Goren M P
St. Jude Children's Research Hospital, Memphis, Tennessee.
Curr Opin Oncol. 1991 Aug;3(4):677-83.
Often treated as a single clinical entity, the pediatric soft tissue sarcomas include neoplasms of diverse histology that can originate from any anatomic site and exhibit varied patterns of local spread and metastasis. Recent developments with potential clinical impact include new diagnostic and prognostic markers stemming from advances in molecular biology, and increasing concern for the late effects of therapy in a growing population of long-term survivors. Initial clinical data indicate the value of MyoD1 protein expression in classifying previously indeterminate primitive undifferentiated tumors. The reported sensitivity and specificity of P-glycoprotein expression for the identification of chemoresistant disease in pediatric sarcomas should spawn studies to clarify its prognostic value and potential therapeutic strategies to circumvent the multidrug-resistance phenotype. Tumor cell DNA ploidy may also have prognostic and diagnostic value. An abundant interest in alleviating the late effects of adjuvant therapy and surgery is reflected in many clinical reports by oncologists, surgeons, radiotherapists, ophthalmologists, and other specialists.
小儿软组织肉瘤通常被视为单一的临床实体，包括组织学多样的肿瘤，这些肿瘤可起源于任何解剖部位，并表现出不同的局部扩散和转移模式。具有潜在临床影响的最新进展包括源于分子生物学进步的新诊断和预后标志物，以及在越来越多的长期幸存者群体中对治疗晚期效应的日益关注。初步临床数据表明，MyoD1蛋白表达在对先前不确定的原始未分化肿瘤进行分类方面具有价值。报道的P-糖蛋白表达在小儿肉瘤中识别化疗耐药疾病的敏感性和特异性，应促使开展研究以阐明其预后价值以及规避多药耐药表型的潜在治疗策略。肿瘤细胞DNA倍性也可能具有预后和诊断价值。肿瘤学家、外科医生、放射治疗师、眼科医生和其他专家的许多临床报告都反映出人们对减轻辅助治疗和手术晚期效应的浓厚兴趣。
