术前化疗对ⅡB期骨肉瘤Bcl-2、PCNA表达的影响及临床意义

目的研究术前化疗对骨肉瘤细胞中Bcl－2和增殖细胞核抗原（PCNA）表达的影响及其与肿瘤细胞坏死率（TCNR）的相关性。方法应用免疫组化技术柃测我院23例骨肉瘤化疗前后标本中Bcl－2、PCNA的表达，计算化疗TCNR，并对其中21例随访平均21个月。对比分析化疗前后Bcl－2、PCNA的表达及其与TCNR的关系。结果化疗后Bcl-2和PCNA在骨肉瘤细胞中的阳性表达率（39．1％、47．5％）明显低于化疗前的阳性表达率（73．9％、87．0％）：化疗前后Bcl-2阳性表达与TCNR无 相关性：化疗前PCNA的阳性表达与TCNR无相关性，化疗后与TCNR有相关性，PCNA阳性表达率越低的患者TCNR越高、预后越好。结论化疗可以促进骨肉瘤细胞的凋亡，抑制骨肉瘤细胞的增殖。通过检测化疗前后骨肉瘤细胞中PCNA的表达可以反映化疗的疗效，指导术后化疗。

Influence of preoperative chemotherapy on expression of Bcl-2, PCNA in osteosarcoma cells and clinical meaning

Objective To study the influence of preoperative chemotherapy on expression of Bcl-2, PCNA in osteosarcoma cells and the relation between the expression and TCNR. Methods Using immunohistochemical staining, the expression of Bcl-2 and PCNA were examined in 23 osteosarcoma cases. Tumor cell necrosis rate were calculated and 21cases were followed-up with a mean time of 21 months. Results The positive expression rate of Bcl-2 and PCNA after chemotherapy (39.1%, 47.5%) was much lower than that of osteosarcoma cells before chemotherapy (73.9%, 87.0%). No relationship was found between the expression of Bcl-2 and tumor cell necrosis rate before and after chemotherapy. No relationship existed between the expression of PCNA and the TCNR before chemotherapy. After chemotherapy, the lower of the positive expression rate of PCNA resulted the better prognosis. Conclusions Chemotherapy could inhibit proliferate and induce apoptosis on osteosarcoma cells. The determination of PCNA could evaluate the prognosis and guide the postoperative chemotherapy.