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Although high\u2010throughput sequencing and methylation array aid sarcoma diagnosis and are routine in high\u2010income countries, access to these genetic\/epigenetic analyses in many countries, including Japan, remains limited. Nanopore sequencing is an easy, fast, and cost\u2010effective high\u2010throughput sequencing alternative. Nanopore sequencers read long\u2010read DNA to detect fusion DNA and 5\u2010methyl\u2010cytosine in single nucleotide resolution, enabling real\u2010time basecalling for selective enrichment of regions of interest via \u201cadaptive sampling.\u201d Nanopore sequencing of Raw DNA with Adaptive sampling for Prompt Integrated Diagnosis (Nano\u2010RAPID) was developed to test its diagnostic utility. This study included 22 retrospective and nine prospective cases. DNA extracted from fresh\/frozen tissue was sequenced for 46\u201398\u2009h, followed by approximately 12\u2009h of data analysis. Consequently, disease\u2010specific\/characteristic fusion genes were detected in 10 retrospective and six prospective cases. Disease\u2010specific single nucleotide variants were detected in three cases, while disease\u2010specific amplifications were detected in two retrospective cases. Monosomy, trisomy, and chromosomal instability were also detected. Methylation analyses accurately classified 15 retrospective and five prospective cases. Collectively, correct tumor types were identified using at least one modality in 19 retrospective and nine prospective cases. Halving the consumables and re\u2010analyzing 24\u2010h data yielded nearly equivalent results, suggesting faster and cost\u2010effective analyses. In conclusion, Nano\u2010RAPID may be a promising adjunctive for sarcoma diagnosis. Nano\u2010RAPID could be introduced in low\u2010equipped hospitals to assist non\u2010specialized pathologists diagnosing sarcoma. Since this study remains exploratory, further studies with larger cohort should be needed.<\/jats:p>","DOI":"10.1002\/gcc.70174","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:32:32Z","timestamp":1789648352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nano\u2010\n                    <scp>RAPID<\/scp>\n                    : Integrated Diagnosis for Sarcoma Using a Nanopore Sequencer"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6991-747X","authenticated-orcid":false,"given":"Naohiro","family":"Makise","sequence":"first","affiliation":[{"name":"Division of Surgical Pathology Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8086-3185","authenticated-orcid":false,"given":"Jason","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cell Therapy Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Cell Therapy Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Kageyama","sequence":"additional","affiliation":[{"name":"Division of Surgical Pathology Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1410-9862","authenticated-orcid":false,"given":"Ryuta","family":"Kojima","sequence":"additional","affiliation":[{"name":"Division of Cell Therapy Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0515-088X","authenticated-orcid":false,"given":"Hideyuki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Kamoda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Oikawa","sequence":"additional","affiliation":[{"name":"Division of Surgical Pathology Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Division of Surgical Pathology Chiba Cancer Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinobu","family":"Araki","sequence":"additional","affiliation":[{"name":"Division of Surgical 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