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. 1999 Aug;80(11):1809–1814. doi: 10.1038/sj.bjc.6690602

Ki-67 is strongly prognostic in synovial sarcoma: analysis based on 86 patients from the Scandinavian Sarcoma Group Register

B T Skytting 1, H C Bauer 2, R Perfekt 4, G Nilsson 3, O Larsson 3
PMCID: PMC2363112  PMID: 10468301

Abstract

In a study based on formalin-fixed paraffin-embedded material from 86 patients with primary synovial sarcoma located in the extremities or on the trunk wall, the prognostic importance of MIB-1 index, p53-expession and tumour size was analysed. Multivariate analysis identified two metastatic risk factors: increasing tumour size and MIB-1 >9%. The 5-year metastasis-free survival-rate for patients with tumour size ≤5 cm + MIB-1 <10% was 0.83 (95% confidence interval (CI) 0.64–0.92) compared to 0.31 (95% CI 0.11–0.53) in cases with tumour size >5 cm + MIB-1 ≥10%. Our study shows that metastatic disease in synovial sarcoma is closely related to MIB-1 index. Using our model based on tumour size and MIB-1 index, cases with good and poor prognosis can easily be discriminated. Therefore our model can be used to identify patients who should be considered for adjuvant chemotherapy. © 1999 Cancer Research Campaign

Keywords: synovial sarcoma, Ki-67, multivariate analysis, prognosis

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Selected References

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  1. Angervall L., Kindblom L. G., Rydholm A., Stener B. The diagnosis and prognosis of soft tissue tumors. Semin Diagn Pathol. 1986 Nov;3(4):240–258. [PubMed] [Google Scholar]
  2. Brodsky J. T., Burt M. E., Hajdu S. I., Casper E. S., Brennan M. F. Tendosynovial sarcoma. Clinicopathologic features, treatment, and prognosis. Cancer. 1992 Jul 15;70(2):484–489. doi: 10.1002/1097-0142(19920715)70:2<484::aid-cncr2820700217>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  3. Brown D. C., Gatter K. C. Monoclonal antibody Ki-67: its use in histopathology. Histopathology. 1990 Dec;17(6):489–503. doi: 10.1111/j.1365-2559.1990.tb00788.x. [DOI] [PubMed] [Google Scholar]
  4. CADMAN N. L., SOULE E. H., KELLY P. J. SYNOVIAL SARCOMA; AN ANALYSIS OF 34 TUMORS. Cancer. 1965 May;18:613–627. doi: 10.1002/1097-0142(196505)18:5<613::aid-cncr2820180510>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  5. Cattoretti G., Becker M. H., Key G., Duchrow M., Schlüter C., Galle J., Gerdes J. Monoclonal antibodies against recombinant parts of the Ki-67 antigen (MIB 1 and MIB 3) detect proliferating cells in microwave-processed formalin-fixed paraffin sections. J Pathol. 1992 Dec;168(4):357–363. doi: 10.1002/path.1711680404. [DOI] [PubMed] [Google Scholar]
  6. Choong P. F., Akerman M., Willén H., Andersson C., Gustafson P., Baldetorp B., Fernö M., Alvegård T., Rydholm A. Prognostic value of Ki-67 expression in 182 soft tissue sarcomas. Proliferation--a marker of metastasis? APMIS. 1994 Dec;102(12):915–924. doi: 10.1111/j.1699-0463.1994.tb05253.x. [DOI] [PubMed] [Google Scholar]
  7. Coindre J. M., Trojani M., Contesso G., David M., Rouesse J., Bui N. B., Bodaert A., De Mascarel I., De Mascarel A., Goussot J. F. Reproducibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer. 1986 Jul 15;58(2):306–309. doi: 10.1002/1097-0142(19860715)58:2<306::aid-cncr2820580216>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  8. Cordon-Cardo C., Latres E., Drobnjak M., Oliva M. R., Pollack D., Woodruff J. M., Marechal V., Chen J., Brennan M. F., Levine A. J. Molecular abnormalities of mdm2 and p53 genes in adult soft tissue sarcomas. Cancer Res. 1994 Feb 1;54(3):794–799. [PubMed] [Google Scholar]
  9. Drobnjak M., Latres E., Pollack D., Karpeh M., Dudas M., Woodruff J. M., Brennan M. F., Cordon-Cardo C. Prognostic implications of p53 nuclear overexpression and high proliferation index of Ki-67 in adult soft-tissue sarcomas. J Natl Cancer Inst. 1994 Apr 6;86(7):549–554. doi: 10.1093/jnci/86.7.549. [DOI] [PubMed] [Google Scholar]
  10. Finlay C. A., Hinds P. W., Tan T. H., Eliyahu D., Oren M., Levine A. J. Activating mutations for transformation by p53 produce a gene product that forms an hsc70-p53 complex with an altered half-life. Mol Cell Biol. 1988 Feb;8(2):531–539. doi: 10.1128/mcb.8.2.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gerdes J., Becker M. H., Key G., Cattoretti G. Immunohistological detection of tumour growth fraction (Ki-67 antigen) in formalin-fixed and routinely processed tissues. J Pathol. 1992 Sep;168(1):85–86. doi: 10.1002/path.1711680114. [DOI] [PubMed] [Google Scholar]
  12. Gerdes J., Lemke H., Baisch H., Wacker H. H., Schwab U., Stein H. Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody Ki-67. J Immunol. 1984 Oct;133(4):1710–1715. [PubMed] [Google Scholar]
  13. Hajdu S. I., Shiu M. H., Fortner J. G. Tendosynovial sarcoma: a clinicopathological study of 136 cases. Cancer. 1977 Mar;39(3):1201–1217. doi: 10.1002/1097-0142(197703)39:3<1201::aid-cncr2820390328>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  14. Heslin M. J., Cordon-Cardo C., Lewis J. J., Woodruff J. M., Brennan M. F. Ki-67 detected by MIB-1 predicts distant metastasis and tumor mortality in primary, high grade extremity soft tissue sarcoma. Cancer. 1998 Aug 1;83(3):490–497. doi: 10.1002/(sici)1097-0142(19980801)83:3<490::aid-cncr18>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  15. Kawai A., Noguchi M., Beppu Y., Yokoyama R., Mukai K., Hirohashi S., Inoue H., Fukuma H. Nuclear immunoreaction of p53 protein in soft tissue sarcomas. A possible prognostic factor. Cancer. 1994 May 15;73(10):2499–2505. doi: 10.1002/1097-0142(19940515)73:10<2499::aid-cncr2820731008>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  16. Levine E. A., Holzmayer T., Bacus S., Mechetner E., Mera R., Bolliger C., Roninson I. B., Das Gupta T. K. Evaluation of newer prognostic markers for adult soft tissue sarcomas. J Clin Oncol. 1997 Oct;15(10):3249–3257. doi: 10.1200/JCO.1997.15.10.3249. [DOI] [PubMed] [Google Scholar]
  17. Limon J., Mrozek K., Mandahl N., Nedoszytko B., Verhest A., Rys J., Niezabitowski A., Babinska M., Nosek H., Ochalek T. Cytogenetics of synovial sarcoma: presentation of ten new cases and review of the literature. Genes Chromosomes Cancer. 1991 Sep;3(5):338–345. doi: 10.1002/gcc.2870030504. [DOI] [PubMed] [Google Scholar]
  18. Meis-Kindblom J. M., Kindblom L. G. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol. 1998 Jun;22(6):683–697. doi: 10.1097/00000478-199806000-00005. [DOI] [PubMed] [Google Scholar]
  19. Nakanishi H., Ohsawa M., Naka N., Uchida A., Ochi T., Aozasa K. Immunohistochemical detection of bcl-2 and p53 proteins and apoptosis in soft tissue sarcoma: their correlations with prognosis. Oncology. 1997 May-Jun;54(3):238–244. doi: 10.1159/000227695. [DOI] [PubMed] [Google Scholar]
  20. Nigro J. M., Baker S. J., Preisinger A. C., Jessup J. M., Hostetter R., Cleary K., Bigner S. H., Davidson N., Baylin S., Devilee P. Mutations in the p53 gene occur in diverse human tumour types. Nature. 1989 Dec 7;342(6250):705–708. doi: 10.1038/342705a0. [DOI] [PubMed] [Google Scholar]
  21. Raycroft L., Wu H. Y., Lozano G. Transcriptional activation by wild-type but not transforming mutants of the p53 anti-oncogene. Science. 1990 Aug 31;249(4972):1049–1051. doi: 10.1126/science.2144364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Shi S. R., Key M. E., Kalra K. L. Antigen retrieval in formalin-fixed, paraffin-embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections. J Histochem Cytochem. 1991 Jun;39(6):741–748. doi: 10.1177/39.6.1709656. [DOI] [PubMed] [Google Scholar]
  23. Wadayama B., Toguchida J., Yamaguchi T., Sasaki M. S., Yamamuro T. p53 expression and its relationship to DNA alterations in bone and soft tissue sarcomas. Br J Cancer. 1993 Dec;68(6):1134–1139. doi: 10.1038/bjc.1993.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Wright P. H., Sim F. H., Soule E. H., Taylor W. F. Synovial sarcoma. J Bone Joint Surg Am. 1982 Jan;64(1):112–122. [PubMed] [Google Scholar]
  25. Würl P., Taubert H., Meye A., Berger D., Lautenschläger C., Holzhausen H. J., Schmidt H., Kalthoff H., Rath F. W., Dralle H. Prognostic value of immunohistochemistry for p53 in primary soft-tissue sarcomas: a multivariate analysis of five antibodies. J Cancer Res Clin Oncol. 1997;123(9):502–508. doi: 10.1007/BF01192205. [DOI] [PubMed] [Google Scholar]
  26. Yin Y., Tainsky M. A., Bischoff F. Z., Strong L. C., Wahl G. M. Wild-type p53 restores cell cycle control and inhibits gene amplification in cells with mutant p53 alleles. Cell. 1992 Sep 18;70(6):937–948. doi: 10.1016/0092-8674(92)90244-7. [DOI] [PubMed] [Google Scholar]
  27. Zehr R. J., Bauer T. W., Marks K. E., Weltevreden A. Ki-67 and grading of malignant fibrous histiocytomas. Cancer. 1990 Nov 1;66(9):1984–1990. doi: 10.1002/1097-0142(19901101)66:9<1984::aid-cncr2820660923>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]

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