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Pleomorphic liposarcoma: clinical observations and molecular variables.
[pleomorphic liposarcoma]
Pleomorphic
liposarcoma
(
PLS
)
is
a
rare
high
-grade
sarcoma
that
has
lipoblastic
differentiation
.
In
this
study
,
the
authors
evaluated
PLS
natural
history
,
patient
outcomes
,
and
commonly
deregulated
protein
biomarkers
.
Medical
records
from
patients
(
n
=
155
)
who
had
PLS
from
1993
to
2010
were
reviewed
.
Univariate
and
multivariate
analyses
were
conducted
to
identify
independent
prognosticators
.
A
PLS
tissue
microarray
(
TMA
)
(
n
=
56
patient
specimens
)
was
constructed
for
immunohistochemical
analysis
of
molecular
markers
,
and
p
53
gene
sequencing
(
exons
5
-
9
)
was
conducted
.
The
average
patient
age
was
57
years
,
and
the
patients
presented
with
primary
disease
(
n
=
102
)
,
recurrent
disease
(
n
=
16
)
,
and
metastatic
disease
(
n
=
37
)
.
Lower
extremity
was
the
most
common
disease
site
(
40
%
)
,
and
the
average
tumor
size
was
11
cm
.
Complete
follow-up
data
were
available
for
83
patients
,
and
their
median
follow-up
was
22
.
6
months
.
The
5
-
year
disease-
specific
survival
rate
was
53
%
;
and
recurrent
disease
,
unresectability
,
and
microscopic
positive
margins
were
identified
as
predictors
of
a
poor
prognosis
.
Systemic
relapse
(
the
strongest
poor
prognostic
determinant
)
developed
in
35
%
of
patients
with
localized
PLS
.
Immunohistochemical
analysis
revealed
increased
expression
of
peroxisome
proliferator-activated
receptor
gamma
(
an
adipogenic
marker
)
,
B-
cell
leukemia
2
and
survivin
(
survival
factors
)
,
vascular
endothelial
growth
factor
(
an
angiogenic
factor
)
,
matrix
metalloproteinase
2
,
and
other
biomarkers
.
Frequent
loss
of
retinoblastoma
protein
expression
and
high
p
53
mutation
rates
(
approximately
60
%
)
were
observed
.
PLS
is
an
aggressive
,
metastasizing
sarcoma
.
Identifying
ubiquitous
molecular
events
underlying
PLS
progression
is
crucial
for
progress
in
patient
management
and
outcomes
.
Diseases
Validation
Diseases presenting
"rare high-grade sarcoma"
symptom
pleomorphic liposarcoma
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