Despite improvements in the clinical management of soft tissue sarcomas (STS), 50% of patients will die of metastatic disease that is largely unresponsive to conventional chemotherapeutic agents. The aims of this study were to identify genes and pathways that are dysregulated in progressive and metastatic STS. In addition to this, cell lines from fresh tumours were initiated and established, thus increasing the repository of cell lines available for functional studies. Recent advances in the understanding of the molecular biology of STS have thus far not resulted in the use of molecular markers for clinical prognostication. Identifying novel genes and pathways will lead to molecular diagnostic methods to better stratify prognostic groups and could identify cellular targets for more efficacious treatments. Gene expression profiling of sarcoma cell lines of increasing metastatic potential revealed over-expression of genes involved in the epidermal growth factor (EGF) and transforming growth factor beta (TGFb) pathways. Factors involved in invasion and metastasis such as integrins and MMPs were over-expressed in the cell lines with higher metastatic potential. The developmental Notch pathway and cell cycle regulators were also dysregulated. NDRG1 was significantly over-expressed in the high grade sarcoma cell line, a novel finding in sarcomas. The expression of EGFR, NDRG1 and other genes from the above pathways was validated using quantitative RT-PCR in real time (qRT-PCR). A tissue microarray (TMA) comprising STS of varying tumour grades was constructed for high throughput assessment of target proteins. EGFR, its activated form and its signal transducers were investigated using immunohistochemistry (IHC). Activated EGFR (HR 2.228, p < 0.001) and phosphorylated Akt (HR 2.032, p = 0.003) were found to be independent predictors of overall survival and both correlated with tumour grade. Of the several STS cultures initiated and maintained, two of these cell lines were fully characterised in terms of cytogenetics, telomerase and alternate lengthening of 5 telomeres (ALT) status, KIT and TP53 mutation and the expression of certain biomarkers using both qRT-PCR and IHC. In summary, transcript profiling identified several potential biomarkers of tumour progression and metastasis in STS. Crucially, activated EGFR and pAkt were found in a cohort of STS samples to correlate with clinical outcome, identifying them as potential diagnostic and therapeutic targets in the treatment of STS. Activated EGFR can be used as a diagnostic marker for patient selection, as well as for target effect monitoring. Furthermore, the cell lines established in this project will serve as valuable tools in future preclinical studies.

Despite improvements in the clinical management of soft tissue sarcomas (STS), 50% of patients will die of metastatic disease that is largely unresponsive to conventional chemotherapeutic agents. The aims of this study were to identify genes and pathways that are dysregulated in progressive and metastatic STS. In addition to this, cell lines from fresh tumours were initiated and established, thus increasing the repository of cell lines available for functional studies. Recent advances in the understanding of the molecular biology of STS have thus far not resulted in the use of molecular markers for clinical prognostication. Identifying novel genes and pathways will lead to molecular diagnostic methods to better stratify prognostic groups and could identify cellular targets for more efficacious treatments. Gene expression profiling of sarcoma cell lines of increasing metastatic potential revealed over-expression of genes involved in the epidermal growth factor (EGF) and transforming growth factor beta (TGFb) pathways. Factors involved in invasion and metastasis such as integrins and MMPs were over-expressed in the cell lines with higher metastatic potential. The developmental Notch pathway and cell cycle regulators were also dysregulated. NDRG1 was significantly over-expressed in the high grade sarcoma cell line, a novel finding in sarcomas. The expression of EGFR, NDRG1 and other genes from the above pathways was validated using quantitative RT-PCR in real time (qRT-PCR). A tissue microarray (TMA) comprising STS of varying tumour grades was constructed for high throughput assessment of target proteins. EGFR, its activated form and its signal transducers were investigated using immunohistochemistry (IHC). Activated EGFR (HR 2.228, p < 0.001) and phosphorylated Akt (HR 2.032, p = 0.003) were found to be independent predictors of overall survival and both correlated with tumour grade. Of the several STS cultures initiated and maintained, two of these cell lines were fully characterised in terms of cytogenetics, telomerase and alternate lengthening of 5 telomeres (ALT) status, KIT and TP53 mutation and the expression of certain biomarkers using both qRT-PCR and IHC. In summary, transcript profiling identified several potential biomarkers of tumour progression and metastasis in STS. Crucially, activated EGFR and pAkt were found in a cohort of STS samples to correlate with clinical outcome, identifying them as potential diagnostic and therapeutic targets in the treatment of STS. Activated EGFR can be used as a diagnostic marker for patient selection, as well as for target effect monitoring. Furthermore, the cell lines established in this project will serve as valuable tools in future preclinical studies.

Despite improvements in the clinical management of soft tissue sarcomas (STS), 50% of patients will die of metastatic disease that is largely unresponsive to conventional chemotherapeutic agents. The aims of this study were to identify genes and pathways that are dysregulated in progressive and metastatic STS. In addition to this, cell lines from fresh tumours were initiated and established, thus increasing the repository of cell lines available for functional studies. Recent advances in the understanding of the molecular biology of STS have thus far not resulted in the use of molecular markers for clinical prognostication. Identifying novel genes and pathways will lead to molecular diagnostic methods to better stratify prognostic groups and could identify cellular targets for more efficacious treatments. Gene expression profiling of sarcoma cell lines of increasing metastatic potential revealed over-expression of genes involved in the epidermal growth factor (EGF) and transforming growth factor beta (TGFb) pathways. Factors involved in invasion and metastasis such as integrins and MMPs were over-expressed in the cell lines with higher metastatic potential. The developmental Notch pathway and cell cycle regulators were also dysregulated. NDRG1 was significantly over-expressed in the high grade sarcoma cell line, a novel finding in sarcomas. The expression of EGFR, NDRG1 and other genes from the above pathways was validated using quantitative RT-PCR in real time (qRT-PCR). A tissue microarray (TMA) comprising STS of varying tumour grades was constructed for high throughput assessment of target proteins. EGFR, its activated form and its signal transducers were investigated using immunohistochemistry (IHC). Activated EGFR (HR 2.228, p < 0.001) and phosphorylated Akt (HR 2.032, p = 0.003) were found to be independent predictors of overall survival and both correlated with tumour grade. Of the several STS cultures initiated and maintained, two of these cell lines were fully characterised in terms of cytogenetics, telomerase and alternate lengthening of 5 telomeres (ALT) status, KIT and TP53 mutation and the expression of certain biomarkers using both qRT-PCR and IHC. In summary, transcript profiling identified several potential biomarkers of tumour progression and metastasis in STS. Crucially, activated EGFR and pAkt were found in a cohort of STS samples to correlate with clinical outcome, identifying them as potential diagnostic and therapeutic targets in the treatment of STS. Activated EGFR can be used as a diagnostic marker for patient selection, as well as for target effect monitoring. Furthermore, the cell lines established in this project will serve as valuable tools in future preclinical studies.

Os sarcomas de partes moles constituem um grupo diverso de neoplasias que podem surgir nos tecidos conjuntivos praticamente de qualquer região do corpo. A ressonância magnética (RM) é atualmente o exame de escolha para detecção, estadiamento regional e acompanhamento desses tumores. A segmentação das lesões a partir das imagens de RM da rotina permite extrair dados quantitativos, que tem potencial para adicionar informações a análise. O propósito do estudo é avaliar a reprodutibilidade da segmentação manual de sarcomas de partes moles em imagens de RM de pacientes com diagnóstico definitivo confirmado por meio da histopatologia. Como objetivo secundário foi realizada a comparação da segmentação manual e semiautomática a fim de validar a segmentação semiautomática como método alternativo para segmentação desses tumores. Foi estudada uma coorte retrospectiva de 15 pacientes consecutivos com diagnóstico confirmado de sarcoma de partes moles acompanhados em nosso serviço, no período de janeiro de 2006 até janeiro de 2016, com imagens de RM adquiridas previamente ao tratamento e disponíveis para análise no formato DICOM. Foi utilizado o software 3D Slicer para realizar as segmentações pelos métodos manual e semiautomático. Três radiologistas fizeram as segmentações de forma independente e às cegas para permitir avaliação interobservador. Os resultados obtidos demonstram haver alta reprodutibilidade intraobservador com coeficiente de similaridade de Dice entre as segmentações variando de 0,849 a 0,979 e as distâncias Hausdorff variando de 3,53 mm a 20,96 mm e uma boa reprodutibilidade interobservador com coeficientes de similaridade de Dice variando de 0,741 a 0,972 e distâncias Hausdorff variando de 5,83 a 60,84 mm. Foi encontrada uma concordância substancial entre as segmentações realizadas pelo método semiautomático quando comparadas com as segmentações realizadas pelo método manual com coeficientes de similaridade de Dice variando de 0,871 a 0,973 e distâncias Hausdorff variando de 5,43 mm a 31,75 mm. Em relação ao tempo de segmentação não houve diferença estatisticamente significativa do método semiautomático quando comparado ao método manual (p>0,05). Também foram calculados os volumes obtidos nas diferentes segmentações e houve concordância quase perfeita entre as duas segmentações manuais realizadas pelo radiologista 1, entre as segmentações realizadas pelo radiologista 1 e pelo radiologista 2, entre as segmentações realizadas pelo radiologista 1 e pelo radiologista 3, e entre a segmentação manual e semiautomática realizadas pelo radiologista 1, sendo obtidos coeficientes de correlação intraclasse (ICC) entre 0,9927 e 0,9990. Os resultados obtidos demonstram boa reprodutibilidade intra e interobservador da segmentação manual utilizando o software 3D Slicer validando dessa forma esse método como ferramenta confiável para servir de padrão de referência em futuros estudos quantitativos desses tumores. Foi encontrada concordância quase perfeita entre as segmentações realizadas pelo método semiautomático quando comparadas com as segmentações realizadas pelo método manual, mas nossos resultados não demonstraram diferença significativa de tempo de segmentação do método semiautomático em relação ao método manual. / Soft tissue sarcomas constitute a diverse group of neoplasms that can arise in the connective tissues from virtually any region of the body. Magnetic resonance imaging (MRI) is currently the examination of choice for detection, regional staging and followup of these tumors. The segmentation of the lesions from the routine MR images allows the extraction of quantitative data, which has the potential to add information to the analysis. The purpose of the study is to evaluate the reproducibility of manual segmentation of soft tissue sarcomas in MRI images of patients with definitive diagnosis confirmed by histopathology. As a secondary objective, a comparison of manual and semiautomatic segmentation was performed to validate semiautomatic segmentation as an alternative method for segmentation of these tumors. We studied a retrospective cohort of 15 consecutive patients with confirmed diagnosis of soft tissue sarcoma accompanied at our service from January 2006 to January 2016 with MR images acquired prior to treatment and available for analysis in the DICOM format. The software was used 3D Slicer to perform segmentation by manual and semiautomatic methods. Three radiologists did the segmentations independently and blindly to allow inter-observer evaluation. The results obtained show high intraobserver reproducibility with Dice similarity coefficient between the segmentations ranging from 0.849 to 0.979 and Hausdorff distances ranging from 3.53 mm to 20.96 mm and good interobserver reproducibility with Dice similarity coefficients ranging from 0.741 to 0.972 and Hausdorff distances varying from 5.83 to 60.84 mm. A substantial agreement was found between the segmentations performed by the semiautomatic method when compared to the segmentations performed by the manual method with Dice similarity coefficients ranging from 0.871 to 0.973 and Hausdorff distances ranging from 5.43 mm to 31.75 mm. Regarding the segmentation time, there was no statistically significant difference of the semiautomatic method when compared to the manual method (p> 0.05). The volumes obtained in the different segmentations were also calculated and there was almost perfect agreement between the two manual segmentations performed by the radiologist 1, between the segmentations performed by radiologist 1 and radiologist 2, between the segmentations performed by radiologist 1 and radiologist 3, and between The manual and semi-automatic segmentation performed by the radiologist 1, and intraclass correlation coefficients (ICC) between 0.9927 and 0.9990 were obtained. The results obtained demonstrate good intra and interobserver reproducibility of the manual segmentation using 3D Slicer software, thus validating this method as a reliable tool to serve as a reference standard in future quantitative studies of these tumors. Almost perfect agreement was found between the segmentations performed by the semiautomatic method when compared to the segmentations performed by the manual method, but our results did not show a significant difference in segmentation time of the semiautomatic method in relation to the manual method.

The Procollagen-Lysine, 2-Oxoglutarate 5-Dioxygenase (PLOD) family contains three members: PLOD1, PLOD2 and PLOD3. The PLOD family catalyze the lysyl hydroxylase (LH) which plays a crucial role in the synthesis of collagen. As one of the most important components in ECM, collagen plays a crucial role in normal tissues. Soft tissue sarcomas (STS) are malignant tumors with more than 100 subtypes which origin from mesenchymal tissue. Although the STS is a rare malignancy accounting for less than 1% of all adult tumors, it has been reported to be responsible for 20% of all cancer-related deaths in childhood and adolescence. In this study, the relation between PLOD family and STS was analyzed. The overexpression of PLOD family is associated with poor prognosis and the PLOD family seems to be a regulator in TME. The PLOD family could serve as strong novel biomarkers and may be used as a therapy target for personalized treatment in STS.

Changwu Wu's doctoral dissertation with the date of the award decision on the title page. Changwu Wu defended his dissertation on March 21, 2023 and was awarded the Dr.rer.med by the University of Leipzig School of Medicine on March 28, 2023. The dissertation is entitled 'RNA-sequencing-based risk stratification and individualized immunotherapy strategies for soft tissue sarcoma'.

No description available.

Introduction : Le TNF-a, impliqué dans l’inflammation et la défense de l’hôte, aaussi des propriétés anti-tumorales et est utilisé dans le traitement local des sarcomesdes membres. P53 est un anti-oncogène dont la mutation est associée audéveloppement de tumeurs. Des données expérimentales ont démontré une relationentre activité anti-tumorale de TNF-a et le statut de p53. Matériel et méthodes : Notre objectif a été d’étudier en immunohistochimie lestatut de p53 chez 110 patients atteints de sarcomes et traités par TNF-a. Ensuite,dans 8 sarcomes cultivés ex-vivo, nous avons étudié la localisation de l’apoptoseinduite par le TNF-a par microscopie confocale. Puis, dans 9 lignées de sarcomeshumains, nous avons testé la relation p53/TNF-a en abrogeant p53 grâce à un sh-RNA, ou en utilisant des petites molécules telles que CP-31398 ou Nutlin-3a aptes àrestaurer p53. Enfin, pour mieux comprendre les mécanismes de résistance au TNF-a,nous avons mesuré par méthode EMSA la liaison de NF-kB à l’ADN et recherché parRT-PCR quels gènes de l’apoptose étaient différentiellement régulés.Résultats : Le statut muté de p53 corrèle avec la réponse histologique autraitement par TNF-a chez l’homme. L’apoptose induite par le TNF-a est trouvée aussibien au niveau de la cellule endothéliale que de la cellule tumorale. De plus, laréponse au TNF-a est modulée par le statut de p53 puisque dans les lignées étudiées,l’abrogation de p53 supprime celle-ci alors que la réparation d’une activité p53 permetde l’augmenter. Enfin, une potentialisation de l’apoptose induite par TNF-a estobservée lorsqu’il est associé avec CP-31398 ou Nutlin-3a et elle corrèle avec ladiminution de la liaison du NF-kB à l’ADN. Une augmentation de l’expression desgènes RIPK2, TP53BP2 et GADD45 et une diminution de l’expression de TGF-b1 etFAIM est observée lorsque l’association de Nutlin-3a et TNF-a est synergique sur lamort cellulaire.Conclusions : Ces résultats suggèrent que l’utilisation de molécules capablesde restaurer l’activité de p53 peut inverser la résistance des sarcomes des tissusmous au traitement par TNF-a. Dans ce contexte, des études cliniques pourraientexploiter cette approche pour l’utiliser dans le cadre des sarcomes particulièrementrésistants aux traitements conventionnels ainsi que dans d’autres tumeurs. / Introduction: Although named for its antitumor properties, TNF-a is implicatedin a wide spectrum of diseases including chronic inflammation, autoimmunity andcancer. It is used for the loco regional treatment of limb’s sarcoma. P53 is an antioncogenewhose mutation is associated with tumour development. Experimental datademonstrated that TNF-a cytotoxic activity and p53 status are related.Material and methods: Our objective was to study by immunohistochemistrythe p53 status in 110 sarcoma patients treated by isolated limb perfusion with TNF-a. Then, we studied by confocal microscopy in 8 freshly obtained sarcoma tumours,the localization of apoptosis. Finally, in 9 sarcoma cell lines with different p53 status,we tested the p53/TNF-a relationship by abrogating p53 with a sh-RNA and by usingsmall molecules known to restore p53 functions. To better understand the mechanismsof resistance to TNF-a, we measured by EMSA the NF-kB-binding to DNA and withRT-PCR, we explored the regulation of some apoptosis related genes.Results: We demonstrated a relationship between p53 status and thehistological response to TNF-a use in humans. TNF-a induced apoptosis was presentin endothelial cells as well as in the tumour cells. TNF-a cytotoxicity was dependent onthe p53 status since in the cell lines studied, p53 abrogation reduced it and p53restoration allowed it to increase. Moreover, a potentiation of TNF-a cytotoxic effectwas observed when it was combined to CP-31398 or Nutlin-3a. The killing magnitudewas therefore related to the decrease in the NF-kB-binding to DNA when Nutlin-3awas added. A gene expression increase for RIPK2, TP53BP2 and GADD45 and adecrease for TGF-b1 and FAIM was observed if the combined treatment wassynergistic on tumour death cells.Conclusions: These results suggest that the use of compounds able to restorep53 activity could reverse the soft tissue sarcoma’s resistance to TNF-a treatment.Clinical studies should be performed in order to utilize this approach and to use it inthe context of sarcomas that are particularly resistant to conventional treatments.

Bakgrund: Mjukdelssarkom är en ovanlig cancerform som behandlas med kirurgi, strålbehandling och cytostatika. Dessa behandlingar kan orsaka funktionsnedsättning som påverkar livstillfredsställelsen hos individerna som drabbas. Livstillfredsställelse är den subjektiva upplevelsen av livskvalitet. Syfte: Beskriva hur livstillfredsställelsen påverkats av diagnos, behandling och funktionsnedsättning vid mjukdelssarkom. Metod: Kvalitativ ansats innefattande åtta semistrukturerade intervjuer. Intervjuerna transkriberades före analys med kvalitativ innehållsanalys. Resultat: Genom analysen framkom ett övergripande tema Vidare i livet. Temat omfattar kategorierna Reaktion vid diagnos, Upplevelse av behandling, Livet efter sjukdom och Må bra Slutsats: Besvär förekommer i vardagen men individerna begränsas inte av dem, de upplever ingen funktionsnedsättning. Livstillfredsställelsen var påverkad under behandlingen. Efter avslutad behandling det vill säga vid tidpunkt för intervjun ansåg forskningspersonerna att deras livstillfredsställelse inte var påverkad. / Background: Soft tissue sarcoma is a rare form of cancer treated with surgery, radiotherapy and cytostatic. These treatments can cause impairment that affects the life satisfaction for those affected. Life satisfaction is the subjective experience of quality of life. Purpose: Describe how life satisfaction has been affected by the diagnosis, treatment and disability of soft tissue sarcoma. Method: Qualitative approach included eight semi structured interviews. The interviews were transcribed before analysis with qualitative content analysis Result: Through the analysis, an overall theme emerged Further in life. The theme covers the categories Reaction in diagnosis, Experience of treatment, Life after illness and Feel good Conclusion: Discomfort occurs in everyday life, but individuals are not restricted by them, they experience no disability. Life satisfaction was affected during treatment. After termination of treatment, ie at the time of the interviews, the researchers felt that their life satisfaction was not affected.

Soft tissue sarcomas account for about 1% of all malignancies. The increase in incidence of soft tissue sarcomas during the recent decades may predominantly be attributed to AIDS-related Kaposi’s sarcoma; when this tumor is excluded, conclusive evidence for an age-adjusted increase is lacking. Beside the well investigated role of the human immunodeficiency virus 1 (HIV-1) and the human herpesvirus 8 (HHV-8) in the tumorigenesis of AIDS-related Kaposi’s sarcoma and several inherited disorders, considerable evidence support a relationship between occupational chemicals as vinyl chloride, phenoxyacetic acid herbicides, chlorphenols, dioxin, medicinal measures as Thorotrast exposure and therapeutic irradiation, and the development of soft tissue sarcoma. Hormones and chronic repair processes are further probably sarcoma-promoting factors. Considering the rarity of soft tissue sarcomas despite the vast portion that soft tissues comprise in the human body, additional knowledge on the tumorigenesis of soft tissue sarcomas might considerably contribute to the understanding of the etiologic pathways of malignant tumors in humans. / Weichteilsarkome stellen etwa 1% aller bösartigen Neubildungen. Der in den vergangenen Jahrzehnten beobachtete Inzidenzanstieg geht fast ausschließlich auf die rasante Zunahme an AIDS-assoziierten Kaposi-Sarkomen zurück. Bei Außerachtlassung dieses Tumors gibt es bisher keinen schlüssigen Beweis für eine wirkliche alterskorrigierte Häufigkeitszunahme der Weichteilsarkome. Neben der gut untersuchten Rolle des HIV-1-Virus und des humanen Herpes-Virus 8 bei der Entstehung des AIDS-assoziierten Kaposi-Sarkoms und einigen prädisponierenden genetischen Erkrankungen existieren starke Hinweise für einen Zusammenhang zwischen Industriegiften wie Vinylchlorid, Phenoxyessigsäure-Herbiziden, Chlorphenolen, Dioxinen, medizinischen Maßnahmen wie therapeutischer Bestrahlung oder dem Einsatz von Thorotrast, und der Entwicklung von Weichteilsarkomen. Hormone und chronische Reparaturprozesse sind weitere wahrscheinlich fördernde Einflüsse auf die Entstehung von Weichteilsarkomen. Die Tatsache, daß trotz des großen Anteils, den die Binde- und Stützgewebe an der Körpermasse stellen, nur selten maligne Tumoren von diesen Strukturen ausgehen, läßt hoffen, daß ein besseres Verständnis der an der Kanzerogenese von Weichteilsarkomen beteiligten Mechanismen in der Zukunft wichtige Erkenntnisse über die Entstehung menschlicher Tumoren liefern kann. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.