CAJ | 학술논문

目的：探讨朊蛋白PrPc(cellularprionprotein)在EnnekingIII期骨肉瘤中的表达以及分析其与骨肉瘤转移和患者预后的相关性。方法采用免疫组织化学法(SP法)对初诊已发生肺转移的EnnekingIII期骨肉瘤15例以及相应瘤旁组织中朊蛋白 PrPc 的表达进行检测。同时，检测同期收治的初诊未转移骨肉瘤标本33例作为对照组。比较已有转移的骨肉瘤和未转移骨肉瘤中 PrPc 蛋白的表达水平。对2006年1月至2009年12月收住院的两组骨肉瘤患者的临床资料进行回顾性分析。收集年龄、性别、肿瘤部位、肿瘤大小、病理性骨折、生存时间等资料。应用 Kaplan-Meier 法计算患者生存年率，应用 Log-rank 检验进行单因素分析，应用Cox回归模型进行多因素分析，探讨PrPc的表达和不同的临床特征与骨肉瘤患者预后生存率之间的关系。结果 PrPc蛋白在骨肉瘤组织中普遍表达，在瘤旁组织中不表达；EnnekingIII骨肉瘤中PrPc的表达要显著高于Enneking II期对照组( P＝0.006)。Kaplan-Meier生存分析和Log-rank检验显示PrPc的表达水平与骨肉瘤患者预后相关( P＝0.010)，Enneking分期与预后相关( P＝0.025)。多因素分析显示，PrPc表达水平和肿瘤的Enneking分期可以作为骨肉瘤预后的独立影响因素。结论朊蛋白PrPc在已有转移的EnnekingIII骨肉瘤中的表达高于未转移患者。PrPc高表达的骨肉瘤患者预后较差。PrPc的高表达可能与骨肉瘤预后不良有一定相关性。
목적：탐토원단백PrPc(cellularprionprotein)재EnnekingIII기골육류중적표체이급분석기여골육류전이화환자예후적상관성。방법채용면역조직화학법(SP법)대초진이발생폐전이적EnnekingIII기골육류15례이급상응류방조직중원단백 PrPc 적표체진행검측。동시，검측동기수치적초진미전이골육류표본33례작위대조조。비교이유전이적골육류화미전이골육류중 PrPc 단백적표체수평。대2006년1월지2009년12월수주원적량조골육류환자적림상자료진행회고성분석。수집년령、성별、종류부위、종류대소、병이성골절、생존시간등자료。응용 Kaplan-Meier 법계산환자생존년솔，응용 Log-rank 검험진행단인소분석，응용Cox회귀모형진행다인소분석，탐토PrPc적표체화불동적림상특정여골육류환자예후생존솔지간적관계。결과 PrPc단백재골육류조직중보편표체，재류방조직중불표체；EnnekingIII골육류중PrPc적표체요현저고우Enneking II기대조조( P＝0.006)。Kaplan-Meier생존분석화Log-rank검험현시PrPc적표체수평여골육류환자예후상관( P＝0.010)，Enneking분기여예후상관( P＝0.025)。다인소분석현시，PrPc표체수평화종류적Enneking분기가이작위골육류예후적독립영향인소。결론원단백PrPc재이유전이적EnnekingIII골육류중적표체고우미전이환자。PrPc고표체적골육류환자예후교차。PrPc적고표체가능여골육류예후불량유일정상관성。
Objective To investigate the expressions of cellular prion protein ( PrPc ) in Enneking III osteosarcoma and analyze its correlation with the metastasis and prognosis.Methods Immunohistochemistry streptavidin-perosidase ( SP ) method was used to detect the expressions of PrPc in 15 patients with osteosarcoma of Enneking III who had pulmonary metastases at the ifrst visit and in the corresponding adjacent tissues. By contrast, the same detection was performed on 33 patients with non-metastatic osteosarcoma at the first visit who were adopted during the same period. The expressions of PrPc between the 2 groups were compared. The clinical data of the 48 patients with osteosarcoma were retrospectively reviewed, including the sex, age, tumor location, tumor size, pathologic fractures, survival time and so on. Their admission time ranged from January 2006 to December 2009. The Kaplan-Meier method was used to measure the overall survival rate. A log-rank univariate analysis was used to determine the prognostic factors related to the survival rate. The Cox multivariate analysis model was used to identify the independent prognostic factors. The relationship between the expressions of PrPc and different clinical features and the survival rate in the patients with osteosarcoma were explored.Results The expressions of PrPc were noticed in the osteosarcoma tissues but not in the adjacent tissues. The expression level in the patients with Enneking III osteosarcoma was signiifcantly higher than that in the control group (P=0.006 ). The Kaplan-Meier survival analysis and Log-rank test showed that the PrPc expression level (P=0.010 ) and the Enneking staging (P=0.025 ) were related to the prognosis. The Cox regression analysis showed that the PrPc expression level and the Enneking staging were the prognostic factors of osteosarcoma patients.Conclusions The PrPc expressions are signiifcantly higher in the patients with metastatic osteosarcoma of Enneking III than in the non-metastatic group. The higher PrPc expressions indicate a poor prognosis. The PrPc expressions may be associated with the poor prognosis of osteosarcoma.