SDF-1 Expression is Associated with Poor Prognosis in Osteosarcoma

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Abstract

Background.

Stromal cell-derived factor-1 (SDF-1) expression has been reported to be a predictor of poor clinical symptoms in certain types of cancer. Vascular endothelial growth factor (VEGF) is a well-known factor that mediates the micro-angiogenesis of solid tumors, and SDF-1 mediated expression of VEGF may promote tumor growth and metastasis, resulting in poor clinical outcome. Therefore, we explored the expression levels of SDF-1 and VEGF in patients with osteosarcoma in order to determine the association between their expression levels and unfavorable outcomes.

Methods.

A total of 54 patients with osteosarcoma were included in the current study. The protein expression levels of SDF-1 and VEGF were evaluated on immunohistochemical and immunofluorescence staining. The correlation between the expression levels of SDF-1 and VEGF and their association with clinical parameters were analyzed using the Pearson chi-square test and the Spearman-rho test. Univariate and multivariate Cox regression analyses were used to identify potential prognostic factors. The Kaplan-Meier method was employed to analyze overall survival.

Result.

Low SDF-1 and VEGF expression levels were detected in 20.4% (11 of 54) and 22.2% (12 of 54) of the patients with osteosarcoma, respectively; moderate expression was detected in 35.2% (19 of 54) and 37.0% (20 of 54) of the patients, respectively; and high expression was detected in 44.4% (24 of 54) and 40.7% (22 of 54) of the patients, respectively. Protein levels of both SDF-1 and VEGF were significantly associated with the histologic grade (p=0.004 and p=0.042 respectively), the presence of metastasis (p=0.009 and p=0.028 respectively), and Enneking staging (p<0.001 and p=0.003 respectively). The association between expression levels of SDF-1and VEGF had a significantly positive correlation (p<0.001and r=0.618). The expression levels of both SDF-1 and VEGF were significantly associated with shorter overall survival on univariate analysis; however, the association was significant for SDF-1 expression alone in the multivariate analysis (p=0.26, hazard ratio =2.640 [1.124–6.200]).

Conclusion.

SDF-1 and VEGF expression levels were both significantly associated with osteosarcoma, and SDF-1 expression is a potential independent prognostic indicator in patients with osteosarcoma.

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