| Background: Desmoid-type fibromatosis(DTF)is a borderline soft tissue tumor of mesenchymal origin.There is no obvious difference in pathological histology between DTF and fibroma,but its biological behavior is similar to malignant tumors.DTF has strong invasive ability and high postoperative recurrence rate.If DTF recurs repeatedly,it will turn into a sarcoma.The nuclear Ki67 antigen is considered as an objective marker of proliferative activity in tumors.Except for the G0 phase,the antigen is expressed in other cycles of cell division.Ki67 is less expressed in the early stage of cell division and higher in the later stage.In clinical practice,Ki67 value is often used to evaluate the aggressiveness and prognosis of malignant tumors.In some patients with malignant tumors such as breast cancer and highly differentiated serous ovarian cancer,the higher Ki67 value in tumor tissue means that tumor cells grow faster and have a worse prognosis.Wnt pathway is involved in regulating the complex cellular behaviors required in various processes in the human body.Many studies have found that Wnt pathway is over-activated in human cancers,we can know that the Wnt pathway has a certain effect on the occurrence and development of tumors.?-catenin is a core protein in Wnt pathway.This protein is released from the complex when the Wnt pathway is open,and participates in the expression and transcription of target genes in the nucleus.In the end,It can mutate the target genes.Objective:Through the study of the expression of Ki67 and ?-catenin in the DTF of the extremities,and the statistical analysis of the clinical related factors of the patients,the relationship between the two markers and their clinical factors was found.to provide new way for the postoperative evaluation of DTF in extremities.Explore a new idea for postoperative evaluation of DTF.Materials and Methods: Twenty-eight patients were selected from April 2014 to May 2019 in the Department of Bone,Joint and Bone Oncology of the Second People's Hospital of Shenzhen City and were diagnosed as DTF by two pathologists.Ten patients with extremity fibroma were selected as the control group.Immunohistochemistry SP method was used to determine the expression of Ki67 and ?-catenin in Pathology Department.Statistical software SPSS19.0 was used for processing,and Fisher's exact probability method was used to statistically examine the expression differences of Ki67 and ?-catenin in the subgroups such as gender,age,maximum diameter of tumors and recurrence.Spearman rank correlation test was used to analyze the correlation between Ki67 and ?-catenin expression in DTF of the extremities.If P < 0.05,the difference is statistically significant,otherwise the difference is not statistically significant.Result: 1.In this experiment,sixteen patients in the experimental group had Ki67 <5%,accounting for 57.14% of the total in the experimental group.Twelve patients in the experimental group had Ki67?5%,accounting for 42.86% of the total in the experimental group.In the experimental group,there were 24 cases of positive expression of ?-catenin,accounting for 85.71% of the total in the experimental group.And there were 4 cases of negative expression of ?-catenin.In the control group,the expression of Ki67 and ?-catenin were negative in 10 cases of extremity fibroma.The difference in expression of Ki67 and ?-catenin in extremity DFT and extremity fibroma was statistically significant(P<0.05)2.When the Ki67 value?5%,six patients with extremity DTF relapsed,and six patients did not relapse.When the Ki67 value<5%,two patients with extremity DTF relapsed,and fourteen patients did not relapse.The data is tested by Fisher's exact probability method and the P value is 0.04(P<0.05).It showed that the expression difference of Ki67 in the subgroup of relapse was statistically significant.The statistical difference of Ki67 expression in subgroups such as gender,age,and tumor largest diameter was not statistically significant after statistical testing(P>0.05).3.In the experimental group,the expression differences of ?-catenin in the subgroups of gender,age,tumor diameter,recurrence and other subgroups were not statistically significant after statistical testing(P > 0.05).4.The correlation between the expression of Ki67 and ?-catenin in the experimental group was determined by Spearman rank correlation test and the P value was 0.76.There is no obvious correlation between the two expressionsConclusion: 1.The expression results of Ki67 and ?-catenin in the excised specimen may be helpful for the differential diagnosis of extremity DTF and extremity fibroma;2.When Ki67 value is greater or equal to five percent,the risk of recurrence after extremity DTF resection may be increased;3.There is no significant correlation between Ki67 and ?-catenin expression in DTF of the extremities. |
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