目的：探究骨肉瘤患者微小RNA124（miR-124）的表达水平及其对预后的预测价值。方法：选择在我院手术治疗的86例骨肉瘤患者，根据miR-124水平分为高水平组（42例）和低水平组（44例），并选择20例新鲜骨折的患者作为对照组；比较3组患者miR-124的表达水平，分析高水平与低水平组患者临床资料及预后的差异，以及影响患者预后的危险因素。结果：低水平组患者的临床分期ⅡB/Ⅲ期、远处转移以及化疗效果不佳的比例显著高于高水平组（P<0.05）。骨肉瘤患者miR-124表达量显著低于对照组（P<0.05）；骨肉瘤患者非肿瘤组织中miR-124表达量明显高于肿瘤组织（P<0.05）。高水平组患者的死亡风险明显低于低水平组（HR=0.463，P=0.029）。Cox回归分析显示，miR-124低表达是患者预后不佳的独立危险因素（HR=2.145，P=0.044），化疗有效是保护因素（HR=0.495，P=0.047）。结论：骨肉瘤患者miR-124表达水平较低，miR-124低表达水平患者的预后较差；化疗有效是骨肉瘤患者术后预后的保护因素，miR-124低表达是独立危险因素。

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