p21WAF1基因表达对人骨肉瘤预后的价值

目的 探讨骨肉瘤组织中p21^WAF1基因的表达与骨肉瘤生物学特性及预后的关系。方法 采用原位杂交及免疫组织化学（LSAB法）检测p21^WAF1mRNA及p21蛋白在45例骨肉瘤、10例骨纤维结构不良实体瘤组织标本的表达。结果 （1）p21蛋白阳性表达率在骨肉瘤中为17．7％（8／45）;（2）骨肉瘤组织高分化组与低分化组的p21蛋白阳性表达率之间的差异有统计学意义（40．0％,11．4％,X^2=4．34,P〈0．05）;（3）p21^WAF1mRNA表达阳性率在骨肉瘤中为42．2％（19／45）,骨肉瘤组织高分化组与低分化组的p21^WAF1mRNA阳性表达率之间的差异有统计学意义（60．0％,37．1％,X^2=20．6,P〈0．01）;（4）p21^WAF1mRNA表达阳性者术后生存时间高于表达阴性者术后生存时间（P〈0．05）。结论 （1）随着骨肉瘤恶性度的升高,p21^WAF1基因mRNA及p21蛋白的表达下降。（2）p21WAF1基因mRNA在骨肉瘤中的表达对评价患者的预后有一定价值。

Prognostic significance of p21(WAF1) expression in osteosarcoma

OBJECTIVE: To investigate the expression of p21(WAF1) gene in human osteosarcoma and their relationships with clinicopathological parameters and prognostic value. METHODS: The p21(WAF1) gene mRNA and p21 protein expression in 45 osteosarcoma and 10 fibrous dysplasia of bone specimens were analyzed by in situ hybridization and immunohistochemistry respectively. RESULTS: (1) The positive rate of p21 protein expression in osteosarcoma was 17.7% (8/45). (2) The expression rate in high proliferation (4/10) significantly higher than that in low proliferation (4/35) osteosarcoma (chi2 = 4.34, P < 0.05). (3) The positive rate of p21(WAF1) mRNA expression in osteosarcoma was 42.2% (19/45). The expression rate in high proliferation (6/10) significantly higher than that in low proliferation (13/35) osteosarcoma (chi2 = 20.6, P < 0.01). (4) The survival time after operation of the patients with p21(WAF1) mRNA expression were higher than that of the patients with p21(WAF1) mRNA negative expression (P < 0.05). CONCLUSIONS: (1) With the increase in degree of malignancy, the expression of p21(WAF1) mRNA and p21 protein in osteosarcoma tend decrease. (2) The expression of p21(WAF1) mRNA has a definite value in judging prognosis in osteosarcoma.