Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria
Spine (Phila Pa 1976). 2012 Jun 1;37(13):E757-67. doi: 10.1097/BRS.0b013e31824782e1.
Retrospective study.
To investigate the immunohistochemical expression profile of ezrin, matrix metalloproteinase-9 (MMP-9), and cyclooxygenase-2 (COX)-2 in chordomas.
Ezrin, MMP-9, and COX-2 are expressed in different solid tumors, including chordomas. This study investigates the immunohistochemical expression of the aforementioned biomarkers and the clinical outcome in regard to immunohistochemistry, tumor volume, and localization.
Fifty brachyury-verified chordoma specimens of 34 primary and 16 recurrent tumors of 44 patients were tested for ezrin, MMP-9, and COX-2 as possible therapeutical targets by immunohistochemistry. The clinical evaluation concentrated on tumor location, volume, and age-related data.
Ezrin expression was detected in 33 of 34 primary chordomas and in 16 of 16 recurrent cases. The primary chordomas located in the sacrum and the spine demonstrated a significantly higher percentage of positively stained tumor cells (P = 0.034) than the skull-based chordomas. An expression of MMP-9 and COX-2 was observed in 33 of 34 primary chordomas and in 16 of 16 recurrences, and in 13 of 34 primary chordomas and in 11 of 16 recurrences, respectively. Patients' survival was significantly influenced by age (P = 0.01), tumor location (P = 0.029), and tumor volume (P = 0.002). A significant positive correlation between tumor volume and the anatomic distance of the chordoma from the skull was calculated (P = 0.00002).
En bloc resection with tumor-free margins is seldom feasible, particularly in the sacrum. Intralesional excisions mostly end in early local recurrence; therefore, the demand for further treatment options is frequently posed. The marked trend of the investigated biomarkers of this study may build a starting point for further investigations as molecular targets for future adjuvant therapies in chordomas. Future multicenter studies on larger patients' series are necessary to elucidate these preliminary data and to test new treatment options for patients with chordomas.
回顾性研究。
研究桥脑脊索瘤中 ezrin、基质金属蛋白酶-9（MMP-9）和环氧化酶-2（COX-2）的免疫组织化学表达谱。
ezrin、MMP-9 和 COX-2 在不同的实体瘤中表达，包括脊索瘤。本研究通过免疫组织化学检测了上述生物标志物的表达，并结合免疫组化、肿瘤体积和定位对临床结果进行了研究。
对 34 例原发性和 16 例复发性脊索瘤患者的 44 例 brachyury 验证标本进行 ezrin、MMP-9 和 COX-2 的免疫组织化学检测，以寻找可能的治疗靶点。临床评估集中于肿瘤位置、体积和年龄相关数据。
34 例原发性脊索瘤中有 33 例和 16 例复发性脊索瘤中有 16 例检测到 ezrin 表达。位于骶骨和脊柱的原发性脊索瘤中，阳性染色肿瘤细胞的百分比明显高于颅底脊索瘤（P = 0.034）。34 例原发性脊索瘤中有 33 例和 16 例复发性脊索瘤中有 16 例表达 MMP-9，34 例原发性脊索瘤中有 13 例和 16 例复发性脊索瘤中有 11 例表达 COX-2。患者的生存与年龄（P = 0.01）、肿瘤位置（P = 0.029）和肿瘤体积（P = 0.002）显著相关。计算出肿瘤体积与脊索瘤距颅骨的解剖距离之间存在显著正相关（P = 0.00002）。
整块切除肿瘤边缘无肿瘤的情况很少见，特别是在骶骨。肿瘤内切除术大多导致早期局部复发，因此经常需要进一步的治疗选择。本研究中所研究的生物标志物的显著趋势可能为未来脊索瘤的辅助治疗提供分子靶点的研究提供了一个起点。未来需要在更大的患者系列中进行多中心研究，以阐明这些初步数据并测试新的治疗选择。
