Analysis of Variance Based Significance Analysis of Cartilage Tumor

Chondrosarcoma is a malignant bone tumor with poor prognosis. Surgical treatment is the first choice for chondrosarcomas. Chondrosarcoma is not sensitive to chemotherapy and radiotherapy. Identification of biological markers is important for the early diagnosis and targeted treatment of chondrosarcoma. This study aimed to investigate the protein expression and clinicopathological significance of APEX1 and Haptoglobin in 85 chondrosarcomas and 38 osteochondromas based on deep learning. The APEX1 and Haptoglobin protein expression in tissues was measured by immunohistochemistry. The percentage of positive APEX1 and Haptoglobin expression was significantly higher in patients with chondrosarcoma than in patients with osteochondroma (P < 0001). The percentage of positive APEX1 and Haptoglobin expression was significantly lower in patients with histological grade I, AJCC stage I, Enneking stage I and non-metastatic chondrosarcoma than patients with histological grade III, AJCC stage III+IV, Enneking stage III, and metastatic chondrosarcoma (P < 0005 or P < 0001). APEX1 expression was positively correlated with Haptoglobin expression in chondrosarcoma (P < 0001). Kaplan—Meier survival analysis demonstrated that histological grade, AJCC stage, Enneking stage, metastasis, invasion, and APEX1 and Haptoglobin expression significantly correlated with a short mean survival time of patients with chondrosarcoma (P < 0005 or P < 0001). Cox multivariate analysis showed that positive APEX1 and Haptoglobin expressions were independent prognostic factors that negatively correlated with postoperative survival and positively correlated with mortality. The AUC for APEX1 (AUC = 0.673, 95% CI: 0.573—0.772), or Haptoglobin (AUC = 0.649, 95% CI: 0.548—0.750), respectively. Positive APEX1 and Haptoglobin expression is associated with the carcinogenesis, progression and poor prognosis of chondrosarcoma.