Massi D, Franchi A, Borgognoni L, Reali U M, Santucci M
Istituto di Anatomia e Istologia Patologica, Università degli Studi di Firenze, Italia.
Hum Pathol. 1999 Mar;30(3):339-44. doi: 10.1016/s0046-8177(99)90014-x.
Osteonectin, also termed BM40 or SPARC (secreted protein, acidic and rich in cysteine) is a multifunctional glycoprotein involved in tissue mineralization, cell-extracellular matrix interactions as well as angiogenesis. It has been suggested that osteonectin may play a key role in the process of tumoral invasion and metastasis in certain malignancies. In this study, we reviewed the clinical records and the histopathologic slides of 188 thin cutaneous malignant melanomas (< or = 0.75 mm). Among them, 12 cases underwent progression and were selected for the study. Osteonectin expression was investigated by immunohistochemistry in these 12 patients and 24 matched controls who did not undergo progression. Osteonectin staining was correlated with clinical outcome and other clinicopathologic parameters. Progression-free and disease-specific survival rates were calculated with the Kaplan-Meier method and their differences were evaluated by the log rank test. Overall, immunoreactivity for osteonectin was found in 23 (63.8%) cases. Eighteen cases (50%) displayed staining in 1% to 50% of neoplastic cells whereas five cases (13.8%) showed a diffuse positivity in more than 50% of the tumor cells. Osteonectin expression was significantly correlated with risk of progression (P = .01), incidence of distant metastases (P = .005) and survival (P = .03). There was a higher incidence of osteonectin-positive tumors in cases that did experience regional lymph node metastases versus those cases that did not, but that difference did not reach statistical significance (P = .06). No significant correlation was found between osteonectin expression and other clinicopathologic features, including age, sex, site, histotype, Clark's level, presence of regression, presence of inflammatory response, and tumor growth phase. Our data showed that osteonectin expression is a predictor of clinical outcome in thin cutaneous melanomas.
骨连接素，也称为BM40或SPARC（分泌性蛋白质，酸性且富含半胱氨酸），是一种多功能糖蛋白，参与组织矿化、细胞与细胞外基质的相互作用以及血管生成。有人提出骨连接素可能在某些恶性肿瘤的肿瘤侵袭和转移过程中起关键作用。在本研究中，我们回顾了188例薄型皮肤恶性黑色素瘤（≤0.75mm）的临床记录和组织病理学切片。其中，12例病情进展并被选入研究。通过免疫组织化学方法对这12例患者以及24例未发生病情进展的匹配对照进行骨连接素表达研究。骨连接素染色与临床结果及其他临床病理参数相关。采用Kaplan-Meier方法计算无进展生存率和疾病特异性生存率，并通过对数秩检验评估两者差异。总体而言，23例（63.8%）病例发现骨连接素免疫反应阳性。18例（50%）肿瘤细胞染色阳性率为1%至50%，而5例（13.8%）肿瘤细胞染色阳性率超过50%，呈弥漫性阳性。骨连接素表达与病情进展风险（P = 0.01）、远处转移发生率（P = 0.005）及生存率（P = 0.03）显著相关。发生区域淋巴结转移的病例中骨连接素阳性肿瘤的发生率高于未发生区域淋巴结转移的病例，但差异未达到统计学意义（P = 0.06）。未发现骨连接素表达与其他临床病理特征之间存在显著相关性，这些特征包括年龄、性别、部位、组织学类型、Clark分级、消退情况、炎症反应情况及肿瘤生长阶段。我们的数据表明，骨连接素表达是薄型皮肤黑色素瘤临床结果的一个预测指标。
