CORRELATION BETWEEN THE EXPRESSION OF POSTN AND CLINICOPATHOLOGICAL FEATURES, PROGNOSIS, AND DIAGNOSTIC EFFICIENCY OF CHONDROSARCOMA

Jiayu Zhang¹, Yi Chen^{2, *}

¹Department of Emergency Trauma, Ningbo Sixth Hospital, Ningbo 315040, Zhejiang Province, China - ²Department of Hand Surgery, Ningbo Sixth Hospital, Ningbo 315040, Zhejiang Province, China

Objective: To analyze the correlation between the expression of osteoperiosteal protein (PostN) and the clinicopathological features, prognosis, and efficacious diagnosis of chondrosarcoma. 

Methods: A total of 86 patients with chondrosarcomas who did not receive radiotherapy or chemotherapy from January 2011 to January 2016 and 41 patients with chondromas that were surgically removed without radiotherapy or chemotherapy were recruited at the same time. The tumor histological grade, postoperative recurrence or metastasis, survival status, and other general information for all patients was recorded and all patients received follow-ups. The expression of PostN, proto-oncogene (c-Myc), and tumor protein p53 (tumor protein) in chondrosarcoma and chondroma were detected by immunohistochemistry. A Pearson linear correlation was used to analyze the correlation between PostN, c-Myc, and p53 levels. Univariate and multivariate Cox regression analyses were used to analyze the factors influencing the overall survival and disease-free survival of chondrosarcoma. An ROC curve was used to analyze the prognostic value of PostN protein expression in patients with chondrosarcoma. 

Results: The high expression rate of PostN was 62.79% in the chondrosarcoma group overall, 52.17% in the low-grade chondrosarcoma group, and 75.00% in the high-grade chondrosarcoma group, all significantly higher rates than those in the chondroma group (26.83%, P<.05). The high expression rate of PostN was 42.50% in grade 1 chondrosarcoma patients, significantly lower than 81.25% and 78.70% in grade 2 and grade 3 chondrosarcoma patients, respectively. The high expression rate of PostN in the recurrent chondrosarcoma group was 86.11%, significantly higher than 48.08% in the non-recurrent chondrosarcoma group (P<.05). There was no significant difference in the high expression rate of PostN in patients with or without metastatic chondrosarcoma (P>.05). In the chondrosarcoma group, the high expression rate of PostN in c-Myc negative patients was 35.00%, significantly lower than that in c-Myc positive patients (86.96%); also in the chondrosarcoma group, the high expression rate of PostN in p53 negative patients was 44.90%, significantly higher than that in p53 positive patients (86.49%; P<.05). Univariate Cox regression analysis showed that the expression of PostN protein, tumor histological grade, and recurrence all affected the overall survival of patients with chondrosarcoma (P<.05 or <.01). Multivariate Cox regression analysis showed that the expression of PostN protein, tumor histological grade, and recurrence were independent risk factors affecting the overall survival of patients with chondrosarcoma (all P < .05). ROC curve analysis showed that the AUC of PostN in the diagnosis of chondrosarcoma was 0.859, the sensitivity was 88.95%, and the specificity was 82.41%. 

Conclusion: The expression level of PostN protein in chondrosarcoma is significantly higher than that in chondroma. The expression of PostN protein is closely related to the histological grade and recurrence of chondrosarcoma and is significantly correlated with c-Myc, p53, and other prognostic factors. It can be used as a clinical evaluation factor for the prognosis of patients with chondrosarcoma.