iNOS及HIF1α在骨肉瘤中表达及其临床病理相关性探究.doc

iNOS及HIF1α在骨肉瘤中表达及其临床病理相关性探究 　 作者：耿艳华 王昌兴 陈培辉 【摘要】 目的 从酶蛋白水平研究骨肉瘤组织缺氧代谢过程中iNOS、HIF1α的表达及与临床、病理特征的关系；探讨它们在肿瘤发展过程中作用的可能机制。方法 筛选不含硬骨组织，未经脱钙处理的骨肉瘤标本59例，依据临床病理特征进行分组，并行术后随访。应用免疫组织化学EnVision法检测肿瘤组织中iNOS、HIF1α表达，应用χ2检验、Spearman等级相关分析等进行统计分析。结果 骨肉瘤中iNOS、HIF1α表达阳性率分别为 86.44%、38.98%，对照组中分别为 9.9%和0，两组比较，差异均有显著性。HIF1α的表达与骨肉瘤患者年龄有关(P＜0.01)，iNOS则无关(P＞0.05)。HIF1α和iNOS的表达均与骨肉瘤组织学类型有关， iNOS、HIF1α在髓内高分化型和骨旁型骨肉瘤总阳性表达率分别为33.33%和0，分别低于其余各组总和阳性率91.30%和41.30%，差异有显著性(P＜0.01和0.05)。HIF1α与iNOS表达正相关，两者共阳率38.98%，共阴率13.56%。iNOS阳性与阴性组中，HIF1α的阳性表达率分别为45.10％和0，差异有显著性(P＜0.01)。结论 iNOS与HIF1α在骨肉瘤组织中均高表达，与肿瘤的发生、发展有关，可能协同促进肿瘤的恶性进展。 【关键词】 骨肉瘤 诱导型一氧化氮合酶 缺氧诱导因子1α 免疫组织化学 　　【Abstract】 Objective To investigate the expressions of HIF1α and iNOS in 59 cases of osteosarcoma and their correlations with clinical and pathological features, and to explore their roles in tumor development . Methods 59 cases typical osteosarcoma specimens without os osseum tissue and non-decalcification were obtained and grouped according to the clinicopathologic characteristics, the followed-up data of postoperative patients were collected. The tests were examined by immunohistochemical staining (EnVision). Data were evaluated by χ2 and Spearman rank correlation analysis. the survival data of postoperative were performed by kaplan-meier survival curve analysis and Log-Rank method. Results The positive expression rates of iNOS and HIF1α in osteosarcoma were 86.44% and 38.98% respectively , which were significantly higher than that of control group (Plt;0.01 and 0.05), respectively. The expression of HIF1α was positively related with the age (P＜0.01),but the iNOS was not (P＞0.05). The expression of HIF1α and iNOS were positively related with the histological classifications, in iNOS and HIF1α positive groups, total positive rates of intraosseous well-differentiated and parostea osteosarcoma was 33.33% and 0, respectively, which was remarkably lower than that of the other groups (91.30% and 41.30%,) with significant difference (P＜0.01