Sujia Wu

Nanjing University, Nan-ching, Jiangsu Sheng, China

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Publications (22)46.87 Total impact

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    ABSTRACT: Despite significant advances in the diagnosis and treatment of osteosarcoma in recent years, overall survival has remained low for over 2 decades. The standard diagnosis of osteosarcoma requires a combination of clinical presentation, radiologic studies, and pathologic tissue evaluation. A typical Codman's triangle in radiologic evaluation is vital in making correct diagnosis for middle or late stage of osteosarcoma. However, there is an actual demand for novel molecular markers with high sensitivity and stability for the diagnosis of early events of osteosarcoma and also the probability of recurrence and metastasis. Except that, some highly relevant gene mutations with these events could also provide valuable information regarding osteosarcoma protection. In this review, we will focus on the molecular markers which have been discovered in recent years with potential application of early stage and recurrence diagnosis and protection.
    No preview · Article · Dec 2015 · Frontiers in Bioscience
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    ABSTRACT: Focal adhesion kinase (FAK) has been implicated in tumorigenesis in various malignancies. We sought to examine the expression patterns of FAK and the activated form, phosphorylated FAK (pFAK), in human osteosarcoma and to investigate the correlation of FAK expression with clinicopathologic parameters and prognosis. In addition, the functional consequence of manipulating the FAK protein level was investigated in human osteosarcoma cell lines. Immunohistochemical staining was used to detect FAK and pFAK in pathologic archived materials from 113 patients with primary osteosarcoma. Kaplan-Meier survival and Cox regression analyses were performed to evaluate the prognoses. The role of FAK in the cytological behavior of MG63 and 143B human osteosarcoma cell lines was studied via FAK protein knock down with siRNA. Cell proliferation, migration, invasiveness and apoptosis were assessed using the CCK8, Transwell and Annexin V/PI staining methods. Both FAK and pFAK were overexpressed in osteosarcoma. There were significant differences in overall survival between the FAK-/pFAK- and FAK+/pFAK- groups (P = 0.016), the FAK+/pFAK- and FAK+/pFAK+ groups (P = 0.012) and the FAK-/pFAK- and FAK+/pFAK+ groups (P < 0.001). There were similar differences in metastasis-free survival between groups. The Cox proportional hazards analysis showed that the FAK expression profile was an independent indicator of both overall and metastasis-free survival. siRNA-based knockdown of FAK not only dramatically reduced the migration and invasion of MG63 and 143B cells, but also had a distinct effect on osteosarcoma cell proliferation and apoptosis. These results collectively suggest that FAK overexpression and phosphorylation might predict more aggressive biologic behavior in osteosarcoma and may be an independent predictor of poor prognosis.
    No preview · Article · Sep 2015 · Oncotarget
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    ABSTRACT: Emerging evidence has suggested that circulating microRNAs (miRNAs) in serum/plasma can serve as noninvasive biomarkers for cancer detection; however, little is known about circulating miRNA profiles in osteosarcoma, a primary malignant bone tumor with high morbidity in young adults and adolescents. The objective of this study was to investigate whether circulating miRNAs in serum could be a useful biomarker for detecting osteosarcoma and monitoring tumor dynamics. Serum samples were obtained from 60 patients before surgery, 28 patients after 1 month of surgery, and 60 healthy individuals. The study was divided into three steps: (1) initial screening of the profiles of circulating miRNAs in pooled serum samples from both healthy controls and pre- and postoperative osteosarcoma patients using a TaqMan low-density qPCR array (TLDA); (2) evaluation of miRNA concentration in individual serum samples from 60 preoperative osteosarcoma patients and 60 healthy controls by a quantitative RT-PCR assay; and (3) evaluation of miRNA concentration in paired serum samples from 28 pre- and postoperative osteosarcoma patients by a quantitative RT-PCR assay. The initial analysis showed that concentrations of serum miRNAs were significantly altered between preoperative osteosarcoma patients and healthy controls and between pre- and postoperative osteosarcoma patients. The quantitative RT-PCR assay showed that serum miR-199a-5p concentrations were significantly higher in osteosarcoma patients than in controls. The value of the area under the ROC curve was 0.8606. Serum levels of miR-199a-5p were significantly lower in post- than preoperative samples. The results indicated the potential of circulating miRNAs as novel noninvasive biomarkers for detecting and monitoring osteosarcoma.
    No preview · Article · Jun 2015 · Tumor Biology
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    Sitan Feng · Xin Shi · Ke Ren · Sujia Wu · Xiaoliang Sun
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    ABSTRACT: The aim of the present study was to analyze the expression of focal adhesion kinase (FAK) in osteosarcoma (OS) cell lines with different migration abilities in order to determine the role of FAK in migration. A number of different 143B subclone cell lines (A1, A2, A3, A4 and A5) were obtained by a limiting dilution method, and the expression of FAK was detected using western blot analysis. The role of FAK in the migration of OS cells was investigated using small interfering RNA (siRNA), and the ratio of the number of lamellipodia was compared by immunofluorescence staining. The A2 and A3 OS 143B subclone cell lines demonstrated a stronger migration ability and exhibited higher FAK expression compared with the A1 cell line (P<0.05). Following transfection with FAK-siRNA, the migration ability of the A3 cells was significantly decreased (P<0.05), and the ratio of the number of lamellipodia formed was reduced from 35 to 11% (P<0.05). In conclusion, the level of FAK expression was higher in the cell lines with a stronger migration ability. FAK affects the migration ability of OS cells by suppressing the formation of lamellipodia.
    Preview · Article · Apr 2015 · Oncology letters
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    ABSTRACT: Vasculogenic mimicry (VM), a formation of nonendothelial microvascular channels, has been generally recognized as a new pattern of neovascularization in aggressive malignancies. However, whether VM is present and clinically significant in osteosarcoma remains unknown. We identified VM by CD34/PAS double-staining of osteosarcoma specimens prior to chemotherapy and investigated its prognostic implications. Tumors were also immunohistochemically stained for focal adhesion kinase (FAK) and migration inducing gene-7(Mig-7) to determine whether these markers are associated with the occurrence of VM. VM was found in 15 of 66 osteoblastic-type osteosarcoma samples (22.7%), and the incidence of VM did not differ with respect to patient sex, age, tumor size, tumor site, surgical type or histological response to pre-operative chemotherapy. However, Kaplan-Meier survival analysis determined that the presence of VM and the tumor necrosis rate after pre-operative chemotherapy are associated with both the overall survival (p = 0.011 and 0.040, respectively) and metastasis-free survival (p = 0.002 and 0.045, respectively). Furthermore, Cox proportional hazards analysis showed that the presence of VM and the histological response to pre-operative chemotherapy were independent indicators for both poor overall survival (p = 0.007 and 0.024, respectively) and poor metastasis-free survival (p = 0.002 and 0.027, respectively). The expression level of FAK and Mig-7 were higher in the VM group than the non-VM group (p = 0.017 and 0.021, respectively). These results demonstrate the presence of VM in osteoblastic osteosarcoma and suggest that VM is an unfavorable prognostic factor with FAK and Mig-7 expression as a potential mechanism of VM formation in osteosarcoma.
    Preview · Article · Oct 2014 · Human pathology
  • Ke Ren · Xing Zhou · SuJia Wu · Xiaoliang Sun
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    ABSTRACT: Hemangiopericytoma (HPC) is a rare tumor of the central nervous system, most commonly found in the cranial cavity. HPCs in the spine are rare, and very few ofthem are primary osseous HPC. The aims of this study were to describe a rare case of primaryosseous HPC in the thoracic spine and review the literature. A 54-year-old man presentedwith a 3-month history of back pain. Aneurological examination revealed no motoror sensory deficits. Magnetic resonance imaging (MRI) and computed tomography (CT) scan showed a tumor originating from the bone structure of the T10 vertebra with paravertebral extension, and chest CT revealedpulmonary metastases. A laminectomy, facetotomy,and subtotal resection of the tumorwas performed with posterior pedicle screw system fixation followed by radiotherapy. The post-operative course was uneventful. His back pain was resolved completely after surgery. The patient survived with tumor during the 18-month follow-up period. Histopathology and immunohistologic findings were consistent with HPC. On immunohistochemistry,the tumor was positive for vimentinand CD34, partially positive for S-100, but negative for EMA, desmin, CD117, andCD1a. A literature review identified eight such cases reported between 1942 and 2013. As a conclusion, clinical manifestations of primary osseous spinal HPCs are different from intraspinal meningeal HPCs. Although showing certain variability, histopathology and immunohistochemical examinations areessential to establish the diagnosis. Surgical resection and radiotherapy are the treatment of choice.
    No preview · Article · Jun 2014 · Clinical neuropathology
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    ABSTRACT: Chondrosarcoma (CHS) in the spine is relatively rare and minimal information has been published in the literature regarding this subject. The objective of our study was to discuss the factors that may affect outcomes of patients with spinal CHS. Univariate and multivariate analyses were performed to identify prognostic factors for recurrence, distant metastasis, and survival of spinal CHS. T test, χ (2) test and rank sum test were used to analyze a single factor for recurrence and metastasis, while survival rate was estimated using the Kaplan-Meier method. Factors with p values of ≤0.1 were subjected to multivariate analyses by binary logistic regression analyses or Cox regression analyses. p Values of ≤0.05 were considered statistically significant. A total of 98 patients with spinal CHS were included in the study. The mean follow-up period was 49.7 months (range 6-178). Recurrence was detected in 42 patients after initial surgery in our center, while distant metastasis and death occurred in 24 and 32 cases, respectively. The statistical analyses suggested that pathology grade III was closely related with distant metastasis which was an independent prognostic factor for overall survival. Total en bloc spondylectomy could significantly decrease the risk of recurrence, distant metastasis, and death of patients with spinal CHS. Total en bloc spondylectomy could significantly decrease the risk of recurrence and distant metastasis, and meanwhile improve overall survival of spinal CHS. Distant metastasis which was closely associated with pathology grade III was an adverse prognostic factor for overall survival of spinal CHS.
    No preview · Article · May 2014 · Annals of Surgical Oncology
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    ABSTRACT: Osteosarcoma is the most common primary bone tumor. Recent data indicated miRNAs may be involved in the pathogenesis of osteosarcoma, suggesting some novel targets for therapy. It is known that miR-429 is down-regulated and functions as a tumor suppressor by targeting c-myc and PLGG1 in gastric and breast cancer. However, the exact role of miR-429 in osteosarcoma remained unknown. In our study, we found MiR-429 was down-regulated in primary osteosarcoma lesion and osteosarcoma cell lines. Moreover, MiR-429 can inhibit the proliferation of osteosarcoma cell lines and induce more cell apoptosis. Also, we discovered MiR-429 plays a role in osteosarcoma by binding the 3′UTR of zinc finger E-box-binding homeobox 1 (ZEB1) mRNA, and that overexpression of ZEB1 could reverse the proliferation, subsequently blocking effect of miR-429. In conclusion, miR-429 serves as a tumor suppressor via interaction with ZEB1. Our finding may provide a new target for osteosarcoma therapy.
    No preview · Article · Mar 2014 · Cell biochemistry and biophysics
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    ABSTRACT: Astrocytomas are common malignant intracranial tumors that comprise the majority of adult primary central nervous system tumors. MicroRNAs (miRNAs) are small, non-coding RNAs (20-24 nucleotides) that post-transcriptionally modulate gene expression by negatively regulating the stability or translational efficiency of their target mRNAs. In our previous studies, we found that the downregulation of miR-106a-5p in astrocytomas is associated with poor prognosis. However, its specific gene target(s) and underlying functional mechanism(s) in astrocytomas remain unclear. In this study, we used mRNA microarray experiments to measure global mRNA expression in the presence of increased or decreased miR-106a-5p levels. We then performed bioinformatics analysis based on multiple target prediction algorithms to obtain candidate target genes that were further validated by computational predictions, western blot analysis, quantitative real-time PCR, and the luciferase reporter assay. Fas-activated serine/threonine kinase (FASTK) was identified as a direct target of miR-106a-5p. In human astrocytomas, miR-106a-5p is downregulated and negatively associated with clinical staging, whereas FASTK is upregulated and positively associated with advanced clinical stages, at both the protein and mRNA levels. Furthermore, Kaplan-Meier analysis revealed that the reduced expression of miR-106a-5p or the increased expression of FASTK is significantly associated with poor survival outcome. These results further supported the finding that FASTK is a direct target gene of miR-106a-5p. Next, we explored the function of miR-106a-5p and FASTK during astrocytoma progression. Through gain-of-function and loss-of-function studies, we demonstrated that miR-106a-5p can significantly inhibit cell proliferation and migration and can promote cell apoptosis in vitro. The knockdown of FASTK induced similar effects on astrocytoma cells as those induced by the overexpression of miR-106a-5p. These observations suggest that miR-106a-5p functions as a tumor suppressor during the development of astrocytomas by targeting FASTK.
    Preview · Article · Aug 2013 · PLoS ONE
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    ABSTRACT: The canonical Wnt-beta -catenin signaling pathway is a key component of normal skeletal development and disease. Alterations within this signaling pathway have been described in human and canine osteosarcoma (OS); however, debate exists as to whether or not alterations in this pathway contribute to OS development in humans. In metastatic OS, the Wnt-β-catenin pathway promotes the invasion and migration of OS cells and β-catenin acts as a biological marker of OS with the potential to metastasize to the lung. The participation of the Wnt-β-catenin pathway in OS development and metastasis is regulated by several factors, including hormones and alkaline phosphatase (ALP). This pathway is also involved in the resistance of OS to chemotherapy, especially in resistance to all three drugs used in standard chemotherapy, i.e. doxorubicin, cisplatin and methotrexate (MTX). In this review, we will summarize recent findings regarding the Wnt-β-catenin pathway in OS development and chemotherapy.
    No preview · Article · Jun 2013 · Frontiers in Bioscience
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    ABSTRACT: Osteosarcoma is a primary malignant bone tumour with high morbidity that occurs mainly in children and adolescents. While the molecular basis of osteosarcoma has received considerable attention, the cellular and molecular mechanisms underlying pre- and postoperative metastasis formation and the development of chemoresistance remain unclear. MicroRNAs (miRNAs), a class of 22-nucleotide noncoding RNAs, have emerged as critical components of gene-regulatory networks controlling numerous important pathophysiological processes, including the initiation and progression of cancers. Studies on miRNAs have opened new avenues for both the diagnosis and treatment of cancer. This review discusses the roles of miRNAs in osteosarcoma and their potential applications for the diagnosis, prognosis and treatment of this malignancy. As a rapidly evolving field of basic and biomedical science, miRNA research will have a revolutionary impact on the management of osteosarcoma.
    Preview · Article · Feb 2013 · The Journal of international medical research
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    ABSTRACT: The aberrant expression of microRNAs (miRNAs) is associated with a variety of diseases, including cancer. In our study, we examined the miRNA expression profile of meningiomas, which is a common type of benign intracranial tumor derived from the protective meninges membranes that surround the brain and spinal cord. To define a typical human meningioma miRNA profile, the expression of 200 miRNAs in a training sample set were screened using quantitative reverse transcription polymerase chain reaction analysis, and then significantly altered miRNAs were validated in a secondary independent sample set. Kaplan-Meier and univariate/multivariate Cox proportional hazard regression analyses were performed to assess whether miRNA expression could predict the recurrence of meningioma after tumor resection. After a two-phase selection and validation process, 14 miRNAs were found to exhibit significantly different expression profiles in meningioma samples compared to normal adjacent tissue (NAT) samples. Unsupervised clustering analysis indicated that the 14-miRNA profile differed between tumor and NAT samples. Downregulation of miR-29c-3p and miR-219-5p were found to be associated with advanced clinical stages of meningioma. Kaplan-Meier analysis showed that high expression of miR-190a and low expression of miR-29c-3p and miR-219-5p correlated significantly with higher recurrence rates in meningioma patients. Cox proportional hazard regression analysis revealed that miR-190a expression level is an important prognostic predictor that is independent of other clinicopathological factors. Our results suggest that the use of miRNA profiling has significant potential as an effective diagnostic and prognostic marker in defining the expression signature of meningiomas and in predicting postsurgical outcomes.
    Preview · Article · Jan 2013 · International Journal of Cancer
  • Sujia Wu · Xin Shi · Guangxin Zhou · Men Lu · Chengjun Li
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    ABSTRACT: The records of 18 patients with periacetabular tumors who underwent composite reconstruction of the hip following resection of periacetabular tumors were analyzed retrospectively. The mean follow-up period was 49.4 months (range, 28-100 months). During follow-up, 3 patients died and one had recurrence. Fifteen patients achieved favorable walking function; 8 had normal hip function and 7 had partial recovery of flexion function of the hip. The mean MSTS rating for hip function was 76.9%. Two patients had common peroneal nerve injury which was resolved in one of them. Middle-term follow-up showed that composite reconstruction of the hip following resection of periacetabular tumors can effectively remove tumors and provide favorable hip function for these patients. This approach is simple and less costly, and can be widely used.
    No preview · Article · Oct 2012 · The Journal of arthroplasty
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    ABSTRACT: A polymer-drug conjugate was developed by conjugating amino bonds of methotrexate (MTX) to succinoylated α,β-poly[(2-hydroxyethyl)-L-aspartamide] (PHEA). The therapeutic efficacy of PHEA-MTX was evaluated in vitro and in vivo. PHEA-MTX showed sustained release properties when incubated in pH 5.5 and pH 7.4 buffering solutions at 37°C. PHEA-MTX induced MG63 cell apoptosis in a time-dependent and concentration-dependent manner in vitro and inhibited the growth of S180 sarcoma in vivo. PHEA-MTX was more potent and, more importantly, displayed less systemic toxicity than free MTX. The enhanced therapeutic effects of PHEA-MTX suggest that the PHEA-MTX conjugate may have a greater potential for chemotherapy of cancers.
    No preview · Article · Aug 2012 · The American Journal of the Medical Sciences
  • Ke Ren · SuJia Wu · Xin Shi · JianNing Zhao · XinWei Liu
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    ABSTRACT: The aim of this study is to systematically review the published literature from East Asia on the clinical, pathological, and epidemiological characteristics of primary clavicle tumor and tumorous lesions. A computerized search based on keywords "clavicle," "tumor," and "tumorous lesion" (both in Chinese and in English) was performed on literature published from 1980 to 2011 in East Asian countries, including China, Japan, South Korea, North Korea, and Mongolia. An analysis was carried out with unified inclusion and exclusion criteria. Two hundred and six cases were identified. The age of onset ranged from 1.5 to 70, with an average age of 29.4, and a male/female ratio of 1.53:1. Lesion locations included 28.9% in medial third, 18.8% in the middle third, and 33.6% in the lateral third of the clavicle. Another 7.4% involved both the medial and middle thirds, 7.4% involved both the middle and lateral thirds, and 4.0% involved the entire length of the clavicle. Major pathological types included 18.5% eosinophilic granuloma, 10.2% plasmocytoma, 7.8% Ewing sarcoma, 8.7% osteosarcoma, 8.7% osteochondroma, and 5.3% chondrosarcoma. The age of onset was found to be strongly correlated with the benign/ malignant ratio. Clavicle malignancy was rarely found in patients younger than 10 years, while the incidence of malignancy greatly increased among patients over 40 years old. Total or subtotal claviculectomy was the most common treatment in cases for which treatment information was available. Of these, 40.8% of patients received reconstruction with allograft or autograft. Clavicle tumors and tumorous lesions in East Asia had an inclined occurrence in respect to age and gender. The most common tumors were eosinophilic granuloma and tumors derived from the bone marrow hematopoietic system. Age of onset was found to be a risk factor for malignancy. These characteristics may be related to the special tissue structures and mode of development in the clavicle as well as to the genetic traits of the typical Mongoloids in East Asia.
    No preview · Article · Feb 2012 · Archives of Orthopaedic and Trauma Surgery
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    ABSTRACT: To investigate the clinical manifestation of thoracolumbar vertebral osteoid osteoma and to evaluate the surgical procedure and effectiveness of transpedicular tumor resection and spine reconstruction with posterior pedicle screw system and bone graft. Between January 2001 and June 2010, 8 cases of thoracolumbar vertebral osteoid osteoma underwent one-stage transpedicular intralesional excision and bone graft combined with spine reconstruction with pedicle screw system through posterior approach. There were 5 males and 3 females with a median age of 15.5 years (range, 6-27 years). Affected segments included T8 in 1 case, T10 in 1 case, L2 in 2 cases, L3 in 1 case, L4 in 1 case, and L5 in 2 cases. All of the cases had back pain, 1 had radiating pain of lower extremity, and 4 patients presented with scoliosis. The mean diameter of lesions was 1.6 cm (range, 0.9-2.0 cm). The mean operation time was 110 minutes (range, 70-170 minutes) and the mean blood loss was 720 mL (range, 300-1 400 mL). The postoperative pathologic examination showed osteoid osteoma in all cases. All patients achieved healing of the incisions by first intention. Immediate relief of pain was observed after operation in all patients without complication. The patients were followed up 12-58 months (mean, 39 months). No local recurrence or spinal deformity was observed during the follow-up. CT can show a low attenuation nidus with central mineralization and varying degrees of perinidal sclerosis, so it has great value for final diagnosis of thoracolumbar vertebral osteoid osteoma. One-stage transpedicular intralesional excision supplemented by impaction bone graft and combined posterior pedicle screw stabilization is a safe and effective treatment.
    No preview · Article · Jan 2012 · Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
  • Xin Shi · Xing Zhou · Sujia Wu · Jiyang Jin · Zhiping Zhou
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    ABSTRACT: Objective The aim of the study was to explore the application of 64-slice spiral computed tomography perfusion imaging (CTPI) in evaluating angiogenesis in human osteosarcoma. Methods Twenty-six patients (18 males and 8 females ranging from 9 to 56 years old, with an average of 19 years) with osteosarcoma underwent 64-slice spiral CTPI. We analyzed the correlations of CTPI parameters including blood flow (BF), blood volume (BV), time to peak (TTP), and permeability surface (PS) with the expression of markers of angiogenesis. Statistical analysis was performed with paired-samples t test, and Pearson correlation analysis was employed to investigate the correlations of CTPI parameters with microvessel density (MVD). Results Mean BF, BV, TTP, and PS values of osteosarcoma group were (46.6 ± 25.1) mL/100 g/min, (61.8 ± 29.5) mL/100 g, (122.9 ± 26.2) seconds, and (44.5 ± 14.6) mL/100 g/min, respectively. Those in the normal muscle group were (5.2 ± 6.6) mL/100 g/min, (9.6 ± 7.3) mL/100 g, (115.5 ± 33.1) seconds and (17.0 ± 29.3) mL/100 g/min, respectively. Osteosarcoma group showed higher BF, BV and PS compared with the normal muscle group (P = 0.000, P = 0.000, and P = 0.000, respectively). However, no significant difference was found in TTP between osteosarcoma tissue and normal adjacent muscle tissue (P = 0.273). BF, BV, and PS were positively correlated with MVD (r = 0.83, P = 0.000; r = 0.87, P = 0.000; and r = 0.63, P = 0.001, respectively). No correlation was found between TTP and MVD (r = -0.02, P = 0.93). Conclusion CTPI is useful for assessing tumor vascularity of osteosarcoma and CTPI parameters are positively correlated with MVD.
    No preview · Article · Mar 2011 · The Chinese-German Journal of Clinical Oncology
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    Jianda Xu · Sujia Wu · Xin Shi
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    ABSTRACT: Reversion-inducing cysteine-rich protein with Kazal motifs (RECK), a novel membrane-anchored matrix metalloproteinase inhibitor, have been shown to be associated with prognosis and suppress tumor progression through angiogenesis inhibition in many cancers. In this study, the expression of RECK in osteosarcoma was examined, and its clinical significance was firstly evaluated. RECK expression was immunohistochemically examined in osteosarcoma from 49 patients. By summing intensity and proportion scores, these patients were categorized as weak and strong. RECK expression in the primary tumor was strong in 27 patients (55.1%) and was weak in the rest of the patients. The 5-year survival rate of patients with RECK-strong tumor (81.5%) was significantly higher than that of patients with RECK-weak tumor (36.4%; p = 0.003). Reduced RECK expression significantly correlated with metastasis (p = 0.010) and recurrence (p = 0.004). A multivariate analysis confirmed that reduced RECK expression was an independent and significant factor to predict a poor prognosis (p = 0.017). RECK status is a useful prognostic factor in osteosarcoma, and an independent prognostic factor contributing to the determination of more adequate therapy strategies for each patient.
    Preview · Article · Dec 2010 · Journal of Orthopaedic Research
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    ABSTRACT: Objective The aim of this study was to determine stand protocol for patients with extremity osteosarcoma by case following up after neoadjuvant chemotherapy and limb salvage operation. Methods Between January 2000 and January 2007, 121 patients with extremity osteosarcoma were eligible for this analysis. After being graded according to Enneking classification, all patients were preoperative chemotherapy (methotrexate, cisplatin, doxorubicin, and ifosfamide. Some patients with IIB tumors received extra interventional embolism). And postoperatively, the same protocols were employed, but poor responders (tumor necrosis < 95%) received more treatment cycles than good responders and took some new medicine in place of the former one. Most of patients underwent limb salvage operation (99/121), and the Musculoskeletal Tumor Society Score (MSTS) was used to evaluate the recovery of their limb functions. Results The followed up last for average 37.3 months (range: 16–101 months). Most patients (76/121) survived, and the overall survival (OS) was 62.8%. Forty-seven of the 121 patients underwent osteoarticular allografts, among which 12 cases of disunion between the host bone and graft bone, 4 cases of allograft absorption and 3 local recurrences appeared. The mean MSTS score was 22.6 ± 4.13, with an excellent limb function in 17 patients, good in 19 patients, fair in 6 patients and poor in 7 patients. The overall excellent and good function outcome was obtained in 76.6% of the patients. Fifty-two of 121 patients underwent custom-made or modular tumor endoprosthesis replacememt, among which 1 case of aseptic loosening, 1 case of peri-prosthesis infection and 4 local recurrences appeared. The mean MSTS was 24.32 ± 3.85, with an excellent limb function in 28 patients, good in 16 patients, fair in 5 patients and poor in 3 patients. The overall excellent and good function outcome was obtained in 84.6% of the patients. Conclusion Neoadjuvant chemotherapy and limb salvage surgery are effective methods to treat osteosarcoma at present, although some patients still dying from postoperative metastases. Therefore, early diagnosis individualized treatment and exploring for new and effective therapeutic strategy should be the key to an ideal treatment for osteosarcoma.
    No preview · Article · Nov 2009 · The Chinese-German Journal of Clinical Oncology
  • Sujia Wu · Xin Shi · Guangxin Zhou
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    ABSTRACT: To discuss the definition of complicated giant cell tumor of the bone and retrospectively analyze the treatment protocols and their therapeutic results so as to provide a clinical basis for reducing the postoperative recurrence of this kind of tumor. From April 2001 to April 2005, 22 patients (11 males and 11 females, aged 15-66 years) with complicated giant cell tumor of the bone were treated by the marginal or wide excision. The tumor was located in the distal femur in 10 patients, the proximal tibia in 5, the proximal femur in 2, the proximal humerus in 2, the hip bone in 2, and the distal radius in 1. The Campanacci's grading system was used and the patients were grouped as follows: Grade II in 4 patients, and Grade III in 18. The functional results of the patients were assessed by the clinical examination. The reconstruction methods were used in the forms of osteoarticular allografting (14 patients) and total arthroplasty (8 patients). The analysis on the follow-up (6-48 months, averaged 23 months) of the 22 patients revealed that the complicated factors were as follows: the tumor breaking through the cortex with an extraosseous mass; the tumor having pathologic fracture; the tumor representing more biologically-aggressive lesions; and the tumor having one or more local recurrences. Two patients (9%) had a local recurrence respectively 8 and 11 months after operation, but improved respectively by limb amputation and radiotherapy. Total arthroplasty achieved a better articular function than osteoarticular allografting. All the patients with osteoarticular allografts showed various degrees of the bone union of the allograft with the host bone. The marginal or wide excision of this kind of complicated giant cell tumor of the bone combined with osteoarticular allograft or total arthroplasty can reduce the local recurrence of the tumor and achieve a certain degree of the articular motion function.
    No preview · Article · Nov 2006 · Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery

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92 Citations
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  • 2013-2015
    • Nanjing University
      • School of Medicine
      Nan-ching, Jiangsu Sheng, China
  • 2014
    • Second Military Medical University, Shanghai
      • Department of Orthopaedics
      Shanghai, Shanghai Shi, China
  • 2010
    • Guangzhou Medical University
      Shengcheng, Guangdong, China
  • 2006
    • 307 Hospital of the Chinese People's Liberation Army
      Peping, Beijing, China