目的：探讨锌-α2-糖蛋白1（zinc-α2-glycoprotein 1，AZGP1）在骨肉瘤组织中的表达及其与患者临床病理特征和预后的关系。方法：选取2012年8月至2014年8月河南省南阳市第二人民医院骨科收治的62例骨肉瘤患者的癌及癌旁组织标本，用免疫组织化学染色法检测骨肉瘤组织中AZGP1表达。所有患者于术后第2天开始进行随访，截止日期2019年8月31日，均随访满5年，以死亡作为终点事件，记录患者5年内发生终点事件的数量和生存期（overall survival，OS），用Kaplan-Meier法进行生存分析，用 Cox 比例风险模型进行影响患者 OS 的多因素分析。结果：AZGP1 在骨肉瘤组织中阳性表达率显著高于癌旁组织（77.42% vs 32.26%，P<0.01），AZGP1阳性表达率在不同Eneeking分期、是否软组织浸润和是否肺转移间比较差异有统计学意义（均P<0.05）。Kaplan-Meier生存分析结果显示，AZGP1 阳性表达患者的平均 OS 和 5 年 OS 率均低于阴性表达患者（[ 24.19±2.68）vs（43.07±3.70）个月 ，P<0.01；18.75% vs 64.29%，P<0.01]；AZGP1 表达和肺转移是影响骨肉瘤患者预后的风险因素（HR=3.407、3.647，均P<0.05）。结论：AZGP1在骨肉瘤组织中高表达，且与患者病情恶性化指标及预后有关，可能是评估患者预后的潜在标志物。

Objective: To investigate the expression of zinc-α2-glycoprotein 1 (AZGP1) in osteosarcoma tissue and its relationship with clinicopathological features and prognosis of patients. Methods: A total of 62 pairs of cancer tissue and adjacent normal tissue samples from patients with osteosarcoma treated in the Department of Orthopedics, Second People's Hospital of Nanyang City were collected from August 2012 to August 2014. The expressions of AZGP1 in osteosarcoma tissues and adjacent tissues were detected by using immunohistochemical staining. All patients were followed up on the second day after the operation. The deadline was August 31,2019. All patients were followed up for 5 years, with death as the end event. The number of end events within 5 years and overall survival (OS) time of the patients were recorded. Kaplan-Meier method was used for survival analysis, and Cox proportional hazard model was used for multivariate analysis of factors affecting patients’survival. Results: The positive expression rate of AZGP1 in the osteosarcoma tissues was significantly higher than that in the adjacent tissues (77.42% vs 32.26%, P<0.01). There were significant differences in the positive expression rates of AZGP1 in patients with different Eneeking stages, soft tissue infiltration or not and lung metastasis conditions (all P<0.05). Kaplan-Meier survival analysis showed that the average OS time and 5-year OS rate of patients in the AZGP1 positive expression group were significantly lower than those in the negative expression group [(24.19±2.68) months vs (43.07±3.70) months, P<0.01; 18.75% vs 64.29%, P<0.01]. The lung metastasis and positive expression of AZGP1 were risk factors affecting the prognosis of patients with osteosarcoma (HR=3.407, 3.647, all P<0.05). Conclusion: AZGP1 is highly expressed in osteosarcoma tissues, and it is related to the malignant indicators and prognosis of patients. It may be a potential marker for evaluating the prognosis of osteosarcoma patients.

河南省医学科技研究计划联合建设资助项目（No. LHGJ20190168）