Oda Y, Hashimoto H, Tsuneyoshi M, Takeshita S
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Surg Pathol. 1993 Jan;17(1):35-44.
A retrospective study of 56 patients with synovial sarcoma was done to search for possible prognostic factors affecting survival. In a univariate analysis, age (> or = 20 years), site (proximal), large tumor size (> or = 5 cm), mitotic rate of more than 15 per 10 per high-power fields (hpf), high nuclear grade, tumor necrosis of more than 50%, the presence of rhabdoid cells, a small number of mast cells (< 20/10 hpf), and a high stage according to the criteria of the American Joint Committee (AJC) staging of soft tissue sarcoma, significantly decreased survival (log-rank test; p < 0.05). Moreover, when comparing the 10-year survival (11 patients) and the deaths within 1 year (12 patients), size, high nuclear grade, presence of rhabdoid cells, tumor necrosis, and stage were all considered to be significant prognostic factors (two-sided chi-square test; p < 0.01). In a multivariate analysis (Cox's model), stage was the only strong predictor of a poor prognosis (p = 0.011). We therefore concluded that large tumor size, high nuclear grade, the presence of rhabdoid cells, extensive tumor necrosis, and a high AJC stage were adverse prognostic factors in synovial sarcoma.
对56例滑膜肉瘤患者进行了一项回顾性研究，以寻找可能影响生存的预后因素。在单因素分析中，年龄（≥20岁）、部位（近端）、肿瘤体积大（≥5 cm）、每10个高倍视野（hpf）有丝分裂率超过15、核分级高、肿瘤坏死超过50%、存在横纹肌样细胞、肥大细胞数量少（<20/10 hpf）以及根据美国联合委员会（AJC）软组织肉瘤分期标准处于高分期，均显著降低生存率（对数秩检验；p<0.05）。此外，比较10年生存者（11例）和1年内死亡者（12例）时，肿瘤大小、核分级高、存在横纹肌样细胞、肿瘤坏死和分期均被认为是显著的预后因素（双侧卡方检验；p<0.01）。在多因素分析（Cox模型）中，分期是预后不良的唯一强预测因素（p = 0.011）。因此，我们得出结论，肿瘤体积大、核分级高、存在横纹肌样细胞、广泛的肿瘤坏死以及AJC高分期是滑膜肉瘤的不良预后因素。
