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目的探讨新辅助化疗对骨肉瘤组织中细胞周期素D1(CyclinD1)、Bcl-2、增殖细胞核抗原(proliferatingcellnuclearantigen,PCNA)和P-糖蛋白(P-glycoprotein,P-gp)表达的影响,及与肿瘤细胞坏死率(tumorcellnecrosisrate,TC-NR)的关系。方法应用免疫组织化学技术检测化疗前后23例骨肉瘤组织标本中CyclinD1、Bcl-2、PCNA和P-gp的表达,并计算TCNR。结果新辅助化疗前CyclinD1、Bcl-2、PCNA和P-gp的阳性表达率分别为73.9%(17/23)、69.6%(16/23)、91.3%(21/23)和21.7%(5/23),新辅助化疗后的阳性表达率分别为52.2%(12/23)、34.8%(8/23)、43.5%(10/23)和56.5%(13/23)。化疗后,骨肉瘤组织中Bcl-2、PCNA的表达低于化疗前,P值分别为0.039和0.034;P-gp高于化疗前,P=0.021;CyclinD1的表达差别无统计学意义,P=0.180。化疗前CyclinD1、Bcl-2、PCNA和P-gp的表达与TCNR无相关性,P值分别为0.155、0.371、1.000和0.640;而化疗后Bcl-2、PCNA和P-gp的表达与TCNR呈负相关,P值分别为0.009、0.012和0.015;CyclinD1的表达与TCNR无相关性,P=0.100。结论新辅助化疗可能通过抑制肿瘤细胞的增殖和促进肿瘤细胞的凋亡达到杀灭骨肉瘤细胞的目的;同时,由于MDR的过度表达,增加骨肉瘤细胞对化疗药物的耐药性。检测化疗前CyclinD1、Bcl-2、PCNA和P-gp在肿瘤细胞中的表达尚难以预测骨肉瘤的化疗疗效。
Objective To investigate the effect of neoadjuvant chemotherapy on the expression of cyclin D1, Bcl-2, proliferating cell nuclear antigen (PCNA) and P-glycoprotein (P-gp) in osteosarcoma tissues. Tumor cell necrosis rate (TC-NR) relationship. Methods Immunohistochemical technique was used to detect the expression of CyclinD1, Bcl-2, PCNA and P-gp in 23 specimens of osteosarcoma before and after chemotherapy and calculate TCNR. Results The positive rates of Cyclin D1, Bcl-2, PCNA and P-gp before neoadjuvant chemotherapy were 73.9% (17/23), 69.6% (16/23), 91.3% (21/23) and 21.7% (5 /23) The positive expression rates after neoadjuvant chemotherapy were 52.2% (12/23), 34.8% (8/23), 43.5% (10/23), and 56.5% (13/23), respectively. After chemotherapy, the expression of Bcl-2 and PCNA in osteosarcoma tissue was lower than that before chemotherapy, the P values were 0.039 and 0.034, respectively; P-gp was higher than before chemotherapy, P=0.021; the expression of CyclinD1 was not statistically significant, P= 0.180. There was no correlation between Cyclin D1, Bcl-2, PCNA and P-gp expression and TCNR before chemotherapy. The P values were 0.155, 0.371, 1.000 and 0.640, respectively. The expression of Bcl-2, PCNA and P-gp and TCNR were positive after chemotherapy. Negative correlation, P values were 0.009, 0.012, and 0.015, respectively; CyclinD1 expression was not correlated with TCNR, P=0.100. Conclusions Neoadjuvant chemotherapy may kill osteosarcoma cells by inhibiting the proliferation of tumor cells and promoting the apoptosis of tumor cells. At the same time, due to the overexpression of MDR, it increases the resistance of osteosarcoma cells to chemotherapeutic drugs. Detecting the expression of CyclinD1, Bcl-2, PCNA and P-gp in tumor cells before chemotherapy is difficult to predict the efficacy of chemotherapy for osteosarcoma.