Prognostic value of nuclear morphometry in myxoid liposarcoma

• Published in: Cancer science Vol. 114; no. 5; pp. 2178 - 2188
• Main Authors: Kawaguchi, Kengo, Kohashi, Kenichi, Iwasaki, Takeshi, Yamamoto, Takeo, Ishihara, Shin, Toda, Yu, Yamamoto, Hidetaka, Nakashima, Yasuharu, Oda, Yoshinao
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-05-2023; John Wiley and Sons Inc
• Subjects: Adult; Carcinoma, Renal Cell - pathology; Cell cycle; cell cycle–related gene; Cell density; Cyclin-dependent kinases; Cytology; DNA damage; Gene expression; Genes; Genetic testing; Humans; Immunohistochemistry; Kidney Neoplasms - pathology; Kinases; Liposarcoma; Liposarcoma, Myxoid - genetics; Lymphocytes; Medical prognosis; Morphology; Morphometry; myxoid liposarcoma; nuclear atypia; Open source software; Original; Pathology; Polo-like kinase 1; Prognosis; Proteins; Renal cell carcinoma; round cell component; Survival Analysis; Telomerase; cell cycle-related gene; morphometry; myxoid liposarcoma; round cell component; nuclear atypia
• DOI: 10.1111/cas.15729
• EISSN: 1349-7006
• ISSN: 1347-9032

Myxoid liposarcoma (MLS) accounts for 20%‐30% of liposarcoma and the round cell component (RCC) is believed to be a specific poor prognostic factor. However, the RCC assessment criteria are vaguely defined and, therefore, are inconsistently employed by pathologists. In this study, we modified and applied two established grading systems to evaluate nuclear atypia (namely, the World Health Organization/International Society of Urological Pathology and the Fuhrman grading in renal cell carcinoma) in 64 MLS cases. Detailed software‐based assessments of the morphology and the cellularity were performed. DNA mutation analysis, comprehensive mRNA expression analysis, and immunohistochemistry were also performed. Our findings revealed that the high–nuclear‐grade group according to the modified Fuhrman grading system exhibited a significantly poor disease‐free survival (hazard ratio: 4.43; 95% confidence interval: 0.9‐22.6; p = 0.047). On the other hand, the cellularity was significantly higher in the modified Fuhrman high‐grade group (p = 0.010 at the percentage of the hypercellular area; p = 0.003 at the maximum cell density) but did not qualify per se as a poor prognostic factor in the survival analyses. Furthermore, the modified Fuhrman high‐grade group significantly expressed the cell cycle–related genes (such as FOXM1, PLK1, and CDK1). In conclusion, our analyses suggest that an evaluation focusing on nuclear morphology (rather than on cellular density) can be more reliable in predicting the MLS prognosis.
The evaluation focusing on nuclear morphology (rather than on cellular density) can be more reliable in predicting the myxoid liposarcoma (MLS) prognosis. Modified Fuhrman grading is useful for the morphology evaluation. The high–nuclear‐grade group significantly expressed the cell cycle–related genes (such as FOXM1, PLK1, and CDK1).