title: Extent, relationship and prognostic significance of apoptosis and cell proliferation in synovial sarcoma.
abstract: OBJECTIVE
  To analyse the extent, relationship and clinical significance of apoptosis and cell proliferation in synovial sarcoma.
  
  
  METHODS
  Apoptosis was detected by TUNEL, and expression of Ki-67, Bcl-2, Bax and p53 was examined immunohistochemically in 72 synovial sarcomas. Their relation and correlation with clinicopathological parameters and survival rate were analysed.
  
  
  RESULTS
  The average values of apoptosis index (AI) and Ki-67 labelling index (LI) were 0.76% and 28.30%, respectively. Both AI and Ki-67 LI in large-volume, high-grade and advanced-stage synovial sarcomas were significantly higher than those in small-volume, low-grade and early-stage ones (P<0.05 for all). And there was a linear relationship between AI and Ki-67 LI (r=0.751, P<0.001). All examined synovial sarcomas were positive for Bcl-2 and Bax, and only 20.8% cases showed expression of p53 protein. The expressions of Bcl-2, Bax and p53 were also significantly correlated with AI (P=0.005, P=0.002, P=0.037, respectively). In addition, patients with high AI (>0.76%) had poor prognosis (log-rank test; P=0.007).
  
  
  CONCLUSIONS
  Alterations in apoptosis and cell proliferation activity might be responsible for the pathogenesis and behaviour of synovial sarcoma. Increased rate of apoptosis in synovial sarcoma was considered to be an indicator of poor prognosis. In addition, apoptosis in synovial sarcoma may be controlled by multiple apoptosis-regulating mechanisms, including the Bcl-2 family and p53 protein.
authors: Department of Pathology, Cancer Institute and Hospital and Department of Pathology, Tianjin Medical University, Tianjin, China. sddpsy@163.com
authors: Baocun
authors: B
authors: Sun
authors: Yan
authors: Y
authors: Sun
authors: Jian
authors: J
authors: Wang
authors: Xiulan
authors: X
authors: Zhao
authors: Xin
authors: X
authors: Wang
authors: Xishan
authors: X
authors: Hao