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目的:检测上皮-间充质转换的转录因子Twist和Snail在滑膜肉瘤组织中的表达,分析二者之间关系及其对滑膜肉瘤远处转移的影响,并探讨其预后意义。方法:通过组织病理学观察和免疫组织化学染色,检测133例滑膜肉瘤组织标本中Twist和Snail的表达情况,应用统计学软件SPSS13.0分析二者的不同表达与各临床病理参数特点的关系,并作KaplanMeier生存分析。结果:Twist和Snail在滑膜肉瘤组织中表达部位为细胞质和/或细胞核,133例组织标本中Twist高表达者55例(55/133)且与组织学分型、临床分期以及融合基因类型有关(P<0.05);Snail高表达者82例(82/133),与组织学分型有关(P<0.05)。二者的表达与不同性别、年龄、肿瘤大小、部位、组织学分级等无关(P>0.05)。Twist和Snail在滑膜肉瘤组织中的表达存在正相关(r_s=0.191,P=0.027),Log-Ranktest显示Twist高表达组,患者总生存期和无转移生存期明显低于低表达组,差异有统计学意义(x~2=8.620,P=0.03和x~2=11.462,P=0.001);Snail高表达组,患者无转移生存期明显低于其弱表达者,差异有统计学意义(x~2=4.575,P=0.032),但两组的总生存期差异无统计学意义(x~2=0.602,P=0.438);且二者联合表达组患者总生存期和无转移生存期明显低于其弱表达组,差异有统计学意义(x~2=13.619,P=0.003和x~2=15.548,P=0.001)。结论:滑膜肉瘤组织中存在EMT的主要转录因子Twist和Snail的高表达,二者可独立诱导EMT,且二者的联合表达更加促进肿瘤转移的发生,提示患者预后不良。
OBJECTIVE: To detect the expression of Twist and Snail in synovial sarcoma of epithelial-mesenchymal transition and analyze the relationship between the two and its effect on the distant metastasis of synovial sarcoma, and to explore its prognostic significance. Methods: The expressions of Twist and Snail in 133 cases of synovial sarcoma were detected by histopathological observation and immunohistochemical staining. The relationship between the expression of Twist and Snail was analyzed by statistical software SPSS 13.0 , And KaplanMeier survival analysis. RESULTS: Twist and Snail expressed cytoplasm and / or nucleus in synovial sarcoma, and 55 (55/133) Twist high expression in 133 tissues were correlated with histological type, clinical stage and type of fusion gene P <0.05). There were 82 cases (82/133) with high expression of Snail in histological type (P <0.05). The expression of the two had no relation with different gender, age, tumor size, location, histological grade, etc (P> 0.05). There was a positive correlation between Twist and Snail expression in synovial sarcoma (r_s = 0.191, P = 0.027). Log-Ranktest showed that Twist high expression group had significantly lower total survival and metastasis-free survival than low expression group There was statistical significance (x ~ 2 = 8.620, P = 0.03 and x ~ 2 = 11.462, P = 0.001). In Snail overexpression group, the metastasis-free survival rate was significantly lower in patients with metastasis There was no significant difference in the overall survival between the two groups (x ~ 2 = 0.602, P = 0.438). The overall survival and metastasis-free survival The difference was statistically significant (x ~ 2 = 13.619, P = 0.003 and x ~ 2 = 15.548, P = 0.001). Conclusions: There are high expression of Twist and Snail, the major transcription factors of EMT in synovial sarcoma. Both of them can induce EMT independently, and the combination of the two can promote the occurrence of tumor metastasis, suggesting the poor prognosis of patients.