Expression And Clinical Significance Of Sperm Associated Antegen9in The Tissue Of Leiomyosarcoma

Background:The leiomyosarcoma is one kind of uterine sarcoma, accounting for about45%of uterine sarcoma. Leiomyosarcoma is malignant tumor which comes from uterine smooth muscle or intramural vascular smooth muscle tissue, also can be malignant transformation of leiomyoma. Uterine leiomyosarcoma is rare, malignant degree is high, sometimes the diagnosis of uterine leiomyoma is difficult to have a divided for benign and malignant, even for high qualification pathologists are difficult to make identification. At present the treatment for patients with leiomyosarcoma is almost surgery, and the choice of the surgery ways is related to the reproductive function of the patients and the life quality of the postoperative, etc. In order to reduce the complications of surgery, to determine the operation scope is especially important, therefore, to confirm uterine leiomyoma benign and malignant diagnosis need more accurate method, and as such, it becomes hot spot at the present to study leiomyosarcoma. Looking for a differential diagnosis can be used for leiomyosarcoma as a molecular biological marker has important clinical significance and pathological significance..Objective:To investigate and compare the expression of sperm-associated antigen9(SPAG9) in leiomyosarcoma,cellular leiomyoma and leiomyoma through immunohistochemical techniques. Evaluating its value as a molecular biological marker. Discussion the possible relationship and its significance between SPAG9and leiomyosarcoma.Methods:1. Subjects:Collect tissue specimens, including19cases of leiomyosarcoma organization and22cases of cellular leiomyoma,30cases of leiomyoma. According to the pathologic classification, there are7cases whose nuclear fission number≥10/10the HPF,the other12casesnuclear fission number <10/10the HPF; the minimal cell atypia is11cases, the moderate to severe cell atypia is8cases.2. Test:Detect the expression of SPAG9protein in leiomyosarcoma, cellular leiomyoma and leiomyoma through immunohistochemical techniques. To clarify its localization in tissues. Stats the positive expression rate of SPAG9in different tissues.3. Results assessScore standard reference the Formwitz grading methods:(1) according to the percentage of positive cells, count the average positive cells,<5%for0points,5%to25%for1points,26%~50%for2points,51%to75%for the three points,>75%for4points;(2) classification according to the show color, no color, light yellow, tan, brown,score for0,1,2,3points respectively.(3) according to the product of both above, we divided the dyeing conditions into4grades:0points for negative,1～4points for weak positive (+),5～8points for positive (++),9～12points for strong positive (+++).Results:1. The positive expression rate of SPAG9in uterine leiomyoma was0, in cellular leiomyoma and leiomyosarcoma the expression rate was100%.2. In19cases of leiomyosarcoma, the Formwitz score was9.11±1.78for expression of SPAG9.To the22cases of cellular leiomyoma, the Formwitz score was4.91±2.07.The expression of SPAG9in leiomyosarcoma was higher than the cellular leiomyoma group, the difference was statistically significant (t=4.941, P<0.05). 3. In19cases of leiomyosarcoma, there were7cases whose nuclear fission number≥10/10the HPF,their Formwitz score was9.43±1.81for expression of SPAG9; the other12cases’ nuclear fission number <10/10the HPF,their Formwitz score was8.92±1.68, the difference of two group was not statistically significant (t=0.418, P>0.05)4.11cases of leiomyosarcoma that histopathologic diagnosis minimal atypia, their Formwitz score was8.27±0.90, the other8cases that histopathologic diagnosis moderate to severe atypia, their Formwitz score was10.25±1.91, the SPAG9protein expression of moderate to severe atypia group was higher than the minimal atypia group, the difference was statistically significant (t=2.813, P<0.05)Conclusion:1. SPAG9protein in leiomyosarcoma organization were high expressed, the average expression was significantly higher than cellular leiomyoma organization, in leiomyoma organization was not expressed;2. The SPAG9protein expression in leiomyosarcoma was relevant to cellular atypia, SPAG9protein expression of moderate to severe atypia group was higher than minimal atypia group;3. The expression of SPAG9in leiomyosarcoma was not relevant to nuclear fission number, the different expression of different nuclear fission number cases has not statistical significance.4. SPAG9may serve as a biological marker for leiomyosarcoma, may be used for differential diagnosis with cellular leiomyoma and may be used for indirect prognosis evaluation of leiomyosarcoma.