降低GCT的复发率,Survivin蛋白和COX-2蛋白均不是预后的独立危险因素。结论 Survivin蛋白和COX-2蛋白可能参与GCT的发生、发展,为GCT的预后判断及开发Survivin蛋白和COX-2蛋白为GCT的靶向治疗提供实验依据。

Expression and the relationship of Survivin and COX-2 with giant cell tumor of bone

Objective To evaluate the value of Survivin and COX-2 in pathogenesis of giant cell tumor of bone （GCT）and discuss the prognostic factors of GCT.Methods The protein expressions of Survivin and COX-2 in different Jaffe grades of GCT tissue and the normal bone tissue were observed by immunohistochemical staining S-P method.And the clinicopathological factors were analyzed.Results In JaffeⅠ,Ⅱ,Ⅲof GCT tissue,the positive expressions of Survivin protein were 18.2%,68.8%and 83.3%;and that of COX-2 were 36.4%,81.3%and 100.0%,respectively. Immuno-staining was negative in the normal bone tissue.There was significant correlation between the expression of Survivin or COX-2 and pathologic grade,but not with sex,age.There was middling consistency between the expression of Survivin and COX-2 in GCT.It was found that neoplasm resection with autogenous bone graft could reduce recurrence rate obviously by logistic regression analysis.Survivin or COX-2 was not an independent risk of prognosis.Conclusion Survivin and COX-2 may participate in the development of GCT,which may provide an experimental evidence for gene targeted therapy and prognosis in GCT.