The prognostic value of proliferative and apoptotic activity of tumors in patients with osteogenic sarcoma was investigated in order to determine which genes are involved in their pathogenesis and prognosis.
Immunohistochemical methods (IHC) were used to study the expression of p53, bcl-2, Ki-67 in patients with osteogenic sarcoma in comparison with the effectiveness of treatment. Patients with positive results of chemotherapy (group 1) underwent radiotherapy for a radical program in the total focal dose up to 60-70 Gy. When receiving a good effect from radiation therapy (group 2), patients received another 4-5 courses of chemotherapy. Surgical treatment was performed in 36 patients (41.9%) with a large pulpy component of the tumor and with ineffective chemotherapy or chemoradiotherapy (group 3).
In group 1 patients, who received chemotherapy, the full effect was observed only in patients with negative and weakly positive IHC reactions to the p53 (18%), Ki-67 (16%) and bcl-2 (10%). For partial effect, the phenotype of tumor cells was as follows: negative and weakly positive IHC reaction to the mutant p53 gene was seen in 52% of patients, in Ki-67 - in 62%, and bcl-2 - in 48%. In 6% of patients in this group, the effect of therapy was negative. In the second group, only 10% of the patients had a full effect of the therapy, while in all patients, the tumor cells were mutant p53 negative, 5% had average Ki-67 and bcl2, and 5% were Ki-67 and bcl-2 negative. 25% of patients in this group had partial effects. In 20% of patients in this group, absence or weak expression of mutant p53 gene was detected in tumor cells, expression of Ki67 and bcl 2 genes in 15% was average, the remaining patients were with Ki-67 and bcl-2 negative. In group 3, 56% of patients had positive effect with therapy, among them, those with weak or no, expression of mutant gene p53 were 75% and only 12.5% showed moderate expression of this protein.
Our findings suggest that the study of the expression of the mutated p53 suppressor gene is a more informative prognostic factor in osteogenic sarcoma and contributes to an understanding of the mechanisms of cancer, development of new diagnostic methods and pathogenetically valid approaches to the therapy of osteogenic sarcoma.
Clinical trial identification
Legal entity responsible for the study
Ministry of Health of Republic of Uzbekistan.
Has not received any funding.
All authors have declared no conflicts of interest.