Orbital mesenchymal chondrosarcoma and its specific fusion gene HEY1-NCOA2.

Abstract

Background: Mesenchymal chondrosarcoma (MC) is an uncommon type of malignant soft tissue tumor. The skeleton is the most common site of MC. Extraosseous sarcoma is rare, especially that of the orbit. Fusion gene HEY1-NCOA2 has diagnostic significance for MC, but there is a lack of research on its related pathways. To analyze the characteristics of orbital mesenchymal chondrosarcoma (MC), and search for HEY1-NCOA2-related pathways in orbital MCs, four cases of orbital MC were included in the study.

Methods: From January 2018 to December 2022, four MC patients hospitalized at Tianjin Medical University Eye Hospital were collected for a retrospective series of case studies. HEY1-NCOA2 of the assay specimens was detected by fluorescence in situ hybridization, and immunohistochemical staining was performed for representative proteins of the relevant pathways. For figure modification and statistical analysis, GraphPad Prism 8.0 (La Jolla, CA, USA) was utilized.

Results: Four orbital MC were reported. Among the 4 ligible MC specimens, two were HEY1-NCOA2-positive and two were HEY1-NCOA2-negative. Immunohistochemistry showed stronger expression of COL2A1, APC, CD99, and Bcl2 in HEY1-NCOA2-positive samples than in HEY1-NCOA2-negative MCs.

Conclusion: We summarized the clinical features, treatments, and prognosis of orbital MC, including our cases and the literature. The expression of COL2A1 and Bcl2 is elevated in HEY1-NCOA2-positive tissues, and they promote tumor cell growth by regulating cell proliferation, apoptosis, epithelial-mesenchymal transition, and drug resistance. For HEY1-NCOA2-positive patients, given the high expression of CD99, drugs targeting the MAPK pathway may be an effective treatment.