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J Clin Pathol. 2015 Sep;68(9):710-7. doi: 10.1136/jclinpath-2015-202915. Epub 2015 May 19.

Immunohistochemical panel to differentiate endometrial stromal sarcoma, uterine leiomyosarcoma and leiomyoma: something old and something new.

Author information

1
Department of Anatomic Pathology, University of Texas at Dallas, Dallas, Texas, USA.
2
Division of Gynecology Oncology, Departments of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.
3
Department of Surgical Pathology, University of Southern California, Los Angeles, California, USA.
4
Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.

Abstract

AIMS:

To evaluate an immunohistochemical panel differentiating endometrial stromal sarcoma (ESS) from uterine leiomyosarcoma (ULMS) and leiomyoma (LM).

METHODS:

94 cases (28 ESS, 41 ULMS, 25 LM) were retrieved and arrayed. 10 immunomarkers (estrogen receptor (ER), progesterone receptor (PR), CD10, smooth muscle actin, desmin, h-caldesmon, transgelin, GEM, ASC1, stathmin1) were used. A predictive model was constructed and examined by receiver operating characteristics curve analysis to determine area under the curve (AUC).

RESULTS:

The combination of ER(+)/PR(+)/CD10(+)/GEM(-)/h-caldesmon(-)/transgelin(-) can predict ESS versus ULMS with AUC predictive value of 0.872 (95% CI 0.784 to 0.961, p<0.0001). The combination of ER(+)/PR(+)/CD10(+)/h-caldesmon(-)/transgelin(-) can predict low grade (LG) ESS from 'LG' ULMS with AUC predictive value of 0.914 (95% CI 0.832 to 0.995, p<0.0001). Finally, ULMS and ESS, including the LGs, were more likely to be stathmin1(+) than LM.

CONCLUSIONS:

Due to the different clinical course and management, adding novel antibodies (GEM, transgelin) to the well established immunohistochemistry panel seemed to be useful in distinguishing ESS from ULMS and LG ESS from 'LG' ULMS. Finally, stathmin1 expression could be of value in differentiating LM from uterine sarcomas.

KEYWORDS:

DIAGNOSIS; ENDOMETRIUM; IMMUNOCYTOCHEMISTRY; SARCOMAS

PMID:
25991737
DOI:
10.1136/jclinpath-2015-202915
[Indexed for MEDLINE]

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