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[Cancer Research 59, 3180-3184, July 1, 1999]
© 1999 American Association for Cancer Research

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[Cancer Research 59, 3180-3184, July 1, 1999]
© 1999 American Association for Cancer Research


Molecular Biology and Genetics

The SYT-SSX1 Variant of Synovial Sarcoma Is Associated with a High Rate of Tumor Cell Proliferation and Poor Clinical Outcome1

Gunnar Nilsson2, Björn Skytting2, Yuntao Xie2, Bertha Brodin2, Roland Perfekt, Nils Mandahl, Joakim Lundeberg, Mathias Uhlén and Olle Larsson3

Cellular and Molecular Tumor Pathology, CCK, R8: 04 [G. N., Y. X., B. B., O. L.] and Department of Orthopedics [G. N.], Karolinska Hospital, SE-171 76 Stockholm, Sweden; Department of Orthopedics, Stockholm Söder Hospital, SE-100 64 Stockholm, Sweden [B. S.]; Department of Biotechnology, Royal Institute of Technology (KTH), SE-100 44 Stockholm, Sweden [B. B., J. L., M. U.]; and Southern Swedish Regional Tumor Registry [R. P.] and Department of Clinical Genetics [N. M.], University Hospital, SE-221 85 Lund, Sweden

Cytogenetically, synovial sarcoma (SS) is characterized by the translocation t(X;18)(p11.2;q11.2), resulting in a fusion between the SYT gene on chromosome 18 and SSX1 or SSX2 on the X chromosome and the formation of new chimeric genes, SYT-SSX1 or SYT-SSX2. We examined the potential clinical relevance of SYT-SSX1 and SYT-SSX2 fusion transcripts together with tumor proliferation. In a series of 33 patients with primary SS, the type of fusion transcript was assessed by reverse transcription-PCR and sequence analysis. The proliferation rate was analyzed using anti-Ki-67 antibodies. One case carrying an atypical transcript with a 57-bp insert was excluded, leaving 13 SYT-SSX1 and 19 SYT-SSX2 cases for analysis. The hazard ratio (with respect to metastasis-free survival for patients with SYT-SSX1 versus patients with SYT-SSX2 fusion transcripts was 7.4 (95% confidence interval, 1.5–36; log-rank P = 0.004). There was also an association with reduced overall survival for patients with SYT-SSX1 compared to patients with SYT-SSX2 (hazard ratio, 8.5; 95% confidence interval, 1.0–73; log-rank P = 0.02). The 5-year metastasis-free survival for patients with SYT-SSX1 was 42% versus 89% for patients with SYT-SSX2. There was a significant association between SYT-SSX1 and a high tumor proliferation rate (P = 0.02). We conclude that the findings suggest that the type of SYT-SSX fusion transcript determines the proliferation rate and is an important predictor of clinical outcome in patients with SS.




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