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Tang C, Wang D, Wu Y, Xu H, Zhang H. Surgery Has Positive Effects on Spinal Osteosarcoma Prognosis: A Population-Based Database Study. World Neurosurg 2022; 164:e367-e386. [PMID: 35504478 DOI: 10.1016/j.wneu.2022.04.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The treatment of osteosarcoma of the spine remains controversial. Our aim was to explore the treatment of patients with spinal osteosarcoma. METHODS We analyzed the data from 727 spinal osteosarcoma patients from the Surveillance, Epidemiology, and End Results database from 1973 to 2015. X-tile software was used to find the optimal cutoff values for age and economic income. The Kaplan-Meier estimator method was used to analyze overall survival and cancer-specific survival. Univariate and multivariate Cox analyses were used to identify the independent prognostic factors. Propensity score matching was used to reduce the possibility of selection bias. A logistic regression model was used to clarify the relevant factors affecting a patient's decision to undergo surgery. RESULTS Among 727 eligible spinal osteosarcoma patients, 370 (50.9%) had undergone surgery and 357 (49.1%) had not undergone surgery. Significant differences were found in the effects of patient age at diagnosis, Surveillance, Epidemiology, and End Results historical stage, and tumor grade on the patients' decision to undergo surgery (P < 0.05). Surgery was an independent prognostic factor for overall survival and cancer-specific survival of patients with spinal osteosarcoma. The same results were found after 1:1 propensity score matching. The surgery group had more favorable survival compared with the nonsurgery group. CONCLUSIONS Surgery can provide survival benefits for patients with osteosarcoma of the spine. The patients with spinal osteosarcoma who had undergone surgery experienced favorable survival benefits. Thus, surgery can be a suitable treatment for patients with spinal osteosarcoma.
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Affiliation(s)
- Chao Tang
- Orthopedic Department, People's Hospital of Putuo District, Tongji University School of Medicine, Shanghai, China; Pain Department, Pizhou City People's Hospital, Xuzhou Medical University, Xuzhou City, China
| | - Dongdong Wang
- Orthopedics Department, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yuman Wu
- Fifth Clinical Medical College, Hubei University of Medicine, Hubei, China
| | - Hengyuan Xu
- Jiakou Community Health Service Center, Pizhou City People's Hospital, Xuzhou Medical University, Xuzhou City, China
| | - Hailong Zhang
- Orthopedic Department, People's Hospital of Putuo District, Tongji University School of Medicine, Shanghai, China.
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Radiomics of Musculoskeletal Sarcomas: A Narrative Review. J Imaging 2022; 8:jimaging8020045. [PMID: 35200747 PMCID: PMC8876222 DOI: 10.3390/jimaging8020045] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 12/23/2022] Open
Abstract
Bone and soft-tissue primary malignant tumors or sarcomas are a large, diverse group of mesenchymal-derived malignancies. They represent a model for intra- and intertumoral heterogeneities, making them particularly suitable for radiomics analyses. Radiomic features offer information on cancer phenotype as well as the tumor microenvironment which, combined with other pertinent data such as genomics and proteomics and correlated with outcomes data, can produce accurate, robust, evidence-based, clinical-decision support systems. Our purpose in this narrative review is to offer an overview of radiomics studies dealing with Magnetic Resonance Imaging (MRI)-based radiomics models of bone and soft-tissue sarcomas that could help distinguish different histotypes, low-grade from high-grade sarcomas, predict response to multimodality therapy, and thus better tailor patients’ treatments and finally improve their survivals. Although showing promising results, interobserver segmentation variability, feature reproducibility, and model validation are three main challenges of radiomics that need to be addressed in order to translate radiomics studies to clinical applications. These efforts, together with a better knowledge and application of the “Radiomics Quality Score” and Image Biomarker Standardization Initiative reporting guidelines, could improve the quality of sarcoma radiomics studies and facilitate radiomics towards clinical translation.
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Wang T, Xu Y, Liu X, Zeng Y, Liu L. miR-96-5p is the tumor suppressor in osteosarcoma via targeting SYK. Biochem Biophys Res Commun 2021; 572:49-56. [PMID: 34343834 DOI: 10.1016/j.bbrc.2021.07.069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/20/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Osteosarcoma is a multiple malignant tumor in adolescents. MicroRNAs (MiRNAs) have been found to express abnormally in OS tissues and are considered as potential targets for OS prognosis and treatment. METHODS MiR-96-5p and SYK expression in clinical samples, osteoblast and OS cell lines were detected. The changes of cell proliferation, apoptosis, adhesion and metastasis of OS cells were detected by CCK-8, BrdU, caspase-3 activity and transwell assay. Dual luciferase report analysis and RNA pull-down were used to confirm binding relation of miR-96-5p and SYK. RESULTS MiR-96-5p was increased in OS tissue and cells. Moreover, miR-96-5p inhibits proliferation, adhesion and migration of HOS and Saos-2 cells, and promotes cell apoptosis. SYK has been identified to be targeted by miR-96-5p. Overexpressed SYK inhibits the suppressive impact of miR-96-5 on OS cells. CONCLUSION MiR-96-5p may function as an effective target in OS treatment.
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Affiliation(s)
- Taiping Wang
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China.
| | - Yong Xu
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Xin Liu
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Yong Zeng
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Lei Liu
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
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Liu J, Lian T, Chen H, Wang X, Quan X, Deng Y, Yao J, Lu M, Ye Q, Feng Q, Zhao Y. Pretreatment Prediction of Relapse Risk in Patients with Osteosarcoma Using Radiomics Nomogram Based on CT: A Retrospective Multicenter Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6674471. [PMID: 33614787 PMCID: PMC7878076 DOI: 10.1155/2021/6674471] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/22/2020] [Accepted: 01/22/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To develop and externally validate a CT-based radiomics nomogram for pretreatment prediction of relapse in osteosarcoma patients within one year. MATERIALS AND METHODS In this multicenter retrospective study, a total of 80 patients (training cohort: 63 patients from three hospitals; validation cohort: 17 patients from three other hospitals) with osteosarcoma, undergoing pretreatment CT between August 2010 and December 2018, were identified from multicenter databases. Radiomics features were extracted and selected from tumor regions on CT image, and then, the radiomics signature was constructed. The radiomics nomogram that incorporated the radiomics signature and clinical-based risk factors was developed to predict relapse risk with a multivariate Cox regression model using the training cohort and validated using the external validation cohort. The performance of the nomogram was assessed concerning discrimination, calibration, reclassification, and clinical usefulness. RESULTS Kaplan-Meier curves based on the radiomics signature showed a significant difference between the high-risk and the low-risk groups in both training and validation cohorts (P < 0.001 and P = 0.015, respectively). The radiomics nomogram achieved good discriminant results in the training cohort (C-index: 0.779) and the validation cohort (C-index: 0.710) as well as good calibration. Decision curve analysis revealed that the proposed model significantly improved the clinical benefit compared with the clinical-based nomogram (P < 0.001). CONCLUSIONS This multicenter study demonstrates that a radiomics nomogram incorporated the radiomics signature and clinical-based risk factors can increase the predictive value of the osteosarcoma relapse risk, which supports the clinical application in different institutions.
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Affiliation(s)
- Jin Liu
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
| | - Tao Lian
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Haimei Chen
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
| | - Xiaohong Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China
| | - Xianyue Quan
- Department of Radiology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510282, China
| | - Yu Deng
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Juan Yao
- Department of Pathology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
| | - Ming Lu
- Department of Oncology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
| | - Qiang Ye
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
| | - Qianjin Feng
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Yinghua Zhao
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, China
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Kaneuchi Y, Hakozaki M, Yamada H, Hasegawa O, Yamada S, Oka Y, Watanabe K, Konno S. Very late relapse of high-grade osteosarcoma: A case report and review of the literature. Medicine (Baltimore) 2020; 99:e21206. [PMID: 32702886 PMCID: PMC7373632 DOI: 10.1097/md.0000000000021206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
RATIONALE Osteosarcoma is the most common primary malignant bone tumor in children. The prognosis of osteosarcoma has improved with the use of aggressive systemic chemotherapy in addition to surgery. The relapse of osteosarcomas is usually as lung metastasis observed within 2 to 3 years after the initial treatment. A relapse is rarely observed at >10 years. PATIENT CONCERNS We report the case of a 51-year-old Japanese man who was treated for high-grade osteosarcoma of the femur at 13 years old. He was referred to our hospital with a suspicion of primary lung cancer based on back pain, respiratory distress, and an abnormal mass on chest radiograph. DIAGNOSES Computed tomography-guided biopsy confirmed the lung lesion as a metastatic recurrence of high-grade osteosarcoma without local recurrence. INTERVENTIONS Chemotherapy was planned, but the patient's general condition rapidly deteriorated and thus palliative therapy was provided. OUTCOMES The patient died 2 months after the initial consultation. LESSONS The survival durations of osteosarcoma patients have been prolonged by recent progress in multimodality therapy, and thus clinicians as well as osteosarcoma patients should always keep in mind the possibility of very late relapse.
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Affiliation(s)
| | | | | | | | - Shoki Yamada
- Department of Pathology and Diagnostic Pathology, Fukushima Medical University School of Medicine
| | - Yuka Oka
- Department of Pathology and Diagnostic Pathology, Fukushima Medical University School of Medicine
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Demirkıran ND, Aktaş S, Erçetin Özdemir AP, Bekçioğlu Ö, Aydın M, Havitçioğlu H. Cadmium in bone cement induces necrosis and decreases the viability of residual osteosarcoma cells: A xenograft study. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:445-452. [PMID: 32609089 DOI: 10.5152/j.aott.2020.20247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to show whether local application of cadmium-impregnated bone cement can induce apoptosis and decrease the viability of residual osteosarcoma (OS) cells in nude mice. METHODS K7M2 tumorigenic OS cell line was cultivated in vitro. The xenograft tumor model was formed by subcutaneously adding the tumor cells to athymic nude mice. Tumor was formed within 1 month. Then, mice were randomly assigned to five groups, each containing seven nude mice: control (group 1), wide resection (group 2), intralesional resection (group 3), intralesional resection + bone cement (group 4), and intralesional resection + cadmium embedded in bone cement (group 5). Tumor resection with 1 cm surgical margins was performed in the wide resection group. In intralesional resection groups, tumor tissue was resected with positive margins aiming to leave 15 mm3 of macroscopic tumor tissue. In group 3, the defect was left empty; groups 4 and 5 received bone cements prepared with saline and cadmium solutions, respectively. After the resection, mice were observed for 15 days and sacrificed. Next, surgical resection sites were evaluated histopathologically in each group. RESULTS Recurrent tumor was formed in all mice in the wide resection group, and apparent progression of residual tumor was observed in groups 3 and 4. On the contrary, only a thin layer of residual tumor was observed around the bone cement in group 5. Histological evaluation revealed remarkable necrosis in group 5 and lowest viability compared to other groups. No systemic toxic effect related to cadmium was observed. CONCLUSION Our data suggest that local application of cadmium in bone cement has a significant potential to increase tumor necrosis and decrease the viability of residual OS cells.
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Affiliation(s)
- Nihat Demirhan Demirkıran
- Department of Orthopedics, Kütahya University of Health Sciences University, School of Medicine, Kütahya, Turkey;Department of Basic Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | - Safiye Aktaş
- Department of Basic Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | | | - Ömer Bekçioğlu
- Department of Basic Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | - Melek Aydın
- Department of Basic Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | - Hasan Havitçioğlu
- Department of Orthopedics, Dokuz Eylül University, School of Medicine, İzmir, Turkey
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Chen H, Liu J, Cheng Z, Lu X, Wang X, Lu M, Li S, Xiang Z, Zhou Q, Liu Z, Zhao Y. Development and external validation of an MRI-based radiomics nomogram for pretreatment prediction for early relapse in osteosarcoma: A retrospective multicenter study. Eur J Radiol 2020; 129:109066. [PMID: 32502729 DOI: 10.1016/j.ejrad.2020.109066] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE To develop and externally validate an MR-based radiomics nomogram from retrospective multicenter datasets for pretreatment prediction of early relapse (≤ 1 year) in osteosarcoma after surgical resection. METHODS This multicenter study retrospectively enrolled 93 patients (training cohort: 62 patients from four hospitals; validation cohort: 31 patients from two hospitals) with clinicopathologically confirmed osteosarcoma who received neoadjuvant chemotherapy and surgical resection at six hospitals between January 2009 and October 2017. Radiomics features were extracted from contrast-enhanced fat-suppressed T1-weighted (CE FS T1-w) images. Least absolute shrinkage and selection operator (LASSO) regression was applied for feature selection and radiomics signature construction. The radiomics nomogram that incorporated the radiomics signature and subjective MRI-assessed candidate predictors was developed to predict early relapse with a multivariate logistic regression model in the training cohort and validated in the external validation cohort. The performance of the nomogram was assessed by its discrimination, calibration, and clinical usefulness. RESULTS The radiomics signature comprised six selected features and achieved favorable prediction efficacy. The radiomics nomogram incorporating the radiomics signature and subjective MRI-assessed candidate predictors (joint invasion and perivascular involvement) from the multicenter datasets achieved better discrimination in the training cohort (C-index:0.907, 95 % CI: 0.838-0.977) and external validation cohort (C-index: 0.811, 95 % CI: 0.653-0.970), and good calibration. Decision curve analysis suggested that the combined nomogram was clinically useful. CONCLUSION The proposed MRI-based radiomics nomogram could provide a non-invasive tool to predict early relapse of osteosarcoma, which has the potential to improve personalized pretreatment management of osteosarcoma.
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Affiliation(s)
- Haimei Chen
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Jin Liu
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Zixuan Cheng
- Department of Radiology, Guangzhou Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080,China.
| | - Xing Lu
- Sigma Technologies Inc, San Diego, CA 92130, United States.
| | - Xiaohong Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
| | - Ming Lu
- Department of Oncology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Shaolin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong 519000, China.
| | - Zhiming Xiang
- Department of Radiology, Panyu Central Hospital of Guangzhou, Guangzhou, Guangdong 511400, China.
| | - Quan Zhou
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Zaiyi Liu
- Department of Radiology, Guangzhou Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080,China.
| | - Yinghua Zhao
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
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Yu XC, Xu SF, Xu M, Liu XP, Song RX, Fu ZH. Alcohol-inactivated autograft replantation with joint preservation in the management of osteosarcoma of the distal femur: a preliminary study. Oncol Res Treat 2014; 37:554-60. [PMID: 25342506 DOI: 10.1159/000367799] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 08/08/2014] [Indexed: 11/19/2022]
Abstract
AIM To evaluate clinical outcomes in patients who underwent alcohol-inactivated autograft replantation with joint preservation for the treatment of osteosarcoma of the distal femur. PATIENTS AND METHODS 10 patients (7 men, 3 women; mean age: 20.1 years) were treated. 9 patients had Enneking stage IIb tumors and 1 patient had stage III. The mean follow-up time was 34 months. All patients obtained first-stage healing. RESULTS 1 patient died of local recurrence and multiple metastases 13 months after surgery; 3 patients died of multiple metastases 9, 12, and 24 months after surgery, respectively. 3 patients required second surgery because of fracture of the inactivated autograft, 1 patient died 6 months later, 1 patient experienced bony healing 4 months later with no further complications, and 1 patient required subsequent open reduction and bone implantation with internal fixation (bony healing was evident 6 months later; however, joint instability and limited knee flexion were apparent). At final follow-up, the mean International Society of Limb Salvage (ISOLS) graft score was 31 (87%), whereas the mean Musculoskeletal Tumour Society (MSTS) function score was 23 (77%). CONCLUSIONS These preliminary findings indicate that alcohol-inactivated autograft replantation with joint preservation may be effective in treating osteosarcoma of the distal femur in some patients. Larger-scale studies are needed to fully evaluate the efficacy/safety of this approach.
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Affiliation(s)
- Xiu-Chun Yu
- Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P. R. China
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Lei P, Xie J, Wang L, Yang X, Dai Z, Hu Y. microRNA-145 inhibits osteosarcoma cell proliferation and invasion by targeting ROCK1. Mol Med Rep 2014; 10:155-60. [PMID: 24789502 DOI: 10.3892/mmr.2014.2195] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/12/2014] [Indexed: 11/05/2022] Open
Abstract
Osteosarcoma (OS), a malignant mesenchymal sarcoma, is the most frequent primary bone tumor, with a peak incidence in young children and adolescents. The downregulation of microRNA‑145 (miRNA/miR‑145) has previously been identified to be associated with the aggressiveness and metastasis of OS. However, the detailed regulatory mechanism by which miR‑145 inhibits OS remains largely unknown. The present study demonstrated that miR‑145 was significantly downregulated in OS tissues and KHOS and U2OS cell lines. Rho‑associated protein kinase 1 (ROCK1), a key regulator of actin cytoskeleton reorganization, was identified as a novel target of miR‑145. Ectopic expression of miR‑145 notably suppressed the protein expression of ROCK1 without affecting its mRNA level. Furthermore, the expression of ROCK1 was significantly increased in the OS tissues and in the KHOS and U2OS cells. It was further demonstrated that the overexpression of miR‑145 downregulated KHOS and U2OS cell proliferation and invasion, which was reversed by restoration of ROCK1. To the best of our knowledge, the present study demonstrates for the first time that, as a tumor suppressor, miRNA‑145 inhibits OS cell proliferation and invasion, at least in part by directly targeting ROCK1. These results indicate that miR‑145 may be a potential candidate for the diagnosis and treatment of OS.
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Affiliation(s)
- Pengfei Lei
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Jie Xie
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Long Wang
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Xucheng Yang
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Zixun Dai
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Yihe Hu
- Department of Orthopedics, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
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