[Roles of immunohistochemistry and detection of SYT-SSX fusion gene in diagnosis of synovial sarcoma].

Abstract

OBJECTIVE:

To assess the diagnostic values of immunohistochemistry and SYT-SSX fusion gene detection for synovial sarcoma.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

• Authors: Yan Sun, Bao-cun Sun, Xiu-lan Zhao, Jian Wang, Jing Chen, Xiao-qing Li, Yu-mei Feng, Zhi-wei Fang, Xi-shan Hao
• Journal: Zhonghua bing li xue za zhi = Chinese journal of pathology (Zhonghua Bing Li Xue Za Zhi) Vol. 36 Issue 7 Pg. 480-4 (Jul 2007) ISSN: 0529-5807 [Print] China
• PMID: 17845763 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Mucin-1
• Oncogene Proteins, Fusion
• S100 Proteins
• SYT-SSX fusion protein
• Vimentin
• Keratins

Topics

• Adolescent
• Adult
• Aged
• Biomarkers, Tumor (metabolism)
• Child
• Child, Preschool
• Female
• Humans
• Immunohistochemistry
• Keratins (metabolism)
• Male
• Middle Aged
• Mucin-1 (metabolism)
• Oncogene Proteins, Fusion (metabolism)
• Reverse Transcriptase Polymerase Chain Reaction
• S100 Proteins (metabolism)
• Sarcoma, Synovial (diagnosis, metabolism, pathology)
• Soft Tissue Neoplasms (diagnosis, metabolism, pathology)
• Vimentin (metabolism)
• Young Adult