Abstract

Myxofibrosarcoma(MFS) is the most common soft tissue sarcoma(STS) in elderly patients. Surgical resection remains the main treatment modality but tumor borders can be difficult to delineate with conventional clinical methods. Incomplete resections are a common problem and local recurrence remains a clinical issue. A technique that has shown great potential in improving surgical treatment of solid tumors is tumor targeted imaging and image-guided surgery with near-infrared fluorescence. To facilitate this technique, it is essential to identify a biomarker that is highly and homogenously expressed on tumor cells, while being absent on healthy non-malignant tissue. The purpose of this study was to identify suitable molecular targets for tumor-targeted imaging of myxofibrosarcoma. Ten potential molecular targets for tumor targeted imaging were investigated with immunohistochemical analysis in myxofibrosarcoma tissue (n = 34). Results were quantified according to the immunoreactive score(IRS). Moderate expression rates were found for uPAR, PDGFRa and EMA/MUC1. High expression rates of VEGF and TEM1 were seen. Strong expression was most common for TEM1 (88.2%). These results confirms that TEM1 is a suitable target for tumor-targeted imaging of myxofibrosarcoma. Keywords Image-guided surgery; Immunohistochemistry; Molecular imaging; Myxofibrosarcoma; Soft tissue sarcoma; Tumor endothelial marker 1(TEM1), Vascular endothelial growth factor (VEGF).

Highlights

  • Myxofibrosarcoma(MFS) is the most common soft tissue sarcoma(STS) in elderly patients

  • Ten of these 34 cases were treated with preoperative radiotherapy Per case a minimum of 2 and a maximum of 3 samples per Formalin fixed paraffin embedded (FFPE) block were taken and processed in the tissue microarrays (TMAs)

  • Expression of PDGFRa was observed in 26(76.5%) cases but strong expression occurred only once. 12(25.3%) cases stained positive for UPAR but strong expression was seen in 1(2.9%) case

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Summary

Introduction

Myxofibrosarcoma(MFS) is the most common soft tissue sarcoma(STS) in elderly patients. A technique that has shown great potential in improving surgical treatment of solid tumors is tumor targeted imaging and image-guided surgery with near-infrared fluorescence. To facilitate this technique, it is essential to identify a biomarker that is highly and homogenously expressed on tumor cells, while being absent on healthy non-malignant tissue. A promising technique that could aid in real-time tumor detection during surgery is tumor-targeted near-infrared (NIR) fluorescence imaging with targeted molecular agents[16]. To facilitate this technique it is essential to identify a biomarker that can be targeted with an imaging agent This biomarker needs to be abundantly and homogeneously expressed on tumor cells while being absent on benign and healthy tissue. The secondary objective was to determine whether the expression of these biomarkers is influenced by preoperative treatment

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