Clinical Sarcoma Research
Genome-wide methylation profiling and copy number analysis in atypical fibroxanthomas and pleomorphic dermal sarcomas indicate a similar molecular phenotype
- Christian Koelsche†,
- Damian Stichel†,
- Klaus G. Griewank,
- Daniel Schrimpf,
- David E. Reuss,
- Melanie Bewerunge-Hudler,
- Christian Vokuhl,
- Winand N. M. Dinjens,
- Iver Petersen,
- Michel Mittelbronn,
- Adrian Cuevas-Bourdier,
- Rolf Buslei,
- Stefan M. Pfister,
- Uta Flucke,
- Gunhild Mechtersheimer,
- Thomas Mentzel and
- Andreas von Deimling
†Contributed equally
- Received: 27 November 2018
- Accepted: 5 February 2019
- Published: 14 February 2019
Abstract
Background
Atypical fibroxanthomas (AFX) and pleomorphic dermal sarcomas (PDS) are lesions of the skin with overlapping histologic features and unspecific molecular traits. PDS behaves aggressive compared to AFX. Thus, a precise delineation, although challenging in some instances, is relevant.
Methods
We examined the value of DNA-methylation profiling and copy number analysis for separating these tumors. DNA-methylation data were generated from 17 AFX and 15 PDS using the Illumina EPIC array. These were compared with DNA-methylation data generated from 196 tumors encompassing potential histologic mimics like cutaneous squamous carcinomas (cSCC; n = 19), basal cell carcinomas (n = 10), melanoma metastases originating from the skin (n = 11), leiomyosarcomas (n = 11), angiosarcomas of the skin and soft tissue (n = 11), malignant peripheral nerve sheath tumors (n = 19), dermatofibrosarcomas protuberans (n = 13), extraskeletal myxoid chondrosarcomas (n = 9), myxoid liposarcomas (n = 14), schwannomas (n = 10), neurofibromas (n = 21), alveolar (n = 19) and embryonal (n = 17) rhabdomyosarcomas as well as undifferentiated pleomorphic sarcomas (n = 12).
Results
DNA-methylation profiling did not separate AFX from PDS. The DNA-methylation profiles of the other cases, however, were distinct from AFX/PDS. They reliably assigned to subtype-specific DNA-methylation clusters, although overlap occurred between some AFX/PDS and cSCC. Copy number profiling revealed alterations in a similar frequency and distribution between AFX and PDS. They involved losses of 9p (22/32) and 13q (25/32). Gains frequently involved 8q (8/32). Notably, a homozygous deletion of CDKN2A was more frequent in PDS (6/15) than in AFX (2/17), whereas amplifications were non-recurrent and overall rare (5/32).
Conclusions
Our findings support the concept that AFX and PDS belong to a common tumor spectrum. We could demonstrate the diagnostic value of DNA-methylation profiling to delineating AFX/PDS from potential mimics. However, the assessment of certain histologic features remains crucial for separating PDS from AFX.
Keywords
- Pleomorphic dermal sarcoma
- Atypical fibroxanthoma
- Sarcomas
- Melanomas
- Carcinomas
- Mimics
- DNA methylation
- Profiling
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