title: Is Dupuytren's disease caused by an imbalance between proliferation and cell death?
abstract: Dupuytren's contracture shares certain properties with malignant tumours, characterized by proliferation and lack of apoptosis, which may be induced by the c-myc oncogene. Because of these similarities, the relationship between the c-myc oncogene expression, bcl-2 oncogene (anti-apoptotic gene) and proliferation was investigated in Dupuytren's disease. Proliferation was assessed by immunohistochemical staining of the mib-1 antibody. Results were compared with those from fibrosarcoma specimens, representing a related malignant tumour. Non-diseased fascia from Dupuytren patients and flexor retinaculum from patients undergoing carpal tunnel release without Dupuytren's disease were used as controls. Expression of c-myc was elevated in primary Dupuytren's disease and fibrosarcoma specimens, whilst recurrent Dupuytren's disease, non-diseased Dupuytren fascia and flexor retinaculum exhibited significantly lower levels. Neither bcl-2 nor mib-1 were detected in Dupuytren's disease, non-diseased fascia or flexor retinaculum, in contrast to fibrosarcoma. The imbalance between proliferation and apoptosis, producing malignant growth was thus confirmed for fibrosarcoma, but not for Dupuytren's disease.
authors.affiliation: Department of Plastic Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK. bjemec@krota.demon.co.uk
authors.forename: B
authors.initials: B
authors.lastname: Jemec
authors.forename: A O
authors.initials: AO
authors.lastname: Grobbelaar
authors.forename: G D
authors.initials: GD
authors.lastname: Wilson
authors.forename: P J
authors.initials: PJ
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Sanders
authors.forename: D A
authors.initials: DA
authors.lastname: McGrouther
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016923:Cell Death / Q000235:genetics; D002455:Cell Division / Q000235:genetics; D003593:Cytoplasm / Q000737:chemistry; D003937:Diagnosis, Differential; D004387:Dupuytren Contracture / Q000235:genetics* / Q000473:pathology*; D005205:Fascia / Q000737:chemistry / Q000166:cytology / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000166:cytology; D005354:Fibrosarcoma / Q000235:genetics* / Q000473:pathology; D015870:Gene Expression; D019254:Genes, bcl-2 / Q000235:genetics*; D016259:Genes, myc / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric