中文摘要：

目的：检测皮-间充质转换的转录因子Twist和Snail在滑膜肉瘤组织中的表达,分析二者之间关系及其对滑膜肉瘤远处转移的影响,并探讨其预后意义.方法：通过组织病理学观察和免疫组织化学染色,检测133例滑膜肉瘤组织标本中Twist和Snail的表达情况,应用统计学软件SPSS13.0分析二者的不同表达与各临床病理参数特点的关系,并作Kaplan Meier生存分析.结果：Twist和Snail在滑膜内瘤组织中表达部位为细胞质和,或细胞核,133例组织标本中Twist高表达者55例（55/133）且与组织学分型、临床分期以及融合基因类型有关（P〈0.05）;Snail高表达者82例（82/133）,与组织学分型有关（P〈0.05）.二者的表达与不同性别、年龄、肿瘤大小、部位、组织学分级等无关（P〉05）.Twist和Snail在滑膜肉瘤组织中的表达存在正相关（rs=0.191,P=0.027）,Log-Rank test显示Twist高表达组,患者总生存期和无转移生存期明显低于低表达组,差异有统计学意义（X2=8.620,P=0.03和X2=11.462,P=0.001）;Snail高表达组,患者无转移生存期明显低于其弱表达者,差异有统计学意义（X2=4.575,P=0.032）,但两组的总生存期差异无统计学意义（X2=0.602,P=0.438）;且二者联合表达组患者总生存期和无转移生存期明显低于其弱表达组,差异有统计学意义（X2=13.619,P=0.003和X=15.548,P=0.001）.结论：滑膜肉瘤组织中存在EMT的主要录因子Twist和Snail的高表达,二者可独立诱导EMT,且二者的联合表达更加促进肿瘤转移的发生,提示患者预后不良.

英文摘要：

Objective： To examine the expression of Twist and Snail, two key transcriptional regulators of epithelial-mesenchymal transition （EMT） and tumor metastasis, in synovial sarcoma（SS） tissue and to investigate their impact on distant metastasis and prognostic value in patients with SS. Methods： Histopathological and immunohistochemical staining were performed to evaluate the expression of Twist and Snail in tissue specimens from 133 patients with SS in Tianjin Cancer Hospital between January 1973 and January 2005. In addition, clinicopathologic characteristics and survival were compared with the expression of Twist and Snail using statistical software SPSS13.0. Results： Twist and Snail were located in the cytoplasm and/or nucleus in SS tissue. The expression of Twist was related with histological subtype （P = 0.002）, AJCC stage （P = 0.045） and syt-ssx （P = 0.000）. The expression of Snail was related with histological subtype only （P = 0.006）. Twist expression was corvelated with that of Snail （rs = 0.191, P = 0.027）. Log Rank test showed that patients with high expression of Twist and Snail had shorter survival than those with low expression （P = 0.03） and the expression of Twist and Snail was related with shorter metastasis-free survival （P = 0.001 and P = 0.032）. Conclusion： These results demonstrate that the high expression of Twist and Snail exist in patients with SS and may play an important role in the EMT and metastasis of SS. Twist and Snail may play a role in regulating the EMT of SS and their co-expression suggests poor prognosis. Evaluation of Twist and Snail expression is helpful for evaluating metastasis and prognosis of patients with SS.