OPN、COX-2在骨肉瘤组织中的表达及临床意义

Objective： To detect the expression of osteopontin （OPN） in benign and malignant bone tumors and investigate the prognostic influence of OPN expression on the outcome of osteosarcoma patients. Methods： Fifty-seven osteosarcomas and 11 osteoblastomas as well as 5 bone specimens with remodeling sites were immunohistochemically analyzed for expression of OPN and cyclooxygenase-2 （COX-2）. Results： OPN was not detected in osteoblasts of remodeling sites. Osteoblastoma osteoblasts as well as osteoclastlike giant cells and osteosarcoma mononuclear cells showed variable staining. In osteosarcomas OPN and COX-2 expression correlated with each other （r = 0.390, P = 0.003, Spearman＇s test）. Although osteosarcoma patients with high COX-2 expression showed a trend towards shorter overall survival （P = 0.0841, log-rank test）, OPN expression had no influence on patients overall or on disease-free survival. Conclusion： Our data indicated that expression of this protein might be unregulated in bone neoplasia. Although OPN expression correlates with COX-2 expression in osteosarcomas, OPN expression does not provide predictive information about the outcome of osteosarcoma patients.     

骨肉瘤组织中E-cadherin和β-catenin的表达及临床意义

Objective To explore the expression and clinical significance of E-cadherin and β-catenin in osteosarcoma tissues. Methods From April 2012 to October 2015， 54 specimens of osteosarcoma tissues and 22 specimens of osteochondroma tissues were enrolled. Immunohistochemistry was used to detect the expression of E-cadherin and β catenin in those above tissues. The correlation of the expression of E-cadherin， β-catenin and clinical parameters of osteosarcoma were analyzed. Results In 54 specimens of osteosarcoma tissues， the positive rate of E-cadherin protein was 35.2％（19／54）， significantly lower than 68.2％（15／22） in osteochondroma tissues （P＜0.05）. However the positive rate of β-catenin protein was 68.5％（37／54）， significantly higher than 9.1％（2／22） in osteochondroma tissues （P＜0.05）. The expression of E-cadherin protein was associated with Enneking stage and metastasis （P＜0.05）. The expression of β-catenin protein was associated with tumor size， Enneking stage and metastasis （P＜0.05）. Moreover， the expression of E cadherin and β catenin was negatively correlated （r=-0.764，P＜0.05）. ConclusionE-cadherin and β-catenin are abnormally expressed in osteosarcoma tissues， and they are correlated to Enneking stage and metastasis. Both of them play a role in the development and progression of osteosarcoma.     

GAS7在人骨肉瘤中的表达及其意义

Objective： To detect the expression of GAS7 in osteosarcoma and discuss its significance. Methods： Immunohistochemistry SABC method was applied to detect GAS7 expression in specimens of 54 osteosarcoma and 15 osteochondroma cases. Results： The positive expression rate of GAS7 was 74.7% （40/54） in the group of osteosarcoma and 0% （0/15） in the group of osteochondroma. There was a significant difference in the comparison of GAS expression in these two groups （P 〈 0.05）. GAS7 was higher expressed in the samples which complicated with relapse or pulmonary metastasis than the control group （P 〈 0.05）. There was no significant association between GAS7 expression and the size of tumor, the gender or the age of the patients （P 〉 0.05）. Conclusion： The hyper-expression ot GAST may play an important role in the initiation and development of human osteosarcoma.     

The Significance and Correlation of SODD and Bcl-2 Protein Expression in Acute Leukemia of Children

OBJECTIVE To explore the expression of SODD and bcl-2 proteins in bone marrow cells of children with acute leukemia （AL）, and to examine the relationship of their expression with the classification, clinical features, therapeutic effect and prognosis for AL patients. METHODS Using the SABC immunohistochemical staining method, the expression of SODD and bcl-2 proteins in the bone marrow cells of 86 AL cases was determined. Tqe patients were studied based on the following groups： 1） a first-visiting group; 2） a refractory-relapse group （some patients were sensitive, to therapy but then suffered a recurrence）; 3） a complete-remission group （CR）; 4） a high risk （HR） and 5） standard risk （SR） group; 6） a control group of patients with non-hematologica diseases. RESULTS The positive rates of SODD and bcl-2 expression in the firstvisit, refractory-relapse and CR groups were significantly higher （P〈0,05） compared to the control group. There was no significant difference in the expression of SODD or bcl-2 proteins between an acute lymphoblastic leukemia （ALL） group and acute nonlymphoblastic leukemia （ANLL） group （t=1.874, t=1.583, P〉0,05）. The positive rates of SODD and bcl-2 expression in the patients who developed complete remission after chemotherapy were significantly lower （t=2,054, t=2.703, P〈0.05） compared to the first-visit pediatric patients. The expression of the SODD protein in the refractory-relapse group was notably higher compared to the group treated initially （t=-1.081, P〈0.05）. A high expression of the bcl-2 protein was found in both the first-visit and refractory-relapse groups, with no significant difference found between the two groups （t= -1.196, P〉0.05）, whereas the percentage of bcl-2 positive cells in the refractory-relapse group （45%-87%） was significantly higher compared to the first-visit group （5%-62%）. The positive expression of the SODD and bcl-2 proteins in the high-risk （HR） group were both significantly higher than the SR group （t=-3.236, t=-3.555, P〈0.01）. The Pearson rank correlation analysis indicated that there was a positive correlation between SODD and bcl-2 expressions （P〈0.01, r=0.726）. Among the 30 AL patients in the initial treatment group, 13 patients showed negative SODD expression. These children reached a complete remission （CR） rate of 84.6% （11/13）, while in the other 17 cases with positive SODD expression, the CR rate was 64.7% （11/17）. In 8 patients with negative bcl-2 expression, the CR rate amounted to 100% （8/8）, and in 22 cases with positive bcl-2 expression, the CR rate reached 63.6% （14/22）. Statistical analysis showed that the CR rates in patients with negative expression of SODD and bcl-2 were all significantly higher （P〈0.05） compared to the patients with positive expression. CONCLUSION Both SODD and bcl-2 are closely related to the onset, progression, curative effect aqd prognosis of AL in children. The expression of SODD and bcl-2 has a definite synergistic relationship with the onset and development of AL.     

MTA1基因表达与人骨肉瘤细胞浸润和转移的关系

Objective： To compare the expression level of metastasis associated-1 （MTA1） in the higher and lower metastasis sublines of human osteosarcoma cells （MG63）, and to investigate the relationship between the expression level of MTA1-EGFP and in vitro invasion and metastasis of human osteosarcoma cells. Methods： The expression level of MTA1 in two sublines of MG63 cells was detected by semi-quantitative RT-PCR, and cell invasion assay and cell proliferation assay were used to evaluate the invasive capacity in vitro in two sublines. The lower metastasis line of MG-63 cells were transfected with MTA1-EGFP full-length cDNA expression plasmid by lipofectamine. The changes of the MTA1-EGFP expression and in vitro invasion potential were measured after transfection. Results： M8 subline expressed significantly higher level of MTA1 than that of M6 subline by RT-PCR. The invasive potentials of low metastasis MG63 cell line were increased after MTA1 gene transfection. Conclusion： There may be a relationship between MTA1 and invasive potentials of human osteosarcoma cells, and MTA1 may play a role in the molecular mechanism of tumor metastases and be a potential target for gene therapy of osteosarcoma. Further studies of MTA1 in human ostersarcoma cell metastasis are needed.     

Effect of cytotoxic T-lymphocyte antigen-4, TNF-alpha polymorphisms on osteosarcoma： evidences from a meta-analysis

Objective： Previous studies have investigated the role of cytotoxic T-lymphocyte antigen-4 （CTLA-4） and tumor necrosis factor-alpha （TNF-a） in carcinogenesis of osteosarcoma, but their results were inconsistent. We aimed to clarify the associations between CTLA-4, TNF-a polymorphism and osteosarcoma risk by using meta-analysis. Methods： We searched relevant studies without language restriction in PubMed, EMbase, Cochrane Library, Google Scholar databases, Chinese National Knowledge Infrastructure （CNKI） and conference literature in humans published prior to March 2013. The strengths of the associations between genetic variants and osteosarcoma risk were estimated by odds ratio （OR） with 95% confidence interval （95% CI）. Results： A total of seven studies with 1,198 osteosarcoma patients and 1,493 controls were selected. Four studies were eligible for CTLA-4 （1,003 osteosarcoma and 1,162 controls）, and three studies for TNF-a （195 osteosarcoma and 331 controls）. Pooled results showed that rs231775 polymorphism of CTLA-4 was associated with osteosarcoma risk （GG vs. AA： OR=1.63, 95% CI=1.24-2.13; GG ＋ GA vs. AA： OR=1.56, 95% CI=1.21-2.01; AA ＋ GA vs. GG： OR=0.83, 95% CI=0.71-0.97; G vs. A： OR=1.21, 95% CI=1.08-1.36）. No significant heterogeneity was observed across the studies. No significant associations were found between rs5742909 polymorphism of CTLA-4 or rs1800629 polymorphism of TNF-a and osteosarcoma risk. Conclusions： These results suggest that the rs231775 polymorphism of CTLA-4 may play an important role in carcinogenesis of osteosarcoma.     

Meta-analysis:prognostic value of survivin in patients with pancreatic cancer

Objective： The aim of the study was to conduct a systematic review of the literature evaluating survivin expres- sion in pancreatic carcinoma as a prognostic indicator. Methods： The relevant literatures were searched using PubMed, EMBASE, and Chinese Biomedicine Databases. A meta-analysis of the association between survivin expression and overall survival in patients with pancreatic cancer was performed. Studies were pooled and summary hazard ratios （HRs） were calculated. Subgroup analysis according to the location of survivin expression was also performed. Results： Seven eligible studies with a total of 448 patients were included in this study. Combined HR suggested that survivin expression had an unfavorable impact on survival of pancreatic cancer patients （HR = 1.65, 95% CI： 1.02-2.68）. When stratified according to the location of survivin expression, the combined HR showed that expression in the cytoplasm was significantly associated with poor prog- nosis of pancreatic cancer patients （HR = 2.09, 95% CI： 1.29-3.40）. In contrast, survivin expression in the nucleus was not significantly associated with poor prognosis （HR = 0.83, 95% CI： 0.24-2.81）, and the heterogeneity was highly significant （I2 = 87.2%, P = 0.005）. Conclusien： Survivin expression was associated with a poor prognosis in patients with pancreatic cancer. Cytoplasmic expression of survivin may be a prognostic factor for pancreatic cancer patients. Based on the current obtained data, there was no evidence that survivin expression in the nucleus had a significant impact on patients＇ overall survival.     

Retrospective analysis of clinical characteristics and prognostic factors for pathologic fracture in 44 patients with extremity osteosarcoma简

Objective： The aim of this study was to identify the clinical features and prognostic factors associated with ex- tremity osteosarcoma with pathologic fracture. Methods： The clinical records of 271 patients with extremity osteosarcomas were retrospectively reviewed. The data obtained covered the period from October 2003 to May 2012, and included sex, age, tumor site etc. The mean follow-up time was 25.2 months （ranged from 1 to 117）. Chi-square method and Kaplan-Meier method were used to compare clinical differences and overall survival between patients with or without pathologic fracture, respectively. The univariate analysis was used to determine the prognostic factors related with survival rate by log-rank test. The multivariate analysis of prognosis was performed by COX proportional hazards regression model. Results： The proportions of patients having a tumor＇s diameter of 10 cm or more （P = 0.038）, locating upper limbs （P = 0.004） and receiving amputation surgery （P = 0.02） were significantly higher with pathological fracture group than without pathological fracture group. The local recurrence rate （P = 0.000） was also significantly higher in the pathological fracture group. The median survival time of patients with or without pathological fracture was 16 （95% confidence interval： 14.6-17.4） months and 22 （95% confidence interval： 19.8-24.1） months （P = 0.002）. The Log-rank univariate analysis indicated that the tumor size, Enneking＇s surgical staging, Karnofsky performance status （KPS） score, cycles of adjuvant chemotherapy, local recurrence and metastasis were significantly related to overall survival. Multivariate Cox regression analysis revealed KPS score, cycles of adjuvant chemotherapy and metastasis were independent prognostic factors （P 〈 0.05）. Conclusion： Compared with the patients without pathological fracture, a higher proportion of patients receiving amputation surgery or having larger tumor size, humeral osteosarcoma or local recurrence was observed in patients with pathological fracture, and the prognosis of these patients was poor. The independent prognostic factors of extremity osteosarcoma with pathologic fracture were the KPS score, cycles of adjuvant chemotherapy and metastasis.     

Expression of Survivin Gene and Its Relationship with Clinical Multidrug Resistance in Osteosarcoma

Objective: To study the expression of survivin and its relationship with clinical multidrug resistance in osteosarcoma. Methods: By using immunohistochemistry (S-P) method, the expression of Survivin in osteosarcoma, osteochondroma and normal osseous tissue, and the expression of P-glycoprotein in osteosarcoma was detected. Results: Survivin positive expression rate was 65.71% in osteosarcoma, but no expression of Survivin was detectable in osteochondroma and normal osseous tissue. The positive expression rate of Survivin was significantly associated with Enneking clinical stages and histological typing (WHO), but no relationship was found among Survivin expression and age, sex and tumor location. The positive expression rate of P-glycoprotein was 45.71%. There was a significant correlation between Survivin and p-glycoprotein. Conclusion: Survivin overexpression was significantly associated with clinical multidrug resistance in osteosarcoma. It could be a potential target for treatment of osteosarcoma.     

Vascular Endothelial Growth Factor Expression in Invasive Ductal Carcinoma of Breast

Objective： To detect the expression of VEGF and MVD count in invasive ductal carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods： The expressions of VEGF, ER, PR, C-erbB-2 and MVD count in 88 cases of invasive ductal carcinoma of breast were examined by immunohistochemistry staining （SP-method）. Results： Sixty-two out of the eighty-eight specimens of breast carcinoma （70.45%） showed positive expression of VEGF. The positive rate of VEGF in cases with lymph node metastasis was higher than that without lymph node metastasis （P〈0.05）. The positive rate of VEGF in stage IIb-Ⅲ was higher than that in stage Ⅰ-Ⅱa （P〈0.05）. The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group （P〈0.05）. Higher expression of VEGF was observed in cases with higher tissue differentiation degree （P〈0.05）. Also, significant higher MVD count was observed in cases with higher tissue differentiation degree （P〈0.01）. The MVD count increased significantly with the increase of the expression of VEGF （P〈0.01）. Conclusion： The result of this study suggested that in invasive ductal carcinoma of breast, angiogenesis and metastasis were mediated mainly by VEGF. The expression of VEGF and MVD might be reference predictors for the biological behavior of breast carcinoma. The antiangiogenic therapy which used VEGF as a target would become a new method to treat patients who were C-erbB-2 positive in the future.     

EXPRESSION OF CDX2 IS ASSOCIATED WITH CLINICOPATHOLOGIC FEATURES AND PROGNOSIS OF GASTRIC CARCINOMA.

Objective： To explore the correlation between the Cdx2 expression and clinicopathologic features of patients with gastric carcinoma, and to evaluate the role of Cdx2 as a prognostic indicator of gastric carcinoma. Methods： The expression of Cdx2 was studied using immunohistochemistry of paraffin-embedded tumor specimens from 154 patients who underwent D2 resection for gastric adenocarcinoma from 1994 to 1998. Results： Cdx2 expression was detected in 35.1% （54 of 154） of gastric carcinoma cases. Expression of Cdx2 was significantly higher in intestinal-type carcinomas than in diffuse-type carcinomas, and in cases with TNM stage Ⅰ and Ⅱ than those with TNM stage Ⅲ and Ⅳ （P〈0.001 and P=-0.012, respectively）. There was a clear negative correlation between Cdx2 expression and lymph node metastasis （P=-0.049）. The patients with Cdx2-positive expression showed higher survival rate than those with Cdx2-negative expression （P〈0.0001）. Multivariate analysis revealed that the expression of Cdx2 was the independent prognostic indicator in this series （P〈0.001）. Conclusion： These data suggest that Cdx2 has significant value in predicting prognosis of gastric carcinoma.     

新辅助化疗对骨肉瘤细胞增殖、凋亡及耐药性的影响及其机制

Objective： To study the influence of neoadjuvant chemotherapy on the expression of cyclin D1, Bcl-2, PCNA and P-gp in osteosarcoma cells and the relationship between the expression and tumor cell necrosis rate （TCNR） after chemotherapy. Methods： By using immunohistochemistry, the expression of cyclin D1, Bcl-2, PCNA and P-gp was detected in 23 cases of osteosarcoma and TCNR were calculated. Results： The pre-chemotherapy positive expression rate of cyclin D1, Bcl-2, PCNA and P-gp was 73.9%, 69.6%, 91.3% and 21.7%, respectively, and that post-chemotherapy positive expression rate was 52.1%, 34.8%, 43.5% and 56.5%, respectively. The positive expression rate of Bcl-2 and PCNA after chemotherapy was much lower than that before chemotherapy （P=0.039, 0.034）. After chemotherapy, the expression rate of P-gp was higher （P=0.021） and the expression of cyclin D1 had no statistically significant difference （P=0.180） comparing with that before chemotherapy. No correlation existed between the expression of cyclin D1, Bcl-2, PCNA, P-gp and TCNR before chemotherapy （P=0.155, 0.371, 1.000 and 0.640）. There was a negative correlation between the expression of Bcl-2, PCNA, P-gp and TCNR （P=0.009, 0.012 and 0.015）, but no relationship existed between the cyclin D1 and TCNR （P=-0.100） after chemotherapy. Conclusion： Chemotherapy could inhibit proliferation and induce apoptosis of osteosarcoma cells. At the same time, due to the overexpression of the P-gp, the drug resistance of the osteosarcoma cells was increased. The detection of cyclin D1, Bcl-2, PCNA and P-gp in osteosarcoma samples before chemotherapy might not be used to predict the curative effect of the chemotherapy.     

Expression of HIF-1α in breast cancer and precancerous lesions and the relationship to clinicopathological features简

Objective： The aim of this study was to observe the expressions and clinical significance of HIF-1a in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： We analyzed the HIF-1a expression in 128 cases of invasive ductal carcinomas, 146 precancerous lesions patients including 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia. 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The specimens were evaluated for HIF-1a, estrogen receptor （ER） ＆ progesterone receptor （PR）, epidermal growth factor receptor type 2 （HER2/neu） and Ki-67. Immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40 x magnification and recorded as the percentage of positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized. The express of HIF-1a and their relationship with multiple biological parameters including ER ＆ PR, HER2/neu and Ki-67, the biomarkers levels of CA153, CA125 TSGF, and CEA in blood serum and nipple discharge, histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： Compared with usual ductal hyperplasia, the positive expression rate of HIF-1a in atypical ductal hyperplasia, ductal carcinoma in situ and invasive ductal carcinomas group was significantly increased （P 〈 0.01）. The positive rates of HIF-1a in invasive ductal carcinomas were 68.75%, which were significantly higher than that in ductal carcinoma in situ （43.8%）, atypical ductal hyperplasia （31.6%）, usual ductal hyperplasia （9.4%; X2 = 13.44, 22.27, 52.79, respectively, P 〈 0.01）. Statistical analysis showed that difference of abnormal expression rate of HIF-1a between ductal carcinoma in situ and usual ductal hyperplasia （X2 = 18.37, P = 0.00）, atypical ductal hyperplasia and usual ductal hyperplasia （x2 = 8.14, P = 0.00） was significant （P = 0.00）. However, no significant difference in the positive expression rate of HIF-1a was found between atypical ductal hyperplasia and ductal carcinoma in situ tissue （X2 = 2.19, P = 0.14）. There was a significantly difference in the mean HIF-1a frequency between ER ＆ PR positive invasive ductal carcinomas group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was not difference in the mean HIF-1a between age （〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm; P 〉 0.05）. The nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in invasive ductal carcinomas HIF-1a positive patients were significantly higher than those in the negative patients （P 〈 0.05）. Conclusion： In breast cancer, HIF-1a expressibn was abnormally increased. The aberration of HIF-1a may play a key role during oncogenesis （atypical ductal hyperplasia or ductal carcinoma in situ） and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. The abnormal expression of HIF-1a may be as an early event in the development of breast tumor. The over-expression of HIF-1a might be important biological markers for invasion, metastasis and recurrence of breast cancer.     

Prognostic significance of ERCC1 expression in postoperative patients with gastric cancer

Aim： This study explored the correlation between the expression of excision repair cross-complementation group 1 （ERCC1） and the prognosis of gastric cancer patients. Methods： From January 2005 to December 2008, 605 patients who underwent radical surgery in The First Affiliated Hospital of Nanjing Medical University were enrolled. We conducted the follow-up every 6 months and its contents included a comprehensive medical history, tumor markers and abdominal ultrasound or CT and other imaging findings. Deadline was April 30, 2013 and follow-up time between 51 to 91 months. Survival time is calculated from the date of diagnosis to death or last follow-up date. Immunohistochemistry （IHC） was used to assess the expression of ERCCI in resected samples. The relationship between ERCCI expression and survival of patients was investigated. The comparison of count data were analyzed by Chi-square test. Median survival time （MST） and the 5-year survival rate were calculated by life table analysis. The Kaplan-Meier curves were used for survival analysis. Results： ERCC1 expression was positive in 412 patients （68.1%）. There is no significant difference between ERCCl-positive group and ERCCl-negative group in terms of the MST and 5-year survival rate （P=0.455）. The MST and 5-year survival rate have no significant difference （P=0.162） between group with chemotherapy and group with no chemotherapy in patients with ERCCl-positive expression. However, the MST and 5-year survival rate in patients with ERCCl-negative expression benefited more from with chemotherapy （P=0.019）. The ERCCl-positive patients survived longer than those ERCCl-negative patients （P=0.183） in subgroup with no adjuvant chemotherapy. In the subgroup analysis, ERCC 1 expression had no significant relationship with overall survival in patients with stage II or llI gastric cancer （P〉0.05）. Conclusions： ERCC1 might be a good prognostic factor for the patients of gastric cancer after radical resection. Patients with ERCC     

Correlation of prothrombin time with clinicopathological features and prognosis of patients with osteosarcoma北大核心CSCD

Objective: To investigate the correlation of prothrombin time (PT) with clinicopathological features and prognosis of the patients with osteosarcoma. Methods: The activated partial thromboplastin time (APTT), PT, fibrinogen (FIB) and D-dimer in peripheral blood of 111 patients with osteosarcoma and 35 concurrent healthy volunteers (as the control) from May 2011 to May 2018 were tested. The correlation of PT with clinicopathological features and prognosis of the patients with osteosarcoma was analyzed. Results: The median survival time of 111 patients with osteosarcoma was 25 months, and the one-and two-year survival rates were 76.6% and 51.4%, respectively. The levels of D-dimer and FIB in the patients with osteosarcoma were higher than those in the control group (both P < 0.01), and the PT was shorter than that in the control group (P < 0.01), while the APTT was not statistical different between these two groups (P > 0.05). The PT was longer in the patients with osteosarcoma younger than 20 years old (P = 0.002), while PT had no correlation with gender, tumor size, clinical stage, tumor location and metastatic status (all P> 0.05). The overall survival time of the patients with osteosarcoma in PT ≥ 10.4 s group was shorter than that in PT < 10.4 s group (P = 0.024), the progression-free survival time of the patients with osteosarcoma had no significant difference between these two groups (P= 0.594). The overall survival time and progression-free survival time of the patients with osteosarcoma in metastasis group were shorter than those in non-metastasis group (both P< 0.001). The overall survival time (P= 0.004) and progression-free survival time (P= 0.013) of the patients with osteosarcoma in stage I / II group were longer than those in stage EI/IV group. The clinical stage, PT and metastasis status were related with the prognosis of patients with osteosarcoma (all P< 0.05). The PT and metastasis status were independent predictive factors for the prognosis of patients with osteosarcoma (both P < 0.05). Conclusion: The changes of PT may provide a reference for monitoring the condition and prognosis of patients with osteosarcoma. © 2019 by TUMOR. All rights reserved.     

STAT1 and Survivin Expression in Full Lymph Node Examined Gastric Cancer by Using Tissue Microarray Technique

Objective： To characterize the relationship between STAT1 and Survivin expression, and the relationship between them and lymph node metastasis, depth of invasion and prognosis in full lymph node examined gastric cancer patients of China. Methods： Specimens of curative dissection between 1988 and 2003 were collected from the affiliated hospital of Jianghan University. All 140 patients had complete examination data. All lymph nodes were found by clearing fat method. The interrupted serial 4 μm sections, routine hematoxylin and eosin staining and immunohistochemical methods were used to detect the lymph node metastases. Gastric cancer tissue microarray was formed and the expression of survivin and STAT1 in gastric cancer was detected by immunohistochemical method. All data were processed using Spearman rank correlation analysis, Kaplan-Meyer Log-rank method and Cox multivariate analysis （SPSS 12.0 software）. Results： Among 140 gastric cancer tissue microarrays constructed, 110 could be used （utilization rate was 78.6%）. 7079 lymph nodes were found in 110 cases （64.4/case）. Metastases were found in 89 cases and 1679 lymph nodes. Positive expression rate of survivin and STAT1 was 52.7% （58/110） and 40% （44/110） respectively. There was a significant negative correlation between STAT1 expression and survivin expression （r=-0.19, P=0.04）. STAT1 expression had a negative correlation with depth of invasion （r=0.21, P=0.04）. Survivin expression had a negative correlation with UICC N stage （r=-0.24, P=0.01） and histological classification （r=-0.21, P=0.03） by Spearman rank correlation analysis. But survivin and STAT1 expression was not related with prognosis. A significant correlation between lymph node metastasis and prognosis was demonstrated by Cox multivariate analysis （X^2=4.85, P=0.028）. Conclusion： STAT1 has a negative correlation with survivin expression in gastric cancer. Both of them have no correlation with prognosis in gastric cancer. STAT1 expression can be a molecular marker to predict advanced gastric cancer and survivin a molecular marker of lymph node metastasis in gastric cancer. UICC N stage is the most important prognostic factor in gastric caner in China.     

Level of circulating PD-L1 expression in patients with advanced gastric cancer and its clinical implications简

Objective：The programmed cell death-1 receptor/programmed cell death-1 ligand （PD-1/PD-L1） pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.Methods：Totally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study.Circulating PD-L1 expression was tested by enzymelinked immunosorbent assay （ELISA）.The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.Results：Expression of PD-L1 in advanced gastric cancer patients was significandy up-regulated compared with health people （P=0.006）.The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis （P=0.026 and P=0.041,respectively）.Although we didn＇t find significant difference in all advanced gastric cancer patients with different PD-L1 expression,the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients （65.6％ vs.44.7％,P=0.028）.Conclusions：PD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.     

Aurora-A is a novel predictor of poor prognosis in patients with resected lung adenocarcinoma

Background： The Aurora-A （AurA） gene, a key regulator of mitosis, has been proved as an oncogene in a variety of cancers. The Aur-A overexpression has been proved correlated with aggressiveness of cancer cells. However, the frequency of Aur-A protein overexpression, as well as its association with clinicopathologic parameters and prognosis remain unclear in lung adenocarcinoma （ADC）. This study tried to clarify the clinical significance of Aur-A in patients with resected lung ADC. Patients and methods： A total of 142 informative patients with surgically resected lung ADC and 20 normal lung tissues were enrolled. Western blot and immunohistochemistry （IHC） were utilized to assess protein expression of Aur-A. Result： The expression of Aur-A was elevated in most of tumor tissues compared with the adjacent tissues by western blot. The IHC results showed that Aur-A protein was over-expressed in 98 of 142 （69.0%） tumor sections, while Aur-A was low-expressed in all normal lung sections. A positive correlation between Aur-A overexpression rate and ascending pathologic stages was observed （P〈0.05）. Kaplan-Meier analysis demonstrated that patients with Aur-A high expression had significantly inferior survival compared to those with Aur-A low expression. Both overall survival （OS） and disease-free survival （DFS） of positive overexpression patients were shorter than the negative group （P=0.036, P=0.041, respectively）. Multivariate analysis confirmed that Aur-A expression, as an independent and significant factor for both DFS and OS, could predict a poor prognosis in patients with resected lung ADC （P=0.022, P=0.049, respectively）. Conclusions： Aur-A was overexpressed in lung ADC and overexpression of Aur-A might be a novel predictor for poor prognosis and potential therapeutic target in lung ADC.     

食管癌细胞P-糖蛋白与CD44表达相关性研究

Objective： To investigate the relationship between P-glycoprotein （P-gp） and adhesion molecule CD44 expression as well as their clinical significance in esophageal carcinoma. Methods： To examine the expressed level of P-gp and CD44 by flow cytometry （FCM） in the operated samples of 70 cases with esophageal carcinoma and their normal mucosa of esophageal incision, and to evaluate their relationship with clinicopathological factors. Results： Among the 70 cases with esophageal carcinoma, the expression of P-gp in the 27 cases （38.6%） was negative （positive cells 〈25%）; 11 cases （15.7%） were 25%-40% expression of P-gp positive cells; 14 cases （20%） were 41%-60% expression of P-gp positive cells; 18 cases （25.7%） were the high expression （positive cells 〉60%） of P-gp. Of the cases with the tumor sizes being more than 4 cm, the expression of CD44 showed a significant difference （P〈0.05） in 25 cases with P-gp positive, compared with 19 cases with P-gp negative. Of the cases with high-mild differentiated esophageal carcinoma, the expression of CD44 showed a significant difference （P〈0.05） in 22 cases with P-gp positive, compared with 17 cases with P-gp negative. Of the cases with clinical Ⅲ-Ⅳ stage, the expression of CD44 showed a significant difference （P〈0.05） in 26 cases with P-gp positive, compared with 10 cases with P-gp negative. Of the cases with lymph node metastasis, the CD44 expression showed a significant difference （P=0.050） in 27 cases with P-gp positive, compared with 11 cases with P-gp negative. Of the cases of the patients＇ age being more than 56 years, the expression of CD44 showed a significant difference （P〈0.01） in 27 cases with P-gp positive, compared with 12 cases with P-gp negative. When the P-gp and CD44 expression were positive, the clinical Ⅱ stage and Ⅲ-Ⅳ stage in esophageal carcinoma was showed a significant difference （P〈0.05）. Conclusion： When the CD44 and P-gp both have the positive high expression, it will be significantly associated with the esophageal carcinoma progression and metastasis, so both were a positive expression in esophageal carcinoma, it might suggest a poor and unfavorable prognosis result.     

Relationship between the expressions of survivin and the prognostic related factors in breast cancer

Objective： To study the relationship between the Survivin expression and the histological grade, status of ER, expression of PS2 and the prognosis of patients with primary invasive breast cancer. Method： By using LSAB and SP immunohistochemical method, the expression of Survivin, PS2 and ER in 95 cases of invasive breast cancer were detected. Results： the positive rate of Survivin was 70.5% （67/95） and the expression of Survivin was positively related to the histological grade and status of PS2 and ER. The survival time after operation of patients without expression of Survivin was longer than those with positive Survivin. Conclusion： These data suggest that Survivin expression may be considered as a new unfavorable prognostic factor of breast cancer.