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Diagnostic and prognostic gene expression signatures in 177 soft tissue sarcomas: hypoxia-induced transcription profile signifies metastatic potential.
[pleomorphic liposarcoma]
Soft
tissue
sarcoma
(
STS
)
diagnosis
is
challenging
because
of
a
multitude
of
histopathological
subtypes
,
different
genetic
characteristics
,
and
frequent
intratumoral
pleomorphism
.
One
-
third
of
STS
metastasize
and
current
risk-stratification
is
suboptimal
,
therefore
,
novel
diagnostic
and
prognostic
markers
would
be
clinically
valuable
.
We
assessed
the
diagnostic
and
prognostic
value
of
array-based
gene
expression
profiles
using
27
k
cDNA
microarrays
in
177
,
mainly
high
-grade
,
STS
of
13
histopathological
subtypes
.
U
nsupervised
analysis
resulted
in
two
major
clusters--
one
mainly
containing
STS
characterized
by
type
-
specific
genetic
alterations
and
the
other
with
a
predominance
of
genetically
complex
and
pleomorphic
STS
.
Synovial
sarcomas
,
myxoid
/
round
-cell
liposarcomas
,
and
gastrointestinal
stromal
tumors
clustered
tightly
within
the
former
cluster
and
discriminatory
signatures
for
these
were
characterized
by
developmental
genes
from
the
EGFR
,
FGFR
,
Wnt
,
Notch
,
Hedgehog
,
RAR
and
KIT
signaling
pathways
.
The
more
pleomorphic
STS
subtypes
,
e
.
g
.
leiomyosarcoma
,
malignant
fibrous
histiocytoma
/
undifferentiated
pleomorphic
sarcoma
and
dedifferentiated
/
pleomorphic
liposarcoma
,
were
part
of
the
latter
cluster
and
were
characterized
by
relatively
heterogeneous
profiles
,
although
subclusters
herein
were
identified
.
A
prognostic
signature
partly
characterized
by
hypoxia-related
genes
was
identified
among
89
genetically
complex
pleomorphic
primary
STS
and
could
,
in
a
multivariate
analysis
including
established
prognostic
markers
,
independently
predict
the
risk
of
metastasis
with
a
hazard
ratio
of
2
.
2
(
P
=
0
.
04
)
.
Diagnostic
gene
expression
profiles
linking
signaling
pathways
to
the
different
STS
subtypes
were
demonstrated
and
a
hypoxia-induced
metastatic
profile
was
identified
in
the
pleomorphic
,
high
-grade
STS
.
These
findings
verify
diagnostic
utility
and
application
of
expression
data
for
improved
selection
of
high
-risk
STS
patients
.
Diseases
Validation
Diseases presenting
"sarcoma"
symptom
alpha-thalassemia
carcinoma of the gallbladder
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
erdheim-chester disease
esophageal adenocarcinoma
focal myositis
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
malignant atrophic papulosis
pleomorphic liposarcoma
primary effusion lymphoma
severe combined immunodeficiency
waldenström macroglobulinemia
well-differentiated liposarcoma
This symptom has already been validated