The Expression Of Cathepsin K In Giant Cell Tumor And Clinical Significance

Giant cell tumor (giant cell tumor of bone, GCTB) is a primary, halfmalignant or potential malignant tumor, containing polynuclear giant cell inpathology, scattered in the round, oval or spindle mononuclear cells forfeatures, Chinese higher incidence, about13%-15%. Giant cell tumor withpostoperative relapse easily and its biological complex have positive transfercharacteristics, and thus its accurate grading and prognosis is associated withthe common concern. According to the shape, size and hyperchromatic nucleidegree of seedless division and nuclear giant cell size, giant cell tumor isdivided into3by Jaffe. But more and more doctors found the systemclassification can’t reflect the tumor biological behavior.Giant cell tumor surged after curettage in bone and soft tissue have thetendency of local recurrence, and bone recurrence rate40%-60%. The maincause of recurrence is doctored not thoroughly, and then residual tumorcontinue to grow, resulting in recurrence. About1%-6%of the patients canhappen the so-called "benign pulmonary metastasis".In present，the researchfocus of the invasive of giant cell tumor is matrix metalloproteinases (MMPS)enzyme system and metal proteasetissue inhibitors (TIMPS) enzyme system at home and abroad. But recentlythere has been some scholars put forward that Cathepsin K (Cath-K) may alsobe in which play an important role.Cathepsin k (cathepsin k) belongs to the lysosomal cysteine proteasepapaya protease in super family members, in1999have been cloned, andcalled cathepsin O2, cathepsin X, cathepsinO. Cathepsin k precursor is a notglycosylated peptides single (i.e., former cathepsin original k), the formercathepsin original k have no activity from cell secretion, and then in vivo pH=410under the condition of the soluble protein cracking effect will front peptide from amino end after conversion with active cathepsin k. In the boneabsorption of cathepsin k is necessary condition, and mouse lack of cathepsink express for bone sclerosis, with bone matri degradation characteristics ofobstacles, but no bone mineralization of the defect.Human cathepsin k geneexpression variation will lead to the variation of compactness osteogenesisimperfecta—A bone sclerosis, GuCuiXing increase, short stature, foreheadand occiput promontory, fontanel and cranial joint broadening, distal phalanxacra osteolysis for characteristics of autosomal recessive genetic disease，andeventually lead to osteoporosis and osteopsathyrosis increase.Therefore, in the giant cell tumor of the mechanism of action, cathepsinK’s role cannot be neglected. But the present study for cathepsin K in giantcell tumor in the role of works less, so further study of cathepsin K in giantcell tumorin in vasion and metastasis, the role for giant cell tumor bytreatment provides a new means.Objective:The experiment design:1. Through the immunohistochemistry method todetect the expression of Cath-K in GCT and normal bone tissue andcompare the expression of Cath-K have significant difference or not，andthen discuss if Cath-K in giant cell tumor of the occurrence and developmentmay play a more important role；2、To confirm whether the Cathepsin K ingiant cell tumor of bone in different pathological grading of expression hasstatistics significance or not，and then discuss the relationship about Cath-Kwith ages、 recurrence and metastasis to the lungs；Discuss the relationshipabout the expression of Cath-K with CD147in GCT recurrence andmetastasis to the lungs，and then in a certain sense to explore cathepsin k inGCT occurring and developing may play a role。In order to provides a newtrain of thought for the giant cell tumor treatment.Methods:1. Take SP immunohistochemical method We selected68cases of giantcell tumor【by the hebei province BaoDingShi second hospital, chengdemedical college hospital, Beijing ji shui tan hospital provides】 all patients were not preoperative chemotherapy and radiation。Control group32-70yearsold, average age46years old, including9cases of male and11cases offemale。With33cases of Male and35cases of female patients, aged12-68years old, average age44years old,including26cases of The distal femur、22cases of distal radius and20cases of tibial near。All specimens wereconfirmed by histopathology GCT and Jaffe classification：Ⅰ level15cases,Ⅱ level24cases, Ⅲ level29cases，the specimens in10%year’s marin fixed,paraffin embedding, sectioning, was used for immunohistochemical staining。We adopt immunohistochemical staining method to observe the expression ofCath-K in the GCT organization, and combined with clinical andpathological data analysis。At the same time, we use the same method fordetecting the expression of CD147，to discuss Cath-K and CD147in GCTrecurrence and metastasis to the lungs about the correlation of cases。Results:1Cath-K positive dyeing product is brown granular，Mainly located inmany nuclear giant cell and individual mononuclear cell cytoplasm，Alsopositive multinuclear giant cell into intravascular。In the experimental group,most of the specimen Cath-K positive cells more, positive rate>60%;In thecontrol group, Cath-K positive expression we did not find.Through theimmunohistochemical experiment,We found that Cath-K positive expressionin normal tissue and giant cell tumor have significant difference，differencehave statistical significance (P <0.05)。2Cath-K positive expression in giant cell tumor Jaffe classification hassignificant difference(P <0.05)，cath-K positive expression is relevant withpatient age, recurrence and metastasis to the lungs，difference have statisticalsignificance (P <0.05)。3CD147positive materialis the dark brown granular， the mainexpression in interstitial mononuclear cell cytoplasm。In the experimentalgroup, most of the specimen CD147positive cells more, positive rate>60%;In the control group, CD147positive cells less, positive rate <40%。Cath-K and CD147in GCT recurrence and metastasis to the lungs was a positive correlation between the expression cases， difference have statisticalsignificance (P <0.05)。Conclusion:1Cath-K have a close relationship with giant cell tumor invasive,andwith the giant cell tumor Jaffe classification increase Cath-K expressiongradually increase;Cath-K positive expression are related with patients ages,And in cases of the recurrence and metastasis to the lungs enhancedsignificantly.2The expression of Cath-K and CD147in GCT recurrence andmetastasis to the lungs cases were positively correlated,cath-K in giant celltumor of the occurrence and development may play a more importantrole,cath-K inhibitor will contribute to the treatment of GCT.