CD147、VEGF在骨巨细胞瘤中的表达及临床研究

目的研究骨巨细胞瘤（GCT）中细胞外基质金属蛋白酶诱导因子（CD147）和血管内皮生长因子（VEGF）的表达情况，探索二者间的相关性以及与临床病理、预后、复发的关系，为临床判断其生物学行为及评估预后提供准确的检验指标，也为临床治疗提供新的思路。方法运用免疫组织化学法（S—P）法检测2008年4月～2013年4月骨科诊治的68例行手术治疗的GCT患者病理切片标本中CD147、VEGF、基质金属蛋白酶（MMPs）等分子的表达情况，分析CD147、VEGF相关性及对患者病理、Jaffe分级、临床预后的影响。结果患者性别、年龄与CD147、VEGF阳性表达无相关；各级Jaffe患者CD147和MMP-2阳性表达差异有统计学意义（P〈0．05），预后各分组患者CD147、MMP-2、MMP-9阳性表达差异有统计学意义（P〈0．05）；CD147的表达和MMP-9的表达呈正相关（R=0．273，P〈0．001），CD147的表达和VEGF表达呈正相关（R=0．417，P〈0．001）。结论CD147的阳性表达与GCT患者病情恶化及复发有密切关系，且和MMP-9、VEGF的阳性表达密切相关，是目前临床上评价GCT恶性程度以及评估预后的重要检测指标，也可作为化疗的新靶点，为临床诊断和治疗GCT提供新思路。

Expression and Clinical Significance of CD147 and VEGF in Giant Cell Tumor of Bone

Objective To study the expression of extracellular matrix metalloproteinase-inducing factor （CD147） of giant cell tumor （GCT） and vascular endothelial growth factor （VEGF） in patients with GCT. The relationship between CD147 and VEGF expression and clinical pathology, prognosis, treatment efficacy and recurrence was analyzed. Methods The immunohistochemistry method, namely S-P method, was used to detect the expression of CD147, VEGF and metalloproteinases （MMPs） in 68 cases of giant cell tumor of bone who underwent surgical treatment from April 2008 to April 2013. The correlation between these two factors and the pathological data, Jaffe classification and prognosis of patients were analyzed. Results The gender and age of patients were not related to positive expression of CD147 and VEGF; The differences between CD147 and MMP-2 positive expressions of patients at all levels of Jaffe were found to be significant （P〈0.05）, the differences between CD147, MMP 2 and MMP 9 positive expression in patients with different prognosis were significant （P〈0. 05） ; The expression of CD147 was positively correlated to the expression of MMP-9 （R=0. 273, P=0. 025）, and the expression of CD147 was positively correlated to the expression of VEGF （R=0. 417, P〈0. 001）. Conclusion The positive expression of CD147 is closely rated to and the disease deterioration and recurrence of OCT patients, and it is closely related to positive expressions of MMP-9 and VEGF. CD147 could serve as an testing indicator for malignant degree of clinical evaluation and prognosis evaluation of GCT, and it also can be used as a new target of chemotherapy, providing a new way for clinical diagnosis and treatment.