Impact of SAMHD1 and phosphorylated ATM levels on the progression and prognosis of patients with soft tissue sarcoma

Soft tissue sarcomas (STSs) are rare and hetero- geneous malignancies that are often associated with a poor prognosis, particularly in advanced stages. DNA damage repair (DDR) pathways serve a crucial role in cancer progres- sion and response to treatment. Among the key regulators of DDR are SAM domain and HD domain-containing protein 1 (SAMHD1) and phosphorylated ataxia-telangiectasia mutated (p-ATM), both of which contribute to maintaining genomic stability. However, to the best of our knowledge, their clinical significance in STS has not been fully elucidated. In the present study, immunohistochemistry was used to assess the levels of SAMHD1 and p-ATM in tumor tissues. The prognostic impact of SAMHD1 and p-ATM levels was evaluated through survival analysis. The results showed that high levels of SAMHD1 and p-ATM were significantly associated with worse overall survival and progression-free survival. Multivariate Cox analysis demonstrated that both SAMHD1 and p-ATM levels were independent predictors of poor prognosis. Notably, patients exhibiting co-expression of SAMHD1 and p-ATM experienced the poorest clinical outcomes, suggesting a synergistic effect in promoting sarcoma progression. These findings indicated that SAMHD1 and p-ATM may serve as valuable prognostic biomarkers in STS. Their involvement in DDR mechanisms also highlights their potential as novel therapeutic targets, especially for patients with aggressive or high-risk disease profiles.