Sun Yan, Sun Bao-cun, Zhao Xiu-lan, Wang Jian, Chen Jing, Li Xiao-qing, Feng Yu-mei, Fang Zhi-wei, Hao Xi-shan
Department of Pathology, Tianjin Cancer Hospital, Tianjin 300060, China.
Zhonghua Bing Li Xue Za Zhi. 2007 Jul;36(7):480-4.
To assess the diagnostic values of immunohistochemistry and SYT-SSX fusion gene detection for synovial sarcoma.
Based on clinical features, histological and immunohistochemical profiles, 195 cases of tumors were divided into three diagnostic categories: definitive synovial sarcoma, probable synovial sarcoma and possible synovial sarcoma. RT-PCR Detection of the SYT-SSX fusion gene was performed using paraffin embedded tissue samples. Comparison between RT-PCR and immunohistochemistry results was carried out and their diagnostic value was evaluated.
There were 62 (31.8%) definite synovial sarcomas, 49 (25.1%) probable synovial sarcomas and 84 cases (43.1%) possible synovial sarcomas. SYT-SSX fusion gene was detected in 140 (78.2%) cases overall, including 94.7% (54/57) definite synovial sarcomas, 86.0% (37/43) probable synovial sarcomas and 62.0% (49/79) possible synovial sarcomas. In tumors in the certain and probable synovial sarcoma categories, the positive rates of epithelial membrane antigen (EMA) were significantly higher in the SYT-SSX positive cases than SYT-SSX-negative cases (P = 0.022, P = 0.010, respectively). EMA was positively correlated with the presence of SYT-SSX (r(s) = 0.431, P = 0.001, r(s) = 0.463, P = 0.002, respectively). However, such a correlation was not seen in cytokeratin (CK), vimentin or S-100 protein immunostains (P > 0.05). In tumors of possible synovial sarcoma category, there were no significant differences of CK, EMA, vimentin or S-100 protein between SYT-SSX-positive and SYT-SSX-negative tumors.
SYT-SSX fusion gene detection is not needed when the conventional approaches are diagnostic. EMA positivity has a similar diagnostic value to that of SYT-SSX by RT-PCR for tumors in the probable synovial sarcoma category. However, detection of SYT-SSX is very important for diagnosis of the tumors in the category of possible synovial sarcoma.
评估免疫组织化学及SYT - SSX融合基因检测对滑膜肉瘤的诊断价值。
根据临床特征、组织学及免疫组织化学特征，将195例肿瘤分为三类诊断范畴：确诊滑膜肉瘤、疑似滑膜肉瘤和可能滑膜肉瘤。采用石蜡包埋组织样本进行SYT - SSX融合基因的逆转录聚合酶链反应（RT - PCR）检测。对RT - PCR与免疫组织化学结果进行比较，并评估它们的诊断价值。
确诊滑膜肉瘤62例（31.8%），疑似滑膜肉瘤49例（25.1%），可能滑膜肉瘤84例（43.1%）。总体上，140例（78.2%）检测到SYT - SSX融合基因，其中确诊滑膜肉瘤中94.7%（54/57）检测到，疑似滑膜肉瘤中86.0%（37/43）检测到，可能滑膜肉瘤中62.0%（49/79）检测到。在确诊和疑似滑膜肉瘤范畴的肿瘤中，SYT - SSX阳性病例上皮膜抗原（EMA）的阳性率显著高于SYT - SSX阴性病例（分别为P = 0.022，P = 0.010）。EMA与SYT - SSX的存在呈正相关（分别为r(s)=0.431，P = 0.001；r(s)=0.463，P = 0.002）。然而，在细胞角蛋白（CK）、波形蛋白或S - 100蛋白免疫染色中未观察到这种相关性（P > 0.05）。在可能滑膜肉瘤范畴的肿瘤中，SYT - SSX阳性和阴性肿瘤之间的CK、EMA、波形蛋白或S - 100蛋白无显著差异。
当常规方法可明确诊断时，无需进行SYT - SSX融合基因检测。对于疑似滑膜肉瘤范畴的肿瘤，EMA阳性与RT - PCR检测SYT - SSX具有相似的诊断价值。然而，SYT - SSX检测对于可能滑膜肉瘤范畴的肿瘤诊断非常重要。
