CAJ | 학술논문

目的：检测埃兹蛋白（Ezrin）在骨巨细胞瘤组织中的表达，探讨其临床意义。方法将本院2008年1月至2013年12月穿刺活检确诊的60例骨巨细胞瘤设为观察组，同期8例良性病变中的反应性新生骨、12例骨样骨瘤及11例骨母细胞瘤的瘤组织作为对照组，用 Western blotting 及实时 PCR 方法检测 Ezrin 蛋白及基因水平。60例骨巨细胞瘤患者接受瘤段切除加假体置换术，术前均接受2个疗程的化疗，观察化疗前后瘤组织线粒体形态的变化以及 Ezrin 蛋白和基因的变化。结果骨巨细胞瘤中Ezrin 蛋白阳性表达主要位于细胞质中，表达阳性率为76.7%，远高于良性病变中反应性新生骨的19.7%、骨样骨瘤的21.2%以及骨母细胞瘤的20.7%，差异有统计学意义（χ2=4.18，P =0.024），良性病变中的反应性新生骨组、骨样骨瘤及骨母细胞瘤之间的 Ezrin 表达差异并无统计学意义（χ2=6.18， P =0.087）。化疗后骨巨细胞瘤组织中线粒体固缩及液态空泡现象较治疗前减少，Ezrin 蛋白表达减少，基因水平降低[（23.99±1.49）：（20.11±1.11），t =5.03，P =0.018）]。结论 Ezrin 在骨巨细胞瘤的表达较其他良性骨肿瘤高，可能成为鉴别良恶性骨肿瘤的辅助生物学指标；对 Ezrin 的早期干预可能有助于骨巨细胞瘤的治疗。
목적：검측애자단백（Ezrin）재골거세포류조직중적표체，탐토기림상의의。방법장본원2008년1월지2013년12월천자활검학진적60례골거세포류설위관찰조，동기8례량성병변중적반응성신생골、12례골양골류급11례골모세포류적류조직작위대조조，용 Western blotting 급실시 PCR 방법검측 Ezrin 단백급기인수평。60례골거세포류환자접수류단절제가가체치환술，술전균접수2개료정적화료，관찰화료전후류조직선립체형태적변화이급 Ezrin 단백화기인적변화。결과골거세포류중Ezrin 단백양성표체주요위우세포질중，표체양성솔위76.7%，원고우량성병변중반응성신생골적19.7%、골양골류적21.2%이급골모세포류적20.7%，차이유통계학의의（χ2=4.18，P =0.024），량성병변중적반응성신생골조、골양골류급골모세포류지간적 Ezrin 표체차이병무통계학의의（χ2=6.18， P =0.087）。화료후골거세포류조직중선립체고축급액태공포현상교치료전감소，Ezrin 단백표체감소，기인수평강저[（23.99±1.49）：（20.11±1.11），t =5.03，P =0.018）]。결론 Ezrin 재골거세포류적표체교기타량성골종류고，가능성위감별량악성골종류적보조생물학지표；대 Ezrin 적조기간예가능유조우골거세포류적치료。
Objective To detect the expression of Ezrin in giant-cell tumor of bone,and to investigate its cilincal significance. Methods 60 cases of biopsy which had been confirmed as bone giant-cell tumors in our hospital from January 2008 to December 2013 were set as observation group;tumor tissues from 8 cases of reactive new bone in nonmalignant bone diseases,12 cases of osteoid osteoma and 11 cases of osteoblastoma in the corresponding period were set as control group. Protein and gene levels of Ezrin were tested with Western blotting method and real-time PCR detection,simultaneously proceeded the corresponding analysis combined with the clinical data of patients;60 cases of bone giant-cell tumor patients accepted tumor resection and pros-thesis replacement,2 courses of preoperative chemotherapy;mitochondria morphological changes of tumor tissue and Ezrin protein and genetic changes were observed before and after chemotherapy. Results In the giant-cell tumors of bone,the Ezrin protein mainly located in the cytoplasm,and its expression positive rate was much higher than that in reactive new bone of nonmalignant bone diseases(19. 7% ),osteoid osteoma(21. 2% )and osteoblastoma(20. 7% );the difference was statistically significant(χ2 = 4. 18,P = 0. 024),but no statistical difference in the Ezrin expression among the groups of osteosarcoma,osteoid osteoma and osteblastoma(χ2 =6. 18,P = 0. 087). In the giant-cell tumors of bone tissue after chemotherapy,mitochondria pyknosis and the phenomenon of liquid cavitation was less than that before the treatment,and Ezrin protein expression decreased and gene levels reduced[(23. 99 ± 1. 49)vs(20. 11 ± 1. 11),t = 5. 03,P = 0. 018)]. Conclusion The expression of Ezrin in giant-cell tumor of bone is much higher than other benign bone tumor,and it could be a biological marker for differentiating benign and malignant bone tumor. Early intervention in Ezrin may be helpful for reatment of giant-cell tumor of bone.