Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2009 Sep;41(3):138-44. doi: 10.4143/crt.2009.41.3.138. Epub 2009 Sep 28.
Ezrin 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.
Seventy 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.
Of 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 (≥or=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).
The 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.
Ezrin 是一种膜细胞骨架连接蛋白，已知与原发性骨肉瘤的转移有关。本研究的目的是确定 ezrin 表达与几个关键临床参数之间的关系，并阐明其对骨肉瘤患者的潜在预后价值。
1995 年至 2005 年期间，在韩国延世癌症中心塞弗伦斯医院，对 70 名经组织学证实患有骨肉瘤且无远处转移的患者进行了研究。回顾性分析了临床参数，并使用手术切除的标本进行 ezrin 的免疫组织化学染色（IHC）。
在 70 个肿瘤标本中，有 39 个（55.7%）显示出 ezrin 表达。与 ezrin 阴性患者相比，ezrin 阳性患者的成骨组织学和初始 ALP 水平升高更为明显（p=0.008 和 0.001）。在 ezrin 阳性患者中，对新辅助化疗反应良好（≥90%坏死）的患者比例明显高于 ezrin 阴性患者（分别为 72.2%和 45.2%，p=0.024）。ezrin 阳性患者的复发频率高于 ezrin 阴性患者（分别为 64.1%和 35.5%，p=0.017）。ezrin 表达的患者的生存率也低于无 ezrin 表达的患者（分别为 5 年 EFS：31.7%和 61.3%，p=0.023，5 年 OS：53.4%和 71.0%，p=0.022）。当根据 ezrin 表达和化疗反应性比较 EFS 时，有趋势表明 ezrin 阴性/化疗反应性组的 5 年 EFS 最佳（71.4%），其次是 ezrin 阴性/化疗耐药组（52.9%）、ezrin 阳性/化疗反应性组（38.1%）和 ezrin 阳性/化疗耐药组（13.6%）。这些趋势具有统计学意义（p=0.036）。
在无转移骨肉瘤患者中，通过免疫组织化学染色发现 ezrin 的表达占 55.7%。ezrin 免疫反应性是骨肉瘤患者生存的负预后因素。确定 ezrin 表达可能为原发性骨肉瘤患者的治疗提供有价值的信息。
