| Objective: To research the expression of Foxp3 and Ki-67 in synovial sarcoma tissue by immunohistochemistry, and analysis the correlation between them. Then to explore the relationship of Foxp3 and Ki-67 with the recurrence, metastasis, tumor size and clinical stage of synovial sarcoma. In order to clear the correlation of Foxp3 and Ki-67 expression with the clinical prognosis.Methods: Choose 98 of synovial sarcoma paraffin tissue samples and 15 cases of lipoma paraffin tissue samples, which were taken by orthopedic surgery at Fourth Hospital of Hebei Medical University from January 2007 to March 2013. And set lipoma as a control group. Immunohistochemical staining SP method was adopted to detect the expression of Foxp3 and Ki-67 in tissue samples of synovial sarcoma and lipoma, in which Foxp3 polyclonal antibody of rabbit against human and Ki-67 polyclonal antibody of rabbit against human were applied. Statistical analysis of the relationship of Foxp3 and Ki-67 with the tumor size, clinical stage and recurrence or metastasis of synovial sarcoma. 98 cases of synovial sarcoma cases was organized, to establish the prognostic factors in synovial sarcoma.Results:1 Test object 113 cases, Include 15 cases of lipoma, 29 cases of primary synovial sarcoma, 55 cases of recurrent synovial sarcoma, 14 cases of metastatic synovial sarcoma. Four groups of patients mean age were between 44-46 years old. By Kruskal-Wallis rank sum test, X2=5.147, P=0.161(α=0.05, Table 1). The overall patient of four groups samples represented showed no significant difference in age.2 Foxp3 was expressed in synovial sarcoma tissue, the positive rate was 76.5%. Foxp3 expression intensity in the four groups which is primary, recurrent and metastatic synovial sarcoma sets, was not all the same(X2=26.238, P<0.001). And was gradually increased, the positive rates were 62.1%, 81.8% and 85.7% respectively. The expression intensity of Foxp3 showed a relationship with the level of malignancy of synovial sarcoma. Multiple comparisons between groups showed that the intensity of Foxp3 expression in all types of synovial sarcoma were significantly higher than that in control group(P<0.01). The intensity of Foxp3 expression in recurrent and metastatic synovial sarcoma were higher than that in primary group(u=-2.106, P=0.035; u=-2.405, P=0.016). There was no significant difference statistically between recurrent and metastatic synovial sarcoma(u=-1.223, P=0.221). In addition, there was no significant difference statistically of Foxp3 positive rate between different tumor size groups(75.6%, 77.2%; u=-0.530, P=0.596).3 The positive rates of Foxp3 expression in synovial sarcoma clinicalⅠ,Ⅱ,Ⅲ and Ⅳ stages were 66.7%, 71.0%, 82.9% and 85.7% respectively. Multiple comparisons between groups showed that the intensity of Foxp3 expression in stage Ⅲ of synovial sarcoma was higher than that in stageⅠ andⅡ(u=-2.719,P=0.007;u=-2.054,P=0.040). And also the expression in stageⅣof synovial sarcoma was higher than that in stageⅠandⅡ(u=-2.636,P=0.010;u=-2.018,P=0.044).4 Ki-67 was expressed in synovial sarcoma tissue, the positive rate was 67.3%. Ki-67 expression rates in the four groups which is primary, recurrent and metastatic synovial sarcoma sets, were 48.3%, 72.7% and 85.7% respectively. Statistical analysis showed that the positive intensity among groups was not all the same(X2=25.736,P<0.001). Multiple comparisons between groups showed that the intensity of Ki-67 expression in all types of synovial sarcoma were significantly higher than that in control group(P<0.05). The intensity of Ki-67 expression in metastatic synovial sarcoma was significantly higher than that in primary group(u=-3.010, P=0.003). And the recurrence group was higher than that in primary ones too(u=-2.343, P=0.019). But there was no significant difference statistically between recurrent and metastatic synovial sarcoma(u=-1.737, P=0.082). In addition, there was no significant difference statistically of Ki-67 positive rate between different tumor size groups(66.7%, 73.3%; u=-1.429, P=0.153).5 The positive rates of Ki-67 expression in synovial sarcoma clinicalⅠ, Ⅲ and Ⅳ stages were 33.3%, 64.5%, 80.0% and 85.7% respectively. Multiple comparisons between groups showed that the intensity of Ki-67 expression in synovial sarcoma Ⅱ, Ⅲ and Ⅳ stages was higher than that in stageⅠ(u=-2.268,P=0.023;u=-3.910,P<0.001;u=-3.651,P<0.001). Where the Ki-67 expression of Ⅲ, Ⅳstages was higher than the stage Ⅱ(u=-2.343,P=0.019;u=-2.437,P=0.015).6 Spearman correlation analysis showed: the expression of Foxp3 and Ki-67 protein were correlated positively in synovial sarcoma tissues(r=0.823,P<0.001).Conclusion:1 Foxp3 and Ki-67 showed high expression in synovial sarcoma tissue, and its expression intensity was significantly higher than benign.2 The expression intensity of Foxp3 and Ki-67 in recurrent and metastatic synovial sarcoma was higher than that in primary group.3 Foxp3 and Ki-67 expression rates in synovial sarcoma were correlated with the clinical stage positively.4 The intensity of Foxp3 and Ki-67 expression in synovial sarcoma Ⅲ and Ⅳstages was higher than that in stagesⅠandⅡ.5 The expression of Foxp3 in synovial sarcoma tissue was correlated positively with Ki-67. Prompt Foxp3 may be able to promote the development of synovial sarcoma, and is closely related to the degree of malignancy and prognosis of synovial sarcoma. So Foxp3 is a potential therapeutic target for synovial sarcoma. |
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