title: Prognostic significance of nuclear accumulation of c-myc and mdm2 proteins in synovial sarcoma of the extremities.
abstract: We retrospectively analysed a group of primary tumours from 32 patients with synovial sarcomas of the extremities by using immunohistochemistry on paraffin-embedded tissue samples in order to investigate the prognostic significance of the nuclear accumulation of c-myc and mdm2 proteins. Nuclear positive immunostaining for c-myc or mdm2 proteins were revealed in 9/32 cases (28%) and in 6/30 cases (20%), respectively. Since c-myc protein appears to be a key factor for keeping cells in an active proliferative stage, we also analysed the growth compartment of each tumour by using the MIB1 monoclonal antibody, specific for Ki-67 antigen. A high MIB1 index was found in 8/31 cases (26%) but was not associated either with c-myc or mdm2 nuclear positivity. Analysis of clinical outcome was performed in a subgroup of 27 patients with a minimum follow-up of 24 months. Among the clinicopathologic parameters and the biological markers, only the nuclear accumulation of c-myc was significantly associated with a higher relapse rate (p = 0.03). Accordingly, survival analysis confirmed a trend toward a poor event-free survival rate and a worse outcome in c-myc-positive cases (p = 0.12). These data demonstrate that assessment of c-myc nuclear accumulation can be useful to identify high-risk subsets of patients with synovial sarcoma of the extremities.
authors.affiliation: Laboratorio di Ricerca Oncologica, Istituti Ortopedici Rizzoli, Bologna, Italia.
authors.forename: J
authors.initials: J
authors.lastname: Shen
authors.forename: K
authors.initials: K
authors.lastname: Scotlandi
authors.forename: N
authors.initials: N
authors.lastname: Baldini
authors.forename: M C
authors.initials: MC
authors.lastname: Manara
authors.forename: S
authors.initials: S
authors.lastname: Benini
authors.forename: V
authors.initials: V
authors.lastname: Cerisano
authors.forename: P
authors.initials: P
authors.lastname: Picci
authors.forename: M
authors.initials: M
authors.lastname: Serra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007866:Leg; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009687:Nuclear Proteins / Q000032:analysis*; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000032:analysis*; D051736:Proto-Oncogene Proteins c-mdm2; D016271:Proto-Oncogene Proteins c-myc / Q000032:analysis*; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000737:chemistry* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D011518:Proto-Oncogene Proteins; D016271:Proto-Oncogene Proteins c-myc; C497206:MDM2 protein, human; D051736:Proto-Oncogene Proteins c-mdm2