Orthopaedics Department, Xuhui central hospital, No, 966, Middle Huaihai Road, Shanghai 200031, China.
Diagn Pathol. 2013 Nov 4;8:183. doi: 10.1186/1746-1596-8-183.
SOX9 plays an important role in bone formation and tumorigenesis. However, its involvement in osteosarcoma is still unclear. The aim of this study was to investigate the expression pattern and the clinical significance of SOX9 in human osteosarcoma.
SOX9 mRNA and protein expression levels were detected by RT-PCR and Western blot assays, respectively, using 30 pairs of osteosarcoma and noncancerous bone tissues. Then, immunohistochemistry was performed to analyze the association of SOX9 expression in 166 osteosarcoma tissues with clinicopathological factors or survival of patients.
SOX9 expression at mRNA and protein levels were both significantly higher in osteosarcoma tissues than those in corresponding noncancerous bone tissues (both P < 0.001). Immunohistochemical staining indicated that SOX9 localized to the nucleus and high SOX9 expression was observed in 120 of 166 (72.3%) osteosarcoma specimens. In addition, high SOX9 expression was more frequently occurred in osteosarcoma tissues with advanced clinical stage (P = 0.02), positive distant metastasis (P = 0.008) and poor response to chemotherapy (P = 0.02). Osteosarcoma patients with high SOX9 expression had shorter overall survival and disease-free survival (both P < 0.001). Furthermore, the multivariate analysis confirmed that upregulation of SOX9 was an independent and significant prognostic factor to predict poor overall survival and disease-free survival (both P = 0.006).
Our data show for the first time that SOX9 is upregulated in aggressive osteosarcoma tissues indicating that SOX9 may participate in the osteosarcoma progression. More importantly, SOX9 status is a useful prognostic factor for predicting the prognosis of osteosarcoma, suggesting that SOX9 may contribute to the optimization of clinical treatments for osteosarcoma patients.
The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1318085636110837.
SOX9 在骨骼形成和肿瘤发生中发挥重要作用。然而，其在骨肉瘤中的作用尚不清楚。本研究旨在探讨 SOX9 在人骨肉瘤中的表达模式及其临床意义。
采用 RT-PCR 和 Western blot 检测 30 对骨肉瘤和非癌骨组织中 SOX9mRNA 和蛋白的表达水平。然后，采用免疫组织化学法分析 166 例骨肉瘤组织中 SOX9 表达与患者临床病理因素及生存的关系。
骨肉瘤组织中 SOX9 的 mRNA 和蛋白表达均明显高于相应的非癌骨组织（均 P<0.001）。免疫组织化学染色显示 SOX9 定位于细胞核，166 例骨肉瘤标本中有 120 例（72.3%）高表达 SOX9。此外，SOX9 高表达更常见于临床分期较晚（P=0.02）、远处转移阳性（P=0.008）和化疗反应差的骨肉瘤组织（P=0.02）。SOX9 高表达的骨肉瘤患者总生存期和无病生存期均较短（均 P<0.001）。此外，多因素分析证实，SOX9 上调是预测总生存期和无病生存期不良的独立且重要的预后因素（均 P=0.006）。
本研究首次表明 SOX9 在侵袭性骨肉瘤组织中上调，提示 SOX9 可能参与骨肉瘤的进展。更重要的是，SOX9 状态是预测骨肉瘤预后的有用预后因素，提示 SOX9 可能有助于优化骨肉瘤患者的临床治疗。
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