Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Asian Pac J Cancer Prev. 2021 Mar 1;22(3):741-747. doi: 10.31557/APJCP.2021.22.3.741.
The receptor activator of nuclear factor kappa B ligand (RANKL) is one of the key regulators of bone remodelling in bone oncology, including osteosarcoma. We assessed RANKL immunohistochemical expression in osteosarcoma, its association, and disease-free survival with the patients' clinicopathological characteristics.
One hundred osteosarcoma cases from 2003 to 2018 in Hospital Universiti Sains Malaysia were retrieved. The tissue samples were stained for RANKL, and the association with the clinicopathological characteristics was evaluated. Staining was interpreted in a semiquantitative scoring system and classified into negative and positive expressions. Results: Eighty-two cases had a positive expression of RANKL in which 56 and 26 patients were classified as low expression and high expression, respectively. The positive expression of RANKL did not show a significant association with clinicopathological characteristics. However, Kaplan Meier survival analysis showed a significant improvement in the disease-free survival patients who underwent limb salvage surgery (LSS) than amputated patients (p-value 0.002), whereas poorer survival was observed among conventional osteosarcomas compared to non-conventional osteosarcoma (p-value 0.01).
Limb salvage surgery had proven to improve osteosarcoma patients' survival compared to amputation, which could improve overall quality of life in osteosarcoma patients. However, our data did not show a significant association between positive RANKL immunohistochemistry with any of the clinicopathological characteristics and patients' final survival. Further studies may be acquired to understand the suitability of using RANKL immunohistochemistry as prognostication in the management of osteosarcoma patients.
核因子-κB 受体激活剂配体（RANKL）是骨肿瘤中骨重塑的关键调节剂之一，包括骨肉瘤。我们评估了骨肉瘤中 RANKL 的免疫组织化学表达及其与患者临床病理特征的关联和无病生存率。
从 2003 年至 2018 年，在马来西亚大学医院检索了 100 例骨肉瘤病例。对组织样本进行 RANKL 染色，并评估其与临床病理特征的关联。染色采用半定量评分系统进行解释，并分为阴性和阳性表达。
82 例 RANKL 阳性表达，其中 56 例和 26 例患者分别归类为低表达和高表达。RANKL 的阳性表达与临床病理特征无显著相关性。然而，Kaplan-Meier 生存分析显示，接受保肢手术（LSS）的患者无病生存率明显优于截肢患者（p 值 0.002），而常规骨肉瘤患者的生存率较非常规骨肉瘤患者差（p 值 0.01）。
保肢手术已被证明可提高骨肉瘤患者的生存率，优于截肢，这可以提高骨肉瘤患者的整体生活质量。然而，我们的数据并未显示 RANKL 免疫组织化学阳性与任何临床病理特征和患者最终生存之间存在显著相关性。可能需要进一步的研究来了解 RANKL 免疫组织化学作为骨肉瘤患者管理中的预后指标的适用性。
