局部及已转移骨肉瘤中VEGF、p53表达及微血管生成的对照研究

目的探讨血管内皮生长因子(VEGF)和p53在骨肉瘤微血管新生中的作用及对原发骨肉瘤侵袭性转移性的影响.方法采用免疫组织化学方法,检测57例局部原发性骨肉瘤和27例伴发转移的骨肉瘤原发灶标本中VEGF、p53的表达,计算MVD值.比照两骨肉瘤组中VEGF、p53表达,MVD以及其它临床病理因子的差别.结果伴发转移骨肉瘤组VEGF阳性表达率高于局部骨肉瘤组(P=0.0494);p53蛋白表达在两组肿瘤中无显著差别(P＜0.05);伴发转移骨肉瘤组的微血管密度高于局部骨肉瘤组的微血管密度(P=0.0302);件发转移骨肉瘤组中肿瘤平均直径大于局部骨肉瘤组的平均直径(P=0.0350);VEGF和P53表达阳性组与阴性组相比,MVD值高(P=0.0125,P=0.0036);VEGF与P53表达阴阳性一致率为51.2%.VEGF和P53共同阳性表达组MVD值最高(42.7±22.4),而VEGF和P53共同阴性表达组MVD值为最低(23.3±20.1),差别显著(P=0.0077).结论p53和VEGF共同参与骨肉瘤血管生成并有协同作用.VEGF和MVD检测对骨肉瘤早期转移的临床预测有实际意义.

Comparison of VEGF,MVD and p53 expression in patients with local and metastatic osteosarcoma

Objective:To investigate the expression of VEGF and p53 in osteosarcoma and their relationships with MVD, to address the role of VEGF, p53 mutation and MVD in the progression and metastases of osteosarcoma. Methods:The specimens from 57 patients with primary local osteosarcoma and 27 patients with osteosarcoma that were metastatic at the time of diagnosis were stained immunohistochemically for VEGF and p53, MVD were counted, the results were comparatively analyzed.Results:The positive expression rates of VEGF and MVD in group of patients who presented with metastases were higher than that in group of those who presented with a local osteosarcoma (P=0.0494, P=0.0302). P53 expression did not differ in the two groups (P<0.05). The tumors in the metastatic group tended to be larger than those in the local group(P=0.0350).MVD was significantly higher in the VEGF or p53 positive tumors than that in the negative ones(P=0.0125, P=0.0036).The coincident rate of VEGF and p53 expression was 51.2%. MVD was the highest in VEGF and p53 positive co-expression tumors, and was the lowest in the VEGF and p53 negative tumors, differences were significant(P=0.0077). Conclusions: Both VEGF and p53 mutation irritate angiogenesis in osteosarcoma. However, as an event happened prior to the metastasis of osteosarcoma, p53 has no direct potential on angiogenesis in osteosarcoma. VEGF and MVD detections have clinical potential for predicting metastasis in osteosarcoma.