title: Expression of Matrix Metalloproteinase-9 and CD34 in Giant Cell Tumor of Bone.
abstract: OBJECTIVE
  Giant cell tumor of bone (GCTB) invades extensively and metastasizes, however, the pathological grade and imaging findings are not accurate predictors of its prognosis. Thus, the aim of this study was to explore the relationships between expression of cluster of differentiation (CD)34 and matrix metalloproteinase-9 (MMP-9) and the biological behavior of GCTB with the hope of identifying predictors of prognosis.
  
  
  METHODS
  Sixty-eight patients with GCTBs attending our institution from September 2008 to August 2013 were enrolled in this prospective study and grouped according to tumor location. Relevant patient characteristics were assessed. Additionally, the expression of CD34 and MMP-9 in these patients was assayed by an immunohistochemistry staining procedure and the relationships between CD34/MMP-9 and microvessel density (MVD) analyzed by Spearman correlation analysis.
  
  
  RESULTS
  It was found that CD34 factor localizes in the cytoplasm of the endothelial cells of small blood vessels in the tumor stroma and is strongly expressed in GCTBs. In addition, radiological grading showed that there was significantly more CD34 antibody-labeled MVD in invasive than in non-invasive tumors (P < 0.05) and significantly more CD34 antibody-labeled MVD in patients who developed recurrences than in those who did not (P < 0.05). Expression of MMP-9 was localized in the cytoplasm of tumor cells and the rate of MMP-9 positivity in GCTBs was significantly higher in active and invasive tumors than in non-invasive tumors (P < 0.01). Moreover, there were significantly more MVDs in MMP-9-positive than in MMP-9 negative tumors (P < 0.01). CD34 and MMP-9 are positively correlated with MVD values in GCTBs and closely correlated with their grade of malignancy.
  
  
  CONCLUSIONS
  Expression of CD34 and MMP-9 accurately predicts clinical behavior detection and prognosis of GCTBs.
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Xiao-Zhou
authors.initials: XZ
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Gen-Tao
authors.initials: GT
authors.lastname: Fan
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Su-Jia
authors.initials: SJ
authors.lastname: Wu
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Jian-Ning
authors.initials: JN
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics; D001859:Bone Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D002648:Child; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000096:biosynthesis / Q000235:genetics*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012334:RNA, Neoplasm / Q000235:genetics*; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D012334:RNA, Neoplasm; D020780:Matrix Metalloproteinase 9
keywords: CD34; Giant cell tumor of bone; Immunohistochemistry; Matrix metalloproteinase-9; Microvessel density