# Molecular Characterization of Soft Tissue Sarcomas Using RNA-Based Next-Generation Sequencing

## TL;DR

RNA sequencing helps reveal the molecular traits of soft tissue sarcomas, offering new insights for diagnosis and treatment.

## Contribution

The study demonstrates RNA-based NGS as a valuable tool for uncovering clinically relevant molecular profiles in soft tissue sarcomas.

## Key findings

- RNA-NGS identified significant differential gene expression linked to tumor proliferation and microenvironment.
- Leiomyosarcoma showed a distinct transcriptomic profile, and clinically relevant gene fusions were detected.
- The approach provides biologically meaningful insights for precision medicine in sarcoma diagnosis.

## Abstract

Soft tissue sarcomas are rare malignant mesenchymal tumors for which accurate diagnosis, prognostic stratification, and therapeutic decision-making remain challenging. Although histopathology and immunohistochemistry are essential diagnostic tools, they frequently fail to capture the molecular complexity underlying tumor aggressiveness and treatment resistance. In this study, we evaluated the utility of RNA-based next-generation sequencing for the molecular characterization of STS and for elucidating transcriptomic mechanisms associated with aggressive tumor behavior. An observational cohort of 24 patients with histologically confirmed soft tissue sarcomas was analyzed, using adipose and skeletal muscle tissue as controls. RNA was extracted from tumor samples, libraries were prepared with a targeted pan-cancer panel, and sequencing was performed on the Illumina platform, followed by bioinformatic analysis using DRAGEN pipelines and DESeq2. RNA-NGS identified a predominance of single-nucleotide polymorphisms and significant differential gene expression, with overexpression of proliferation-related genes (TOP2A, MKI67, BUB1B), extracellular matrix and microenvironment-associated genes (COL11A1, SPP1), and developmental regulators (HOXD13, MELK). Subgroup analysis revealed a distinct transcriptomic profile in leiomyosarcoma, while gene fusion analysis detected clinically relevant alterations. These findings demonstrate that RNA-NGS provides biologically and clinically meaningful insights into the molecular landscape of soft tissue sarcomas and supports its integration into precision medicine-oriented diagnostic workflows.