[An analysis of clinical and genetic feature in pulmonary artery sarcoma].

Q Jiang, H Yan, C Huang, R Ma, C T Zhang, K Yang, J Wang, C L Liu
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Abstract

Objective: To retrospectively analyze the clinical, imaging, pathological and genetic features in patients with pulmonary artery sarcoma (PAS) in a single center, and to investigate the disease origin of PAS, as well as its relationship with other pulmonary vascular diseases. Methods: We retrospectively identified and analyzed clinical features of 13 cases with PAS those were admitted in the First Affiliated Hospital of Guangzhou Medical University between January 2015 and January 2021. Whole exome sequencing (WES) was performed to further analyze their genetic characteristics in 8 postoperative specimens. Results: The average age of PAS patients was 26-67 (43.2±11.6) years, and the median time from symptom to diagnosis was 8 months (IQR: 3, 11.5). The most common symptom of PAS was shortness of breath (84.6%), and the most common complication was pulmonary hypertension (69.2%).A total of 5 genes with specific mutations in PAS patients were identified by genomic analysis. Compared with genetic features of pulmonary embolism (PE), pulmonary arterial hypertension (PAH) and lung cancer (LC),we found genetic similarity between PAS and LC. Using KEEG database, we identified that most of the PAS-mutated genes belonged to cancer-enriched signaling pathways. Conclusions: PAS is a kind of malignant tumor located in the pulmonary vascular trunk, without a good prognosis and specific clinical manifstations. The occurrence of PAS may be associathed with mutations of MDM2, PIK3CA and TP53.

肺动脉肉瘤的临床及遗传特征分析
目的:回顾性分析单一中心肺动脉肉瘤(pulmonary artery sarcoma, PAS)患者的临床、影像学、病理及遗传学特征,探讨PAS的发病原因及其与其他肺血管疾病的关系。方法:回顾性分析2015年1月至2021年1月在广州医科大学第一附属医院收治的13例PAS患者的临床特征。对8例术后标本进行全外显子组测序(WES)进一步分析其遗传特征。结果:PAS患者的平均年龄为26-67岁(43.2±11.6)岁,从出现症状到确诊的中位时间为8个月(IQR: 3,11.5)。PAS最常见的症状是呼吸短促(84.6%),最常见的并发症是肺动脉高压(69.2%)。通过基因组分析,共鉴定出5个PAS患者特异性突变基因。通过对肺栓塞(PE)、肺动脉高压(PAH)和肺癌(LC)的遗传特征进行比较,发现PAS与LC具有遗传相似性。利用KEEG数据库,我们发现大多数pas突变基因属于癌症富集信号通路。结论:PAS是一种位于肺血管干的恶性肿瘤,预后不佳,临床表现特异性差。PAS的发生可能与MDM2、PIK3CA和TP53的突变有关。
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