血管形成、纤维连接蛋白和肿瘤细胞增殖与骨肉瘤侵袭、转移、复发的关系

目的　探讨骨肉瘤中新生血管的形成、纤维连接蛋白的表达以及肿瘤细胞的增殖状况与骨肉瘤侵袭、转移、复发的关系。方法　采用免疫组织化学S -P法检测了 62例骨肉瘤 (初发性骨肉瘤 5 1例 ,复发性骨肉瘤 11例 ;确诊时即伴有肺转移者 9例 ,不伴有肺转移者 5 3例 )和对照组织中CD 34、FN、Ki -67的表达 ,并根据阳性瘤细胞占肿瘤细胞总数的比例进行半定量量化分析和非参数统计检验。结果　骨肉瘤中的MVD值及FN的表达水平均显著性低于骨纤维结构不良组织 (P均 <0 .0 5 ) ,但是 ,复发性和初发性骨肉瘤、以及伴有肺转移与不伴有肺转移的骨肉瘤分别相比较 ,其MVD值和FN的水平均无显著性差异 (P >0 .0 5 ) ;在骨肉瘤和瘤旁正常结缔组织、复发性和初发性骨肉瘤、以及伴有肺转移与不伴有肺转移的骨肉瘤分别相比较 ,Ki -67的表达均有显著性差异 (P均 <0 .0 5 )。结论　骨肉瘤的侵袭能力与新生血管数目的增加、细胞外纤维连接蛋白的减少及肿瘤细胞增殖速率的增高相一致。骨肉瘤是否复发及出现早期肺转移主要由瘤细胞的增殖速率决定 ,与血管形成和FN的表达无关

Relationship Between Angiogenesis ,Fibronectin, Cell Proliferation and Invasion, Metastasis,Recurrence Rate in Osteosarcoma

Objective To investigate the relationship between angiogenesis,the expression of fibronectin,proliferative rate of tumor cells and the invasion,metastasis,recurrence rate in osteosarcoma.Methods Immunohistochemistry staining(labeled streptavidin method) was used to detect CD34,Fifronectin and Ki-67 in 62 cases with osteosarcoma(51 cases with primary tumors and 11 cases with recurrent tumors,9 cases with lung metastasis and 53 cases without) and in negative controls.The positive rate of CD34,FN and Ki-67 in tumor cells,was semi-quantitated and analyzed by nonparametric statistical test.Results MVD and FN were significantly different between osteosarcoma group and control group.However,they were not significantly difference either between primary and recurrent osteosarcoma or between osteosarcoma with lung metastasis and without lung metastasis.The expression of Ki-67 was significantly higer in osteosarcoma than in negative control.There were also significant difference in Ki-67 either between primary and recurrent osteosarcoma or between osteosarcoma with lung metastasis and without lung metastasis.Conclusion Increased angiogenesis,decreased Fibronectin and high proliferative rate of tumor cells have a consistent association with invasion of osteosarcoma.The recurrence rate and early lung metastasis are affected mainly by the proliferative rate of tumor cells,but not by angiogenesis and fibronectin.