Ki-67 immunoexpression and radiological assessment of necrosis improves accuracy of conventional and modified core biopsy systems in predicting the final grade assigned to adult-soft tissue sarcomas. An international collaborative study

Machado, Isidro; Cruz, Julia; Righi, Alberto; Gambarotti, Marco; Ferrari, C.; Ruengwanichayakun, Poosit; Giner, Francisco; Rausell, Nuria; Sugita, Shintaro; Nájera, Laura; Suarez, Lola; Sanjuán, Xavier; García, José Antonio Narváez; Muro, Francisco Javier Garcia Del; Gómez-Mateo, M. Carmen; Valladares, Manuel Moreno; Ramos-Oliver, Irma; Romagosa, Cleofé; Parafioriti, Antonina; Armiraglio, Elisabetta; Bernardo, Andrea Di; Navarro, Samuel; Hasegawa, Tadashi; Arana, Estanislao; Llombart‐Bosch, Antonio

doi:10.1016/j.prp.2021.153562

Cited by 5 publications

(2 citation statements)

References 46 publications

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“…Correlation with radiologic findings (i.e., necrosis assessment) may ameliorate, without definitely resolving, the core biopsy biased view. A Novel approach suggested by Mcaddy [ 16 ] and Machado [ 17 ]) suggested using modified grading systems encompassing both ki67 and radiologic assessments of necrosis.…”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Mediastinum: A Rare and Challenging Diagnosis?

et al. 2022

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(1) Introduction: Leiomyosarcomas are highly aggressive mesenchymal neoplasm derived from smooth muscle cells which, in the mediastinum, are present in various primary organs; To our knowledge, less than 10 cases of primary mediastinal leiomyosarcoma have been described. Here, we report a compelling case of primary mediastinal leiomyosarcoma. (2) Case presentation: A 79-year-old woman was admitted to the Thoracic Surgery Unit of S. Andrea University Hospital for persisting cough, exertional dyspnea, and sternal pain. After multidisciplinary consultation, a CT-guided core needle biopsy of the mass was performed, resulting in a provisional diagnosis of mesenchymal neoplasm with smooth muscle differentiation without apparent signs of atypia. The patient underwent surgery that revealed a large irregularly shaped mass with a whorled pattern cut surface, showing admixed yellowish areas of necrosis and areas of hemorrhage. Histologic examination showed a smooth muscle neoplasm with atypia and necrosis, and a grade 2 primary mediastinal leiomyosarcoma diagnosis was given. (3) Conclusions: Soft tissue sarcomas represent a challenging diagnostic group of tumors due to their location, morphologic spectrum, and unique molecular background. Our case of primary mediastinal leiomyosarcoma shows how tumor heterogeneity and limited tissue sampling impact diagnosis. Further studies are needed to shed light on the disease by finding an appropriate molecular signature for each leiomyosarcoma subgroup, providing a more precise diagnosis and the correct background for tailored therapy.

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Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Mediastinum: A Rare and Challenging Diagnosis?

et al. 2022

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“…2,3 The Ki-67 labeling index (LI) has been extensively used to represent cellular proliferation status and has been shown to be associated with the histological grade and prognosis of soft tissue sarcomas. 4 Bcl-2 and P53 LIs can regulate tumor apoptotic pathways and have been widely used as predictive markers for tumor treatment, while the selective inhibitors against the targets can be used as a promising treatment strategy. 5,6 However, information about cellular proliferation and apoptosis obtained via invasive pathological methods may have sampling errors and may not represent the entire tumor tissue.…”

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Correlation of Apparent Diffusion Coefficient With Proliferation and Apoptotic Indexes in a Murine Model of Fibrosarcoma: Comparison of Four Methods for MRI Region of Interest Positioning

Yang

Fang

Tao

et al. 2022

Magnetic Resonance Imaging

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Background: Diffusion-weighted imaging (DWI) has demonstrated great potential in predicting the expression of tumor cell proliferation and apoptosis indexes. Purpose: To evaluate the impact of four region of interest (ROI) methods on interobserver variability and apparent diffusion coefficient (ADC) values and to examine the correlation of ADC values with Ki-67, Bcl-2, and P53 labeling indexes (LIs) in a murine model of fibrosarcoma. Study Type: Prospective, animal model. Animal Model: A total of 22 female BALB/c mice bearing intramuscular fibrosarcoma xenografts. Field Strength/Sequence: A 3.0 T/T1-weighted fast spin-echo (FSE), T2-weighted fast relaxation fast spin-echo, and DWI PROPELLER FSE sequences. Assessment: Four radiologists measured ADC values using four ROI methods (oval, freehand, small-sample, and wholevolume). Immunohistochemical assessment of Ki-67, Bcl-2, and P53 LIs was performed. Statistical Tests: Interclass correlation coefficient (ICC), one-way analysis of variance followed by LSD-t post hoc analysis, and Pearson correlation test were performed. The statistical threshold was defined as a P-value of <0.05. Results: All ROI methods for ADC measurements showed excellent interobserver agreement (ICC range, 0.832-0.986). The ADC values demonstrated significant differences among the four ROI methods. The ADC values for oval, freehand, small-sample, and whole-volume ROI methods showed a moderately negative correlation with Ki-67 (r = À0.623; r = À0.629; r = À0.642, and r = À0.431) and Bcl-2 (r = À0.590; r = À0.597; r = À0.659, and r = À0.425) LIs, but no correlation with P53 LI (r = 0.364, P = 0.104; r = 0.350, P = 0.120; r = 0.379, P = 0.091; r = 0.390, P = 0.080). Data Conclusion:The ADC value can be used to evaluate cell proliferation and apoptosis indexes in a murine model of fibrosarcoma, employing the small-sample ROI as a reliable method.

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Alveolar Soft Tissue Sarcoma: Correlation of MRI Features With Histological Grading and Patient Prognosis

Yuan,

Xie,

Fang

et al. 2024

Magnetic Resonance Imaging

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BackgroundAlveolar Soft Part Sarcoma (ASPS) is a rare, aggressive cancer whose diagnosis and treatment depend on histological grading. However, tumor variability can lead to underestimation, affecting treatment, and patient survival.ObjectiveTo evaluate MRI features associated with Grade III ASPS and to determine the relationship between MRI features and patient prognosis.Study TypeRetrospective analysis.SubjectsSixty‐seven patients with ASPS were included with 37 males and 30 females (M/F = 1.23) follow‐up and survival analysis on 50 patients.Field Strength/SequenceA 3.0 T, T1WI‐FSE, T2WI‐FSE, DWI‐EPI, DCE‐MRI (gradient echo).AssessmentMRI features (margin, peritumoral oedema, peritumoral enhancement, necrosis, vascular flow void signal, heterogeneous signal intensity [SI] at T1WI and T2WI, ADCmean, time‐intensity curve [TIC] type, distant metastasis, and bone invasion) and histological grading were independently evaluated by three radiologists and two pathologists, with Grade III considered high‐grade.Statistical TestsThe chi‐square or Fisher's exact test was used to assess the correlation between MRI features and histological grading. Multivariable binary logistic regression identified independent factors associated with high‐grade tumors. The Kaplan–Meier method and Cox proportional hazards model were used to calculate hazard ratios for MRI features.ResultsTumor necrosis, heterogeneous SI at T2WI ≥50%, and ADCmean were associated with high‐grade ASPS. Tumor necrosis was an independent factors associated with local relapse‐free survival (odds ratio [OR], 3.88). TIC type was associated with 5‐year survival rate (OR, 2.80) and local relapse‐free survival (OR, 2.69). Heterogeneous SI at T2WI ≥50% was associated with 5‐year survival (OR, 4.00), local relapse‐free survival (OR, 5.58), and local relapse‐free survival (OR, 4.84).Data ConclusionMRI features including tumor necrosis, heterogeneity of SI at T2WI, ADCmean, and TIC type aid in assessing ASPS grading and prognosis.Evidence Level4Technical EfficacyStage 5

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Ki-67 immunoexpression and radiological assessment of necrosis improves accuracy of conventional and modified core biopsy systems in predicting the final grade assigned to adult-soft tissue sarcomas. An international collaborative study

Cited by 5 publications

References 46 publications

Primary Leiomyosarcoma of the Mediastinum: A Rare and Challenging Diagnosis?

Primary Leiomyosarcoma of the Mediastinum: A Rare and Challenging Diagnosis?

Correlation of Apparent Diffusion Coefficient With Proliferation and Apoptotic Indexes in a Murine Model of Fibrosarcoma: Comparison of Four Methods for MRI Region of Interest Positioning

Alveolar Soft Tissue Sarcoma: Correlation of MRI Features With Histological Grading and Patient Prognosis

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