Expression Characteristics And Clinical Significance Of IMP3 In Bone Tumors

BACKGROUNDBone tumors can be roughly divided into primary benign bone tumors,primary malignant bone tumors and metastatic bone cancers.These tumors have their own unique histological and genetic changes.Primary bone malignancies are rare,accounting for less than 0.2%of all malignanciesBiopsy is the most important part of bone tumor diagnosis,including open biopsy and needle biopsy.Pathologists need to rely on small biopsy specimens for tumor classification and diagnosis to guide clinical diagnosis and treatment.However,even for experienced pathologists,it is sometimes not always possible to obtain an accurate diagnosis of a tumor based on a biopsy specimen.Pathologic diagnosis of bone tumor biopsy specimens is a challenge for pathologists,so it is of great clinical significance to seek a valuable marker that can clearly identify benign and malignant bone tumors.However,there is still a lack of good immunohistochemical markers applied in the differential diagnosis between benign and malignant bone tumors.Histologic evaluation of tumor necrosis after chemotherapy for osteosarcoma is the gold standard for determining the efficacy of preoperative chemotherapy.Post-treatment osteosarcoma requires quantification of tumor necrosis as an indicator of tumor chemotherapy response.The clinical value of tumor chemotherapy response in the prognosis of osteosarcoma has reached a consensus.Although the tumor necrosis rate is of high prognostic value in osteosarcoma,the microscopic definition of tumor necrosis is difficult and subjective.Studies have shown that the rate of tumor necrosis is less reliable among different observers,and this difference can sometimes influence the clinician's choice of chemotherapy regimen.Therefore,objective indexes are needed to assist the evaluation of tumor necrosis rate.Insulin-like growth factor ? mRNA-binding protein 3,IMP3 is a member of the family of insulin-like growth factor 2(IGF-2)mRNA binding proteins(IMPs),including IMP 1,IMP2,and IMP3.IMP3 is widely expressed in early embryonic development,weakly expressed in a few normal adult tissues,and highly expressed in malignant tumors,which is related to the proliferation,adhesion,invasive growth and poor prognosis of tumor cells.The expression of IMP3 in osteosarcoma biopsy specimens has not been reported,and whether IMP3 can be used as a diagnostic marker for osteosarcoma needs further detection.In addition,we will discuss the value of IMP3 in evaluating the rate of tumor necrosis after chemotherapy for osteosarcoma.This paper will study and discuss the application value of IMP3 in the pathological diagnosis of bone tumors.OBJECTIVE1.To detect the expression characteristics of IMP3 in the excised specimens of benign primary bone tumor,malignant primary bone tumor and bone metastatic carcinoma,and to analyze the expression differences and clinical significance of IMP3 in different types of bone tumors.2.To study the expression characteristics of IMP3 in osteosarcoma biopsy specimens and verify whether IMP3 can be used as a marker for pathological diagnosis of osteosarcoma biopsy.3.Observe the expression of IMP3 in necrotic tumor cells,residual tumor cells,degenerated tumor cells and new osteoblasts,and discuss the clinical application value of IMP3 in accurately evaluating the rate of tumor necrosis.MATERIAL&METHODS1.Expression characteristics of IMP3 in bone tumors.A total of 951 cases of bone tumor specimens were collected for IMP3 detection from 2013 to 2019,including 596 cases of benign bone tumor and 355 cases of malignant bone tumor.Another 77 cases of normal bone tissue were selected as the normal control.All HE staining sections were reassessed.The expression characteristics of IMP3 in different types of bone tumors were analyzed.Pearson chi-square test was used to analyze the expression differences of IMP3 in normal tissue,benign bone tumors and malignant bone tumors.2.The value of IMP3 in the pathological diagnosis of osteosarcoma by biopsyA total of 133 formalin fixed and paraffin-embedded archived specimens were collected from 2015 to 2019,of which 55 were osteosarcoma biopsy specimens,and 28 were surgically resected specimens paired with the biopsy specimens.The final pathological diagnosis was non-neoplastic lesions,mainly including fractures and infections.The expression characteristics of IMP3 in osteosarcoma biopsy specimens and spinal biopsy specimens were analyzed.3.The value of IMP3 in evaluating the rate of tumor necrosis after chemotherapy for osteosarcomaTwenty patients with formalin fixation and paraffin embedding from 2018 to 2019 were collected for archival surgical resection of osteosarcoma.All patients underwent preoperative neoadjuvant chemotherapy,and the tumor necrosis rate was? 50%.Microscopically,IMP3 immunohistochemical assays were performed in areas with tumor cell necrosis,residual tumor cells,degenerative tumor cells,and newly woven bone.The expression characteristics of IMP3 in different components were analyzed.4.Statistical methodsStatistical software SPSS(version 22.0)was used to statistically process and analyze the experimental results.P<0.05 was considered statistically significant.RESULTS1.Expression characteristics of IMP3 in bone tumors.IMP3 was negatively expressed in all normal tissues(0/77).In benign bone tumors,IMP3 was positively expressed in 20/596(3.4%)of the cases.Among the malignant bone tumors,the positive rate of IMP3 was 64.8%(230/355).The positive rate of IMP3 was statistically significant between groups(p<0.001).2.Value of IMP3 in pathological diagnosis of osteosarcoma by needle biopsyIMP3 was negatively expressed in osteoblasts,fibrous tissue,blood vessels,bone marrow and adipose tissue in all spinal puncture biopsy specimens.In the biopsy specimens of osteosarcoma,94.5%(52/55)of the cases had positive expression of IMP3.The positive rate of IMP3 was statistically significant between the two groups(p<0.001).3.Value of IMP3 in evaluating tumor necrosis rate of osteosarcoma after chemotherapyIMP3 was positively expressed in tumor cells and degenerated tumor cells.The reactivity components such as necrotic tumor cells and normal osteoblasts,fibrous tissue and tissue cells were all negative.CONCLUSIONS1.The expression of IMP3 is closely related to the benign and malignant degree of bone tumors.Benign bone tumors are often negatively expressed,low-grade malignant bone tumors are poorly expressed,and high-grade malignant bone tumors are highly expressed.IMP3 has good clinical value in the diagnosis and differential diagnosis of bone tumors;2.IMP3 was negative in normal bone tissue,while it was highly expressed in osteosarcoma biopsy specimens.IMP3 is a reliable marker for the diagnosis of osteosarcoma in auxiliary biopsy specimens;3.IMP3 can accurately distinguish the survival of tumor cells,and is an objective indicator to evaluate the tumor necrosis rate.IMP3 is helpful to assist the evaluation of tumor necrosis rate of osteosarcoma,and can improve the accuracy and consistency of the evaluation.Therefore,it is of great clinical application value.