SYT-SSX 融合基因E-钙粘素及β-连接素对滑膜肉瘤转移的影响*

The Influence of SYT-SSX Fusion Gene,E-cadherin and β-Catenin on the Metastasis of Synovial Sarcoma

    摘要
  • 摘要: 目的：探讨SYT-SSX 融合基因、E-钙粘素、β-连接素及临床病理学参数对评估滑膜肉瘤患者转移的意义。方法：选择临床及随访资料完整的滑膜肉瘤98例，RT-PCR 方法检测SYT-SSX 融合基因的亚型，免疫组织化学SP法检测E-钙粘素、β- 连接素的表达。单因素和多因素分析上述因素及临床病理学参数对滑膜肉瘤患者无转移生存的影响。结果：1）31例（31.6%）滑膜肉瘤为SYT-SSX 1 阳性，67例（68.4%）为SYT-SSX 2 阳性。2）E-钙粘素的阳性表达率为38.8 %（38/98），β- 连接素的细胞膜阳性表达率为39.8%（39/98），细胞核/浆阳性表达率为53.1%（52/98）。 3）单因素分析结果显示，年龄（P=0.003）、组织学分级（P=0.001）、SYT-SSX 亚型（P=0.014）、E-钙粘素（P=0.015）及β- 连接素的细胞膜表达情况（P=0.020）与滑膜肉瘤患者的无转移生存有关，而性别（P=0.190）、肿瘤部位（P=0.105）、肿瘤大小（P=0.180）、组织学分型（P=0.354）、β- 连接素的细胞核/浆表达（P=0.911）、放疗（P=0.193）及化疗（P=0.249）与患者的无转移生存无明显相关。4）多因素分析结果表明，SYT-SSX 1（RR= 2.505，P=0.003）、E-钙粘素的表达（RR= 3.282，P=0.000）、年龄（RR= 2.157，P=0.004）和组织学分级Ⅲ（RR= 1.784，P=0.030）是影响滑膜肉瘤转移的独立危险因素。结论：SYT-SSX 1 融合基因、E-钙粘素表达、组织学分级及患者年龄可以作为评估滑膜肉瘤患者转移及预后的重要指标。

     

    Abstract: Objective: To study the prognostic significance of the subtype of SYT-SSX fusion gene, E-cadherin, β-Catenin and cl inicopathological parameters for the metastasis of synovial sarcomas. Methods:A total of98synovial sar-coma patients with complete clinical and follow-up data were reviewed. RT-PCR was used to detect the subtype of SYT-SSX fusion gene. The expression of E-cadherin and β-catenin was detected by immunohistochemistry. Univariate and multivariate analyses were performed to analyze the influence of the above factors and clinicopathological parameters on the metastasis free survival to explore the factors affecting the metastasis of synovial sarcoma. Results: Of all the pa-tients, 69.4% (68/98) had metastasis during follow-up. The median metastasis free survival was 48months. The metastasis free 1-, 2-, 3-, 4-, and 5-year survival rate after surgery was 97.5%,75.5%,63.5%,54.0%, and48.5%, respectively;31.6% (31/98) patients were found with SYT-SSX 1 and 68.4% (67/98) patients with SYT-SSX 2. The positive rate of E-cadherin ex -pression was 38.8% (38/98), the posi tive rate of β-catenin expression was 39.8% (39/98) on cellular membrane and 53.1% (52/98) in cellular nucleus/cytoplasm. Univariate analysis showed that age (P=0.003 ), mitotic figure ( P=0.002 ), histological grade (P=0.001 ), the subtype fusion gene of SYT-SSX (P=0.014 ), E-cadherin expression ( P=0.015 ) and β-catenin expres-sion on cellular membrane ( P=0.020 ) were significantly correlated with metastasis free survival of synovial sarcoma pa -tients. Sex ( P=0.190 ), tumor location ( P=0.105 ), tumor size ( P=0.180 ), histological type (P=0.354 ), necrosis ( P=0.451 ), β-catenin expression in cel l nucleus/cytoplasm (P=0.911 ), radiotherapy (P=0.193 ), and chemotherapy ( P=0.249 ) had no sig-nificant correlation with metastasis free survival of synovial sarcoma patients. Multivariate analysis revealed that the sub-type of SYT-SSX 1 fusion gene (RR= 2.505 , P=0.003 ), negative expression of E-cadherin (RR= 3.282 , P=0.000 ), patient age (RR= 2.157 , P=0.004 ), and grade Ⅲ(RR= 1.784 , P=0.030 ) were independent risk factors for metastasis of synovial sarcoma. Conclusion:The subtype of SYT-SSX, expression of E-cadherin, histological grade and the age of patients are important factors for evaluating the metastasis and prognosis of synovial sarcoma.

     

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