Abstract
Simple SummaryMyxoid liposarcoma (MLPS) is the second most common subtype of liposarcoma, occurs predominantly in the extremities, and tends either to recur locally and metastasize to unusual soft tissue locations. To date, the mechanisms of invasion and metastasis of MLPS remain unclear, and yet, there is a high need to identify new prognostic biomarkers to enable the development of novel targeted therapeutic strategies. This study firstly aimed to assess the role of immune cellular components that infiltrate MLPS tissues. Our data show that high grade, heavily vascularized MLPS tissues exhibit T lymphocyte-poor and M2-like macrophage-rich phenotypes, while low grade MLPS tissues are mainly infiltrated by T lymphocytes. In line with these findings, evidence is shown that a crosstalk occurring between MLPS cells and macrophages exists as MLPS cells drive an M2-like phenotype in monocytes which in turn, increase the invasive capability of MLPS cells.Myxoid liposarcoma (MLPS) is the second most common subtype of liposarcoma and has tendency to metastasize to soft tissues. To date, the mechanisms of invasion and metastasis of MLPS remain unclear, and new therapeutic strategies that improve patients’ outcomes are expected. In this study, we analyzed by immunohistochemistry the immune cellular components and microvessel density in tumor tissues from patients affected by MLPS. In order to evaluate the effects of primary human MLPS cells on macrophage polarization and, in turn, the ability of macrophages to influence invasiveness of MLPS cells, non-contact and 3D organotypic co-cultures were set up. High grade MLPS tissues were found heavily vascularized, exhibited a CD3, CD4, and CD8 positive T lymphocyte-poor phenotype and were massively infiltrated by CD163 positive M2-like macrophages. Conversely, low grade MLPS tissues were infiltrated by a discrete amount of CD3, CD4, and CD8 positive T lymphocytes and a scarce amount of CD163 positive macrophages. Kaplan–Meier analysis revealed a shorter Progression Free Survival in MLPS patients whose tumor tissues were highly vascularized and heavily infiltrated by CD163 positive macrophages, indicating a clear-cut link between M2-like macrophage abundance and poor prognosis in patients. Moreover, we documented that, in co-culture, soluble factors produced by primary human MLPS cells induce macrophage polarization toward an M2-like phenotype which, in turn, increases MLPS cell capability to spread into extracellular matrix and to cross endothelial monolayers. The identification of M2-like polarization factors secreted by MLPS cells may allow to develop novel targeted therapies counteracting MLPS progression.
Highlights
Myxoid Liposarcoma (MLPS) is the second most common type of liposarcoma, representing 20–30% of all liposarcomas and an about 5% of all adult soft tissue sarcomas
Metastatic lesions occurred in two Myxoid liposarcoma (MLPS) patients and six MLPS patients died of causes unrelated to the disease
The identification of soluble factors secreted by MLPS cells in the microenvironment milieu and responsible for M2-like polarization deserves further investigation, our findings indicate that MLPS cells really induce macrophage polarization in the direction of an M2-like pro-tumor phenotype and that once polarized, tumor-associated macrophages (TAM) increase MLPS cell ability to spread and infiltrate surrounding tissues and entry of metastatic cells into the blood vessels
Summary
Myxoid Liposarcoma (MLPS) is the second most common type of liposarcoma, representing 20–30% of all liposarcomas and an about 5% of all adult soft tissue sarcomas. These tumors occur in adults and in a younger population, with a peak of incidence in the fourth and fifth decade of life and equal distribution between men and women [1,2]. MLPS is characterized by a mixture of round to oval non-lipogenic cells and small ring lipoblasts dispersed in an abundant myxoid matrix stroma with a thin, delicate, so called “chicken wire” capillary network [3]. A cellular overlap > 5%, decreased myxoid matrix, increased nuclear grade, and high mitotic activity hallmark high-grade MLPS [2]
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