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Volume 2008, Article ID 874075, 14 pages
Research Article

Immunohistochemical Estimates of Angiogenesis, Proliferative Activity, p53 Expression, and Multiple Drug Resistance Have No Prognostic Impact in Osteosarcoma: A Comparative Clinicopathological Investigation

1University Institute of Pathology, Aarhus University Hospital, Aarhus Sygehus, THG, 8000 Aarhus, Denmark
2Department of Oncology, Aarhus University Hospital, Aarhus Sygehus, NBG, 8000 Aarhus, Denmark
3Department of Biostatistics, University of Aarhus, 8000 Aarhus, Denmark
4Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus Sygehus, NBG, 8000 Aarhus, Denmark

Received 24 April 2008; Accepted 17 November 2008

Academic Editor: Kees Verhoef

Copyright © 2008 Flemming Brandt Sorensen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To investigate angiogenesis, multiple drug resistance (MDR) and proliferative activity as prognostic variables in patients suffering from osteosarcoma. Methods. Histologic biopsies from 117 patients treated in the period from 1972 through 1999 were immunohistologically investigated regarding angiogenesis (CD34), proliferative activity (MIB-1), and the expression of p53 and MDR (P-glycoprotein (Pgp); clones JSB-1, C494, and MRK16). Quantitative and semiquantitative scores of immunoreactive cells were analyzed statistically along with retrospectively obtained clinicopathologic variables. Results. Chemotherapy reduced the rate of amputations ( ). The Pgp was overexpressed (score ≥2) in 48% of the primary, diagnostic biopsies, and high Pgp correlated with high Pgp in postsurgical specimens ( ). In contrast, no such associations were disclosed for estimates of angiogenesis ( ) and p53 ( ), whereas the MIB-1 index was reduced in the post-chemotherapy specimens ( ). The overall, disease-specific survival was 47%, increasing to 54% in patients receiving pre-operative chemotherapy. Statistical analyses showed prognostic impact exclusively by patient age and type of osteosarcoma. Discussion. The studied series of patients documented already prior to the chemotherapy era, a rather excellent survival and estimates of angiogenesis, proliferation, p53, and Pgp expressions, did not demonstrate sufficient power to serve as predictors of treatment response or survival.