Clinical Value of Ezrin Expression in Primary Osteosarcoma
Clinical Value of Ezrin Expression in Primary Osteosarcoma
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DOI：
10.4143/crt.2009.41.3.138
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发表时间：
2009-09-01
影响因子：
4.6
通讯作者：
Rha, Sun Young
中科院分区：
文献类型：
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作者：
Kim, Chan;Shin, Eunah;Rha, Sun Young
目的Ezrin是一种膜骨架连接蛋白，与原发性骨肉瘤的转移有关。本研究的目的是确定埃兹蛋白表达和几个关键的临床参数之间的关系，并阐明其潜在的预后价值为骨肉瘤患者。材料和方法70例组织学证实的骨肉瘤，谁没有远处转移，1995年和2005年之间在延世癌症中心，Severance医院，韩国。临床参数进行了回顾性分析和免疫组化染色（IHC）ezrin进行使用手术切除的samples.ResultsOf 70例肿瘤标本，39（55.7%）显示ezrin表达。更多的成骨细胞组织学和升高的初始ALP水平，观察埃兹蛋白阳性患者比埃兹蛋白阴性患者（p=0.008和0.001，分别）。ezrin阳性患者组中对新辅助化疗反应良好（坏死>= 90%）的患者比例显著高于ezrin阴性患者组（分别为72.2% vs 45.2%，p=0.024）。埃兹蛋白阳性的患者比埃兹蛋白阴性的患者复发率更高（分别为64.1%和35.5%，p=0.017）。有ezrin表达的患者的生存率也低于无ezrin表达的患者（5年EFS：分别为31.7%和61.3%，p=0.023，5年OS：分别为53.4%和71.0%，p=0.022）。当根据ezrin表达和化学反应性比较EFS时，有趋势表明ezrin阴性/化学反应性组显示出最好的5年EFS（71.4%），其次是ezrin阴性/化学耐药组（52.9%），ezrin阳性/化学反应性组（38.1%）和ezrin阳性/化学耐药组（13.6%）。这些趋势有统计学意义（p=0.036）。结论通过免疫组化染色的Ezrin的表达被发现在55.7%的无转移骨肉瘤患者。对ezrin的免疫反应性是骨肉瘤患者生存的负性预后因素。识别ezrin表达可能为治疗原发性骨肉瘤患者提供有价值的信息。
PurposeEzrin is a membrane cytoskeletal linker protein and it is known to be associated with metastasis of primary osteosarcoma. The aim of this study is to determine the relationship between an ezrin expression and several key clinical parameters and to elucidate its potential prognostic value for patients with osteosarcoma.Materials and MethodsSeventy patients with histologically confirmed osteosarcoma and who had no distant metastasis were enrolled between 1995 and 2005 at Yonsei Cancer Center, Severance Hospital, Korea. The clinical parameters were retrospectively reviewed and immunohistochemical staining (IHC) for ezrin was performed using the surgically resected specimens.ResultsOf the 70 tumor specimens, 39 (55.7%) revealed an ezrin expression. More of an osteoblastic histology and an elevated initial ALP level were observed in the ezrin positive patients than in the ezrin negative patients (p=0.008 and 0.001, respectively). The proportion of patients who favorably responded to neoadjuvant chemotherapy (>= 90% necrosis) was significantly higher in the group of ezrin positive patients than that in the group of ezrin negative patient (72.2% vs 45.2%, respectively, p=0.024). The ezrin positive patients showed more frequent recurrence than did the ezrin negative patients (64.1% vs 35.5%, respectively, p=0.017). The patients with an ezrin expression also demonstrated poorer survival than did those patients without ezrin expression (5-year EFS: 31.7% vs 61.3%, respectively, p=0.023, 5-year OS: 53.4% vs 71.0%, respectively, p=0.022). When comparing EFS according to both an ezrin expression and chemoresponsiveness, there were trends that the ezrin negative/chemoresponsive group showed the best 5-year EFS (71.4%), followed by the ezrin negative/chemoresistant group (52.9%), the ezrin positive/chemoresponsive group (38.1%) and the ezrin positive/chemoresistant group (13.6%). These trends were statistically significant (p=0.036).ConclusionThe expression of ezrin by IHC staining was found in 55.7% of the patients with metastasis-free osteosarcoma. Immunoreactivity to ezrin is a negative prognostic factor for survival for the patients suffering with osteosarcoma. Identifying an ezrin expression might offer a valuable piece of information when treating patients with primary osteosarcoma.