Di-san junyi daxue xuebao (Feb 2019)
Clinicopathological characteristics of osteosarcoma and prognostic significance of Notch receptors and ligands expression: analysis of 70 cases
Abstract
Objective To investigate the clinicopathological features of osteosarcoma and the prognostic significance of the expression of Notch receptors and ligands. Methods We retrospectively analyzed the clinical and histopathological data of 70 patients with osteosarcoma treated in the Second and Third Affiliated Hospitals of Army Medical University from 2008 to 2015. Immunohistochemical staining was used to examine the expressin levels of 4 Notch receptors (Notch1-4) and 3 Notch ligands (Jagged1, Jagged2 and DLL4) in the surgical specimens. The risk factors that affected the outcomes of the patients were analyzed in 54 cases. Results The patients had a mean age of 25.1 years with a male to female ratio of 3 :2, and 95.7% of the patients were in stage Ⅱ-Ⅲ. Imaging examinations revealed bone destruction in 61 cases (87.1%), medullary cavity involvement in 8 cases (11.4%) and bone cortex involvement in 29 cases (41.4%); periosteal reaction was detected in 28 cases(40%). Histopathologically, 57.1% of patients (40 cases) showed invasive growth of osteosarcoma, and all the patients had sarcoma cells and neoplastic osteoid tissues. Immunohistochemical analysis showed positive Notch1, Notch2, Notch3 and Notch4 expression in 87.1% (61/70), 33.9% (23/70), 68.6% (48/70) and 91.4% (64/70) of the patients, respectively with the last one of the highest; positive expression of Jagged1, Jagged2 and DLL4 were detected in 87.1% (61/70), 84.3% (59/70) and 88.6% (62/70) of the patients. Sixty percent of the patients (42 cases) received chemotherapy, and 95.7% of the patients (67 cases) underwent surgeries. The mean survival time of the 54 patients with full follow-up data was 41.68 months and their 1-, 2- and 5-year survival rates were 87%, 66% and 30%, respectively. Survival curre analysis showed thed Enneking stage, oreoperative chemotherapy and Notch 3 experssion were related with prognosis (P=0.017). Cox regression analysis showed that Enneking stage, preoperative chemotherapy and Notch3 expression were independent prognostic factors in these patients. Conclusion Patients with osteosarcoma have a rather low 5-year survival rate. Advanced Enneking stage, positive Notch3 expression and no preoperative chemotherapy are all predictive of a short survival time of the patients.
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