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. 2024 Jun 6;14(11):1195.
doi: 10.3390/diagnostics14111195.

CXCR4 Expression as a Prognostic Biomarker in Soft Tissue Sarcomas

Anna C Virgili  1   2   3 , Juliana Salazar  3 , Alberto Gallardo  4 , Antonio López-Pousa  1   3 , Raúl Terés  1   3 , Silvia Bagué  4 , Ruth Orellana  4 , Caterina Fumagalli  4 , Ramon Mangues  5   6   7 , Lorena Alba-Castellón  5   6   7 , Ugutz Unzueta  5   6   7 , Isolda Casanova  5   6   7 , Ana Sebio  1   3
Affiliations

CXCR4 Expression as a Prognostic Biomarker in Soft Tissue Sarcomas

Anna C Virgili et al. Diagnostics (Basel). .

Abstract

Poor long-term survival in localized high-risk soft tissue sarcomas (STSs) of the extremities and trunk highlights the need to identify new prognostic factors. CXCR4 is a chemokine receptor involved in tumor progression, angiogenesis, and metastasis. The aim of this study was to evaluate the association between CXCR4 expression in tumor tissue and survival in STSs patients treated with neoadjuvant therapy. CXCR4 expression was retrospectively determined by immunohistochemical analysis in serial specimens including initial biopsies, tumors post-neoadjuvant treatment, and tumors after relapse. We found that a positive cytoplasmatic expression of CXCR4 in tumors after neoadjuvant treatment was a predictor of poor recurrence-free survival (RFS) (p = 0.003) and overall survival (p = 0.019) in synovial sarcomas. We also found that positive nuclear CXCR4 expression in the initial biopsies was associated with poor RFS (p = 0.022) in undifferentiated pleomorphic sarcomas. In conclusion, our study adds to the evidence that CXCR4 expression in tumor tissue is a promising prognostic factor for STSs.

Keywords: CXCR4; prognostic factor; soft tissue sarcomas; synovial sarcomas; undifferentiated pleomorphic sarcomas.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Examples of CXCR4 expression determined by immunohistochemistry. (1-A) CXCR4 nuclear and cytoplasmatic positive immunostaining in high-grade spindle cell sarcoma (20×). (1-B) CXCR4 negative immunostaining in undifferentiated pleomorphic sarcoma (20×). (1-C) CXCR4 nuclear positive immunostaining in synovial sarcoma (20×). (2-A) CXCR4 cytoplasmatic positive immunostaining in the initial biopsy of a 46-year-old woman with biphasic synovial sarcoma (20×). (2-B) CXCR4 negative immunostaining in post-neoadjuvant treatment biopsy of a 46-year-old woman with biphasic synovial sarcoma (20×).
Figure 2
Figure 2
CXCR4 expression in the evolution of the STSs tumors: before and after neoadjuvant treatment and post-relapse.
Figure 3
Figure 3
Overall survival according to cytoplasmatic CXCR4 expression in post-neoadjuvant surgical samples.
Figure 4
Figure 4
(A) Recurrence-free survival according to cytoplasmatic CXCR4 expression in post-neoadjuvant surgical samples from patients with synovial sarcoma. (B) Overall survival according to cytoplasmatic CXCR4 expression in post-neoadjuvant surgical samples obtained from patients with synovial sarcoma.
Figure 5
Figure 5
Recurrence-free survival according to nuclear CXCR4 expression in the initial biopsies for patients with undifferentiated pleomorphic sarcoma.
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