Association of SYT-SSX Fusion Types with Proliferative Activity and Prognosis in Synovial Sarcoma

Department of Pathology, Nagoya City University Medical School, Nagoya, Japan.
Modern Pathology (Impact Factor: 6.36). 06/2000; 13(5):482-8. DOI: 10.1038/modpathol.3880083
Source: PubMed

ABSTRACT The t(X;18)(p11.2;q11.2) translocation commonly found in synovial sarcoma (SS) results in the fusion of the SYT gene on chromosome 18 to either of two closely related genes, SSX1 and SSX2, on chromosome X. It has been suggested that patients who have SS bearing SYT-SSX1 fusion have worse prognosis than those bearing SYT-SSX2 fusion. However, little is known about the biologic basis or the relationship with the histopathologic risk factors in regard to the different fusion types. We analyzed 19 cases of SS with no metastasis at diagnosis. These tumors were classified by reverse transcription-polymerase chain reaction to SYT-SSX1 and SYT-SSX2 types. The expression of Ki-67, p27, p53, and bcl-2 and various clinicopathologic parameters including mitotic rate were compared between the two fusion types. The SYT-SSX1 type fusion was associated with high Ki-67 expression (P = .011) and high mitotic rate (P = .070). No significant differences were found between the two types as to the expression of p27, p53, and bcl-2 and other clinicopathologic parameters. The survival analysis showed that SYT-SSX1-type fusion, high Ki-67 expression, and high mitotic rate correlated with shorter metastasis-free survival. These data suggested that SYT-SSX fusion type is associated with tumor cell proliferative activity and prognosis of patients who have SS.

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    • "The molecular analysis of SYT gene alteration played an important role in the diagnosis of synovial sarcoma. The gene fusion type of SYT-SSX1, as identified in this case, has been reported with worse prognosis than that with SYT-SSX2 [12]. "
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    ABSTRACT: Poorly differentiated synovial sarcomas are diagnostically challenging soft tissue tumors. They can be indistinguishable from other "small blue cell tumors" based on morphology and even immunohistochemical studies. Here we report a rare case of poorly differentiated metastatic synovial sarcoma to lung without known primary, diagnosed with molecular genetic analysis. The tumor was negative for EMA and cytokeratin, previously reported as the most sensitive immunostaining markers for synovial sarcomas. SYT-SSX gene fusion, characteristic for synovial sarcoma, was identified in this case by FISH and RT-PCR assays.
    International journal of clinical and experimental pathology 11/2009; 3(2):217-21. · 1.78 Impact Factor
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    • "The ratio of SYT-SSX1 to SYT-SSX2 cases is close to 2:1 in the majority of studies [4] [6] [9]. However, other investigators have reported different frequencies of SYT-SSX1 and SYT-SSX2 fusions with ratio of SYT-SSX1:SYT-SSX2 from approximately 1:1 [10] [27] to even 6:1 [18]. These findings raise the question whether there are geographical differences in the frequency of SYT-SSX1 and SYT-SSX2 fusions among different populations. "
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    ABSTRACT: Synovial sarcoma (SS) is characterized by the t(X;18)(p11.2;q11.2) chromosomal translocation, which results in generating either SYT-SSX1, SYT-SSX2 or, infrequently, SYT-SSX4 fusion gene. The ratio of SYT-SSX1:SYT-SSX2 fusions is close to 2:1 in the majority of studies, and SYT-SSX2 fusion has been only rarely observed in biphasic SS. In the present study, we compared two series of patients with SS, Slovenian (37 cases) and Dutch (14 cases), with respect to clinical, pathological and molecular findings. The two groups did not differ with regard to clinicopathological features. Whereas the frequency of different SYT-SSX fusions in the Dutch group was similar to that reported in the literature, we found an unexpectedly high number of tumors with SYT-SSX2 fusion in the Slovenian group. The ratio of SYT-SSX1:SYT-SSX2 fusion was 7:18 for monophasic and 2:7 for biphasic tumors in the Slovenian group. This distribution differs significantly from that observed in the Dutch group in the present study (P = 0.041) as well as from data reported in the recent large multi-institutional study on 243 patients (P = 0.0001). Our findings indicate possible geographical differences in the frequency of two SYT-SSX fusion transcripts in patients with synovial sarcoma. -------------------------------------------------------------------- LINK:
    Cancer Detection and Prevention 02/2004; 28(4):294-301. DOI:10.1016/j.cdp.2004.06.002 · 2.52 Impact Factor
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    • "Both systems have been shown to split SSs into favourable and unfavourable cases (Bergh et al, 1999). Additional biological markers of possible prognostic significance have been recently investigated, including Ki-67 (Inagaki et al, 2000), c-myc (Shen et al, 2000), and the co-expression of HGF and c-MET (Oda et al, 2000). Two recent studies have focused on the relevance of the different fusion gene types in affecting the outcome of disease (Kawai et al, 1998; Nilsson et al, 1999). "
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    ABSTRACT: A case series of 64 synovial sarcomas was characterized for the SYT-SSX fusion transcripts and statistically analysed in order to correlate molecular data with prognosis and morphology. SYT-SSX1 fusion transcript appeared to be an independent, though not reaching statistical significance (P = 0.183), prognostic factor clearly associated with a reduced metastasis-free survival. Regarding the association between transcript type and histologic subtype we found, a borderline P value (P = 0.067) between the SYT-SSX1 transcript and the biphasic subtype which, subsequently expanding the analysis to 70 cases, turned out to be significant. However, we could not confirm the prediction value of the biphasic subtype for the presence of the SYT-SSX1 transcript since in our hands 6 out 33 (18%) biphasic tumours carried the SYT-SSX2 transcript.
    British Journal of Cancer 12/2001; 85(10):1535-9. DOI:10.1054/bjoc.2001.2088 · 4.82 Impact Factor

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