title: Smooth muscle differentiation identifies two classes of poorly differentiated pleomorphic sarcomas with distinct outcome.
abstract: The clinical relevance of accurately diagnosing pleomorphic sarcomas has been shown, especially in cases of undifferentiated pleomorphic sarcomas with myogenic differentiation, which appear significantly more aggressive. To establish a new smooth muscle differentiation classification and to test its prognostic value, 412 sarcomas with complex genetics were examined by immunohistochemistry using four smooth muscle markers (calponin, h-caldesmon, transgelin and smooth muscle actin). Two tumor categories were first defined: tumors with positivity for all four markers and tumors with no or incomplete phenotypes. Multivariate analysis demonstrated that this classification method exhibited the strongest prognostic value compared with other prognostic factors, including histological classification. Secondly, incomplete or absent smooth muscle phenotype tumor group was then divided into subgroups by summing for each tumor the labeling intensities of all four markers for each tumors. A subgroup of tumors with an incomplete but strong smooth muscle differentiation phenotype presenting an intermediate metastatic risk was thus identified. Collectively, our results show that the smooth muscle differentiation classification method may be a useful diagnostic tool as well as a relevant prognostic tool for undifferentiated pleomorphic sarcomas.
authors.affiliation: 1] Institut Bergonié, Department of Pathology, Bordeaux, France [2] INSERM U916, Bordeaux, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Pérot
authors.affiliation: Institut Bergonié, Clinical and Epidemiological Research Unit, Bordeaux, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Mendiboure
authors.affiliation: Institut Bergonié, Clinical and Epidemiological Research Unit, Bordeaux, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Brouste
authors.affiliation: Institut Bergonié, Department of Pathology, Bordeaux, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Velasco
authors.affiliation: Institut Gustave Roussy, Department of Pathology, Villejuif, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Terrier
authors.affiliation: Institut Gustave Roussy, Department of Surgery, Villejuif, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bonvalot
authors.affiliation: University Institute of Pathology, CHUV, Lausanne, Switzerland.
authors.forename: Louis
authors.initials: L
authors.lastname: Guillou
authors.affiliation: Léon Bérard Center, Department of Pathology, Lyon, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Ranchère-Vince
authors.affiliation: 1] Institut Bergonié, Department of Pathology, Bordeaux, France [2] INSERM U916, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Aurias
authors.affiliation: 1] Institut Bergonié, Department of Pathology, Bordeaux, France [2] INSERM U916, Bordeaux, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Coindre
authors.affiliation: 1] Institut Bergonié, Department of Pathology, Bordeaux, France [2] INSERM U916, Bordeaux, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chibon
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D002454:Cell Differentiation; D006801:Humans; D007150:Immunohistochemistry; D009130:Muscle, Smooth / Q000473:pathology*; D011379:Prognosis; D012509:Sarcoma / Q000145:classification* / Q000401:mortality / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000145:classification* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor