Abstract

BackgroundSarcomas are highly heterogeneous in molecular, pathologic, and clinical features. However, a classification of sarcomas by integrating different types of pathways remains mostly unexplored.MethodsWe performed hierarchical clustering analysis of sarcomas based on the enrichment scores of 14 pathways involved in immune, stromal, DNA damage repair (DDR), and oncogenic signatures in three bulk tumor transcriptome datasets.ResultsConsistently in the three datasets, sarcomas were classified into three subtypes: Immune Class (Imm-C), Stromal Class (Str-C), and DDR Class (DDR-C). Imm-C had the strongest anti-tumor immune signatures and the lowest intratumor heterogeneity (ITH); Str-C showed the strongest stromal signatures, the highest genomic stability and global methylation levels, and the lowest proliferation potential; DDR-C had the highest DDR activity, expression of the cell cycle pathway, tumor purity, stemness scores, proliferation potential, and ITH, the most frequent TP53 mutations, and the worst survival. We further validated the stability and reliability of our classification method by analyzing a single cell RNA-Seq (scRNA-seq) dataset. Based on the expression levels of five genes in the pathways of T cell receptor signaling, cell cycle, mismatch repair, focal adhesion, and calcium signaling, we built a linear risk scoring model (ICMScore) for sarcomas. We demonstrated that ICMScore was an adverse prognostic factor for sarcomas and many other cancers.ConclusionsOur classification method provides novel insights into tumor biology and clinical implications for sarcomas.

Highlights

  • Sarcomas are highly heterogeneous in molecular, pathologic, and clinical features

  • This study demonstrated two key findings for these adult soft tissue sarcomas: (1) copy number alterations (CNAs) are predominant over somatic mutations; and (2) molecular subtypes and the tumor immune microenvironment are highly associated with clinical outcomes

  • Based on the single-sample gene-set enrichment analysis (ssGSEA) scores of the 14 pathways involved in immune, stromal, DNA damage repair, or oncogenic signatures, we hierarchically clustered sarcomas in three different datasets, respectively

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Summary

Introduction

Sarcomas are highly heterogeneous in molecular, pathologic, and clinical features. A type of cancer that develops in the bones and soft tissues, are highly heterogeneous in pathologic and clinical features [1]. This study demonstrated two key findings for these adult soft tissue sarcomas: (1) CNAs are predominant over somatic mutations; and (2) molecular subtypes and the tumor immune microenvironment are highly associated with clinical outcomes. Many studies have performed molecular classification of sarcomas based on genomic profiling. Kim et al classified complex karyotype sarcomas into three subtypes based on their CDK4 and RB1-associated CNAs [3]. Koelsche et al developed an algorithm to classify sarcomas based on DNA methylation profiling [5]. Gibault et al identified five subtypes of soft tissue sarcomas with complex genomics by clustering analysis of transcriptome data [6]

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