CAJ | 학술논문

目的：本实验旨在研究骨肉瘤组织中 H19基因的特异性表达模式，探讨其在骨肉瘤发生发展、浸润转移中的作用及其与预后的关系。方法收集并筛选出2009年至2010年就诊的骨肉瘤患者手术切除标本30例，采集临床指标包括患者性别、年龄、发病部位、大小、Enneking分期、组织病理学分型、有无肺转移及术后随访患者生存情况。应用PCR、RT-PCR及限制性内切酶( AluI )酶切等方法，检测30例骨肉瘤组织中H19基因的印迹状态，分析H19基因印迹丢失及其与骨肉瘤各临床病理因素参数之间的关系。结果(1) H19基因印迹丢失率在骨肉瘤组织中为41.67%，瘤近旁组织中为16.67%，瘤远旁组织中为8.33%。Kappa相关分析结果表明，上述不同组织中 H19基因印迹丢失的发生频率间存在显著相关性( P＜0.05)。(2)单因素方差分析结果表明，H19基因的印迹丢失与骨肉瘤患者 Ennecking 分期、肺转移灶的存在与否有关( P＜0.05)，而与患者的性别、年龄、部位、大小和病理分型无关( P＞0.05)。(3) Log-rank单因素生存分析表明， H19基因印迹丢失、肿瘤分期、病理学分类及转移灶的存在与否和骨肉瘤患者预后相关( P＜0.05)，而性别、年龄、发病部位与患者预后无关( P＞0.05)。H19基因印迹丢失骨肉瘤患者的生存率明显降低，其差异具有统计学意义( P＜0.05)。结论骨肉瘤组织中H19基因印迹状态的改变，对骨肉瘤的发生发展、浸润转移起重要作用并与患者的不良预后相关，可能成为预测患者预后情况的新靶点。
목적：본실험지재연구골육류조직중 H19기인적특이성표체모식，탐토기재골육류발생발전、침윤전이중적작용급기여예후적관계。방법수집병사선출2009년지2010년취진적골육류환자수술절제표본30례，채집림상지표포괄환자성별、년령、발병부위、대소、Enneking분기、조직병이학분형、유무폐전이급술후수방환자생존정황。응용PCR、RT-PCR급한제성내절매( AluI )매절등방법，검측30례골육류조직중H19기인적인적상태，분석H19기인인적주실급기여골육류각림상병리인소삼수지간적관계。결과(1) H19기인인적주실솔재골육류조직중위41.67%，류근방조직중위16.67%，류원방조직중위8.33%。Kappa상관분석결과표명，상술불동조직중 H19기인인적주실적발생빈솔간존재현저상관성( P＜0.05)。(2)단인소방차분석결과표명，H19기인적인적주실여골육류환자 Ennecking 분기、폐전이조적존재여부유관( P＜0.05)，이여환자적성별、년령、부위、대소화병리분형무관( P＞0.05)。(3) Log-rank단인소생존분석표명， H19기인인적주실、종류분기、병이학분류급전이조적존재여부화골육류환자예후상관( P＜0.05)，이성별、년령、발병부위여환자예후무관( P＞0.05)。H19기인인적주실골육류환자적생존솔명현강저，기차이구유통계학의의( P＜0.05)。결론골육류조직중H19기인인적상태적개변，대골육류적발생발전、침윤전이기중요작용병여환자적불량예후상관，가능성위예측환자예후정황적신파점。
Objective To study the speciifc expression pattern of H19 gene in osteosarcoma tissues, and to explore its role in the carcinogenesis, progression, invasion and metastasis of osteosarcoma and its relationship with the prognosis. Methods 30 patients with osteosarcoma were selected from those who were treated in our hospital from 2009 to 2010, and 30 surgical excision specimens were obtained. Patients’ information was obtained, including the gender, age, location of lesions, staging according to the Enneking system, histopathological type, with or without lung metastases and survival of patients in the postoperative follow-up. The imprinting status of H19 gene was determined by the Polymerase Chain Reaction ( PCR ), Reverse Transcription-PCR ( RT-PCR ) and restrictive endonuclease ( AluI ) digestion in 30 patients with osteosarcoma. The loss of imprinting ( LOI ) of H19 gene and its relationship with different clinicopathologic parameters of osteosarcoma were studied. Results ( 1 ) The LOI rate of H19 gene was 41.67%in osteosarcoma tissues, 16.67%in adjacent neighboring tissues and 8.33%in distant neighboring tissues. The Kappa results of correlation analysis showed that the occurrence frequencies of LOI of H19 gene among different kinds of tissues stated above were signiifcantly correlated ( P<0.05 ). ( 2 ) One-way analysis of variance ( ANOVA ) revealed that the LOI of H19 gene in osteosarcoma were related with the Ennecking staging and lung metastases or not ( P<0.05 ). However, it was irrelevant with the gender, age, location, size and pathological type of patients ( P>0.05 ). ( 3 ) Log-rank univariate survival analysis suggested that the LOI of H19 gene, tumor staging, pathological type and presence of metastases or not were related with the prognosis of patients with osteosarcoma ( P<0.05 ), but the gender, age or location of lesions were not related with the prognosis ( P>0.05 ). The survival rate of the patients with the LOI of H19 gene was signiifcantly declined, and the differences were statistically signiifcant ( P<0.05 ). Conclusions The changes of imprinting status of H19 gene in osteosarcoma mean that it plays an important role in the carcinogenesis,progression, invasion and metastasis of osteosarcoma, and is related with the poor prognosis. It may become the new target to predict the patients’ prognosis.