Background: αV integrins and vascular endothelial growth factor (VEGF) have been shown to play an important role in osteosarcoma metastasis. However, their expression in osteosarcoma after chemotherapy remains unknown. Patients and Methods: Here, using immunohistochemistry, we analyzed the levels of αV integrins and VEGF in paraffin sections of 20 patients with untreated osteosarcoma, and 31 patients with adriamycin/cisplatin/ifosfamide-treated osteosarcoma. Results: Expression of αV integrins and VEGF was much higher in osteosarcoma compared with normal bone tissues (p < 0.001) and was reduced dramatically after adriamycin/cisplatin/ifosfamide treatment (p < 0.01). Their expression in osteosarcoma after chemotherapy positively correlated with each other (r = 0.418; p = 0.019, Spearman test). The rank sum test indicated that both positively correlated with osteosarcoma relapse (p < 0.01 and p < 0.05, respectively), Enneking stages (p < 0.05), and invasion of osteosarcoma (p < 0.05), but not with gender, age, tumor necrosis, tumor subtype, or location. VEGF expression was also associated with metastasis incidence (p < 0.05). Multinomial forward conditional logistic regression analysis showed that αV integrins might be an independent risk factor of osteosarcoma relapse (odds ratio = 3.96, p = 0.047, 95% confidence interval = (2.12–12.47)). Conclusion: Expression of αV integrins and expression of VEGF may be helpful indicators of osteosarcoma diagnosis and predictors of prognosis after chemotherapy, serving as putative targets for osteosarcoma treatment.

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