目的：观察P16蛋白表达在骨肉瘤（OS）患者新辅助化疗效果预测中的价值。方法骨肉瘤患者40例，术前均进行了药物辅助化疗，通过手术标本及组织活检构建石蜡包埋组织芯片40例，采用免疫组化染色法对P16的表达进行分析。当＞30％的细胞核着色时为P16阳性。对化疗后手术切除的38例标本进行分析，≥90％的肿瘤坏死时为良，＜90％为差。统计患者性别、年龄、肿瘤部位以及组织病理类型与肿瘤坏死之间的关系。采用单因素和多因素分析法进行分析。结果 P16总体表达率为62墘．5％（25／40），治疗后肿瘤中位坏死率为95．0％，57．9％（22／38）的手术患者化疗反应为“良”。单因素分析表明：P16阳性表达患者中位坏死率以及化疗反应评“良”率高于P16阴性患者（ P ＜0．01）。 Logistic回归分析表明：P16是反映骨肿瘤细胞对药物化疗反应的独立预测因素（OR＝43．50，CI 2．64～708．90， P ＝0．01），与患者的年龄、肿瘤类型、性别、部位无关。结论 P16的表达同骨肉瘤药物化疗效果显著相关，可作为一种分子标志物用于对术前进行化疗患者的首选。%Objective To study the predictive value of P16 protein expression in osteosarcoma(OS) patients under neoadjuvantchemotherapy.Methods 40patientswithOSwereselected,allpatientsreceiveddurgadjuvantchemotherapy, paraffin embedded chips were established through the operation specimens and biopsy,immunohistochemistry staining method was used to analyze the expression of P16.P16 was positive when nuclear stained were more than 30%.The resection speci-mens of 38 patients after chemotherapy were analyzed to determine tumor necrosis percentage, when tumor necrosis was more than 90%it’ s good, when tumor necrosis was less than 90%, it’ s bad.The relationship between patient gender, age, tumor location, pathological type and tumor necrosis were analyzed using single factor and multiply factor analysis.Results The ex-pression rate of P16 was 62.5%(25/40), after treatment the median tumor necrosis rate was 95.0%,57.9%(22/38) of pa-tients were"good"at response to chemotherapy.Single factor analysis showed that:P16 positive patient’ s median necrosis rate and chemotherapy response"good"rate were higher than P16 negative patients( P <0.01).Logistic regression analysis showed that:P16 was independent predictor of chemotherapy response(OR=43.50,95% CI 2.64-708.90, P <0.01), there was no correlation between P16 expression and gender, age, tumor type, location.Conclusion The expression of P16 was significantly related to chemotherapy effect in osteosarcoma, it could be used as a marker to choice the patients in the need for chemotherapy before operation.
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