70例骨肉瘤临床病理分析及其Notch亚型表达的预后意义

唐雪峰; 曾英; 王亚丽; 谭秋林; 吕杨帆; 郭乔楠

doi:10.16016/j.1000-5404.201810022

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70例骨肉瘤临床病理分析及其Notch亚型表达的预后意义

临床医学 | 更新时间：2026-01-09

- 70例骨肉瘤临床病理分析及其Notch亚型表达的预后意义
- Clinicopathological characteristics of osteosarcoma and prognostic significance of Notch receptors and ligands expression: analysis of 70 cases
- 第三军医大学学报 2019年41卷第4期页码：339-345
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院病理科
  2.400042 重庆，陆军军医大学(第三军医大学)第三附属医院(野战外科研究所)病理科
- 作者简介：
  
  [ 郭乔楠，E-mail:qiaonan85@263.net GUO Qiaonan, E-mail:qiaonan85@263.net
- 基金信息：
  
  国家自然科学基金面上项目(81672653);重庆市基础科学与前沿技术研究重点项目(CSTC2015jcyjBX0067)
- DOI：10.16016/j.1000-5404.201810022
  中图分类号： R730.23;R730.7;R738.1
- 收稿：2018-10-08，
  
  修回：2018-10-24，
  
  纸质出版：2019-02-28
- 稿件说明：
移动端阅览
唐雪峰, 曾英, 王亚丽, 等. 70例骨肉瘤临床病理分析及其Notch亚型表达的预后意义[J]. 第三军医大学学报, 2019,41(4):339-345.

Xuefeng TANG, Ying ZENG, Yali WANG, et al. Clinicopathological characteristics of osteosarcoma and prognostic significance of Notch receptors and ligands expression: analysis of 70 cases[J]. Journal of Third Military Medical University, 2019, 41(4): 339-345.
唐雪峰, 曾英, 王亚丽, 等. 70例骨肉瘤临床病理分析及其Notch亚型表达的预后意义[J]. 第三军医大学学报, 2019,41(4):339-345. DOI： 10.16016/j.1000-5404.201810022.

Xuefeng TANG, Ying ZENG, Yali WANG, et al. Clinicopathological characteristics of osteosarcoma and prognostic significance of Notch receptors and ligands expression: analysis of 70 cases[J]. Journal of Third Military Medical University, 2019, 41(4): 339-345. DOI： 10.16016/j.1000-5404.201810022.

摘要

目的

探讨骨肉瘤的临床病理特征、Notch受体配体表达及其对预后的影响。

方法

收集2008-2015年陆军军医大学(第三军医大学)第二附属医院、陆军特色医学中心病理科70例骨肉瘤进行临床资料总结和组织学观察，并行Notch通路4个受体Notch 1~4和3个配体Jagged1、Jagged2、DLL4免疫组织化学染色。对54例病例行预后因素分析。

结果

70例患者平均年龄25.1岁，男女比例3 :2。95.7%(67/70例)的患者就诊时处于临床Ⅱ~Ⅲ期。影像学表现显示：61例(87.1%)存在骨质破坏，

8例(11.4%)髓腔累及，29例(41.4%)骨皮质累及，28例(40%)有骨膜反应。组织病理学可见，40例(57.1%)浸润性生长，70例肉瘤细胞和肿瘤性骨样组织。免疫组化结果显示：受体Notch4表达率最高，为91.4%(64/70)，其次分别为Notch1(87.1%)、Notch3(68.6%)、Notch2(33.9%)。配体Jagged1、Jagged2、DLL4表达率分别为87.1%(61/70)、84.3%(59/70)、88.6%(62/70)。42例患者(60%)接受了化疗，67例患者(95.7%)进行了手术。54例有随访资料的患者平均生存时间41.68个月。1、2年和5年生存率分别为87%、66%和30%。生存曲线比较示Enneking分期、术前化疗、Notch3表达与预后相关(

=0.017)，Cox比例风险回归模型分析Enneking分期、术前化疗、Notch3表达是独立预后因素。

结论

骨肉瘤5年生存率低，Enneking分期晚、未行术前化疗、Notch3表达的患者生存时间短。

Abstract

Objective

To investigate the clinicopathological features of osteosarcoma and the prognostic significance of the expression of Notch receptors and ligands.

Methods

We retrospectively analyzed the clinical and histopathological data of 70 patients with osteosarcoma treated in the Second and Third Affiliated Hospitals of Army Medical University from 2008 to 2015. Immunohistochemical staining was used to examine the expressin levels of 4 Notch receptors (Notch1-4) and 3 Notch ligands (Jagged1

Jagged2 and DLL4) in the surgical specimens. The risk factors that affected the outcomes of the patients were analyzed in 54 cases.

Results

The patients had a mean age of 25.1 years with a male to female ratio of 3 :2

and 95.7% of the patients were in stage Ⅱ-Ⅲ. Imaging examinations revealed bone destruction in 61 cases (87.1%)

medullary cavity involvement in 8 cases (11.4%) and bone cortex involvement in 29 cases (41.4%); periosteal reaction was detected in 28 cases(40%). Histopathologically

57.1% of patients (40 cases) showed invasive growth of osteosarcoma

and all the patients had sarcoma cells and neoplastic osteoid tissues. Immunohistochemical analysis showed positive Notch1

Notch2

Notch3 and Notch4 expression in 87.1% (61/70)

33.9% (23/70)

68.6% (48/70) and 91.4% (64/70) of the patients

respectively with the last one of the highest; positive e

xpression of Jagged1

Jagged2 and DLL4 were detected in 87.1% (61/70)

84.3% (59/70) and 88.6% (62/70) of the patients. Sixty percent of the patients (42 cases) received chemotherapy

and 95.7% of the patients (67 cases) underwent surgeries. The mean survival time of the 54 patients with full follow-up data was 41.68 months and their 1-

2- and 5-year survival rates were 87%

66% and 30%

respectively. Survival curre analysis showed thed Enneking stage

oreoperative chemotherapy and Notch 3 experssion were related with prognosis (

=0.017). Cox regression analysis showed that Enneking stage

preoperative chemotherapy and Notch3 expression were independent prognostic factors in these patients.

Conclusion

Patients with osteosarcoma have a rather low 5-year survival rate. Advanced Enneking stage

positive Notch3 expression and no preoperative chemotherapy are all predictive of a short survival time of the patients.

关键词

Keywords

references

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