Sacral Chordoma Tissue Expression Of Telomerase And Cancer Prognosis Of Recurrence Study

Objective:Through the analysis of sacral chordoma tissue expression of telomerase and its laws, in order to find reliable chordoma survival and/or recurrence predictor. Thus provide a new basis of theoretical and experimental studies for the treatment of sacral chordoma patients, reduce the relapse rate, in order to achieve the purpose to improve patient survival and quality of life.Methods:1、Through the inclusion and exclusion criteria for screening and follow-up to my hospital from January2000to July2009hospitalized patients, to obtain the complete medical records and tumor tissue paraffin block specimens of20cases, and tumor adjacent normal tissue in seven cases;2、SP immunohistochemical assay the specimen in telomerase expression positive rates and expression intensity;3、Statistical analysis of the expression of telomerase in the sacral chordoma tissue adjacent to the tumor organizations in the difference between the two;4、Expression of telomerase in tumor tissue strength and gender, age, tumor size, surgical approach, tumor recurrence, contact between the variety of factors;5、Single factor in the Kaplan-Meier analysis of recurrence results and draw CDFS curve, Log-Rank method for hypothesis testing;6、Spearman rank correlation analysis to determine the recurrence factors and expression of telomerase in the relationship between the intensity and extent of close.Results:1、20patients were followed up for38to174, an average of94.5±43.9months, the median time of88.5months, relapse11patients (55%),1year relapse rate of5%,3-year recurrence rate of25%,5-year recurrence rate of55%;2、Telomerase expression in20cases of sacral chordoma tissue samples were positive (100%),11cases of which strongly positive, and9cases was weakly positive.7cases the tumor adjacent normal tissues telomerase expression was negative (100%);3、Wilcoxon rank sum test results show that, the positive expression of telomerase in tumor tissue of the patients with chordoma recurrence was significantly higher than those without recurrence (P=0.0027<0.05);4、Chi-square analysis results showed that, intensity of expression of telomerase in tumor tissue and gender, age, tumor size, surgical approach, tumor location were not statistically significant, relapse is a significant difference (P=0.0004<0.05);5. Free survival using the Kaplan-Meier method for the response variable, draw the CDFS curve, analysis of telomerase positive hypothesis test of time to recurrence of the Log-Rank method (X2=8.8278, P=0.003<0.05), the results suggest that telomerase is highly expressed by the recurrence rate was significantly increased;6^Spearman rank correlation (r=-0.58389, P=0.0069<0.05) results show that, telomerase-positive intensity and direction of recurrence relations for the negative correlation, positive degree, the higher the shorter disease-free survival, the greater the possibility of recurrence.Conclusion:1、Chordoma tissue telomerase positive rate was100%, tumor tissue (>3mm) were negative. Therefore, the indicators can be used as the standard of the tumor and surrounding normal tissue boundaries, so that accurate and thorough surgical resection of tumor;2、Intensity of the expression of telomerase activity in chordoma tissues, the shorter disease-free survival of their patients;3、Chordoma degree of expression of telomerase, can as an independent predictor of recurrent sacral chordoma, its forecast of chordoma recurrence of great significance.