| [Background and Objective]Chondrosarcoma is the third most common primary malignant tumor(after multiple myeloma and osteosarcoma),accounting for 20-27%of all primary malignant tumors.The incidence of men and women is basically the same,and the average age of diagnosis is between 30-60 years old.It is generally believed that tumor cells are not sensitive to radiotherapy and chemotherapy due to the presence of extracellular matrix produced by tumor cells,low percentage of splitting cells and poor blood vessel distribution.So the most effective treatment is a wide range of resection,resulting in high morbidity and very low survival efficiency.Although most chondrosarcomas grow slowly and rarely migrate,it has a high recurrence rate of about 24 percent.Postoperative recurrence requires a wider range of surgical resection and the patient has a worse prognosis.So finding a new therapeutic target is critical to the treatment of chondrosarcoma.Periostin(POSTN)is also known as osteoblast-specific factor-2,which is an extracellular matrix secreted glycoprotein encoded by the POSTN gene which located on human chromosome 13.POSTN expresses in many normal organs and tissues which plays an important role in formation and structural maintenance of bone,tooth and heart valve.At the same time,POSTN plays an important role in the process of physiological epithelial-mesenchymal transition(EMT),which is necessary for the normal development of embryos.In recent years,studies have confirmed that POSTN is involved in the development of various cancers such as colorectal cancer,head and neck cancer,pancreatic cancer,ovarian cancer,breast cancer,prostate cancer,gastric cancer,osteosarcoma and neuroblastoma,etc,in which POSTN plays a role in promoting tumor survival,proliferation,metastasis and epithelial-mesenchymal transition.However,the expression and prognosis of POSTN in chondrosarcoma is unclear.This study mainly analyzes the expression of POSTN in chondroma and chondrosarcoma,then explores the relationship between the expression of POSTN in chondrosarcoma and clinicopathological parameters and prognostic analysis.[Materials and methods]We collected 107 cases of chondrosarcoma and 59 cases of chondroma patients’ paraffin tissues which were made into tissue microarray.The expression of POSTN,Ki67,c-Myc and P53 in chondrosarcoma and chondroma were measured by immunohistochemistry.Kaplan-Meier survival analysis was used to observe the correlation between survival rate and POSTN expression level in chondrosarcoma patients.COX proportional regression risk model was established to analyze the value of POSTN as a risk factor.[Results]The expression of POSTN in chondrosarcoma was significantly higher than that in chondroma(X2 = 15.433,P<0.001),and the expression of low-grade chondrosarcoma was also the same(X2 = 3.900,P = 0.048).The expression of POSTN was significantly correlated with histological grade(X2= 11.660,P = 0.003),recurrence(X2 = 8.172,P = 0.004).In particular,the expression of POSTN in the low-grade chondrosarcoma(grade Ⅰ)and intermediate-/high-grade chondrosarcoma(Ⅱ,Ⅲ)were significantly different.In addition,overexpression of POSTN was positively correlated with high expression of c-Myc(r = 0.482,P<0.001),Ki67(r = 0.277,P =0.004)and P53(r=0.606,P=0.002).KM analysis showed that overexpression of POSTN was significantly associated with the reduction of overall survival rate(P =0.003)and disease-free survival rate(P = 0.001).COX multivariate analysis showed that POSTN is an independent prognostic factor that affected the overall survival(HR:3.016,95%CI:1.009-9.016,P=0.048)and disease-free survival(HR:3.305,95%CI:1.086-10.056,P=0.035)of chondrosarcoma patients.[Conclusion]The expression of POSTN in chondrosarcoma was significantly higher than that in chondroma.And in chondrosarcoma with POSTN overexpression,the overall survival and disease-free survival are all significantly reduced.So POSTN can be used as an evaluation factor for the prognosis of chondrosarcoma patients. |
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