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Molecular classification of soft tissue sarcomas and its clinical applications.
[pleomorphic liposarcoma]
Sarcomas
are
a
heterogeneous
group
of
tumors
that
are
traditionally
classified
according
to
the
morphology
and
type
of
tissue
that
they
resemble
,
such
as
rhabdomyosarcoma
,
which
resembles
skeletal
muscle
.
However
,
the
cell
of
origin
is
unclear
in
numerous
sarcomas
.
Molecular
genetics
analyses
have
not
only
assisted
in
understanding
the
molecular
mechanism
in
sarcoma
pathogenesis
but
also
demonstrated
new
relationships
within
different
types
of
sarcomas
leading
to
a
more
proper
classification
of
sarcomas
.
Molecular
classification
based
on
the
genetic
alteration
divides
sarcomas
into
two
main
categories
:
(
i
)
sarcomas
with
specific
genetic
alterations
;
which
can
further
be
subclassified
based
on
a
)
reciprocal
translocations
resulting
in
oncogenic
fusion
transcripts
(
e
.
g
.
EWSR
1
-
FLI
1
in
Ewing
sarcoma
)
and
b
)
specific
oncogenic
mutations
(
e
.
g
.
KIT
and
PDGFRA
mutations
in
gastrointestinal
stromal
tumors
)
and
(
ii
)
sarcomas
displaying
multiple
,
complex
karyotypic
abnormalities
with
no
specific
pattern
,
including
leiomyo-
sarcoma
,
and
pleomorphic
liposarcoma
.
These
specific
genetic
alterations
are
an
important
adjunct
to
standard
morphological
and
immunohistochemical
diagnoses
,
and
in
some
cases
have
a
prognostic
value
,
e
.
g
.
,
Ewing
family
tumors
,
synovial
sarcoma
,
and
alveolar
rhabdomyosarcoma
.
In
addition
,
these
studies
may
also
serve
as
markers
to
detect
minimal
residual
disease
and
can
aid
in
staging
or
monitor
the
efficacy
of
therapy
.
Furthermore
,
sarcoma
-
specific
fusion
genes
and
other
emerging
molecular
events
may
also
represent
potential
targets
for
novel
therapeutic
approaches
such
as
Gleevec
for
dermatofibrosarcoma
protuberans
.
Therefore
,
increased
understanding
of
the
molecular
biology
of
sarcomas
is
leading
towards
development
of
newer
and
more
effective
treatment
regimens
.
The
review
focuses
on
recent
advances
in
molecular
genetic
alterations
having
an
impact
on
diagnostics
,
prognostication
and
clinical
management
of
selected
sarcomas
.
Diseases
Validation
Diseases presenting
"can aid in staging or monitor the efficacy of therapy"
symptom
pleomorphic liposarcoma
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