P16, Ki67, P53, and WT1 Expression in Uterine Smooth Muscle Tumors: An Adjunct in Confirming the Diagnosis of Malignancy in Ambiguous Cases.
Biomarkers, Tumor
/ metabolism
Cyclin-Dependent Kinase Inhibitor p16
/ metabolism
Female
Humans
Immunohistochemistry
Ki-67 Antigen
/ metabolism
Leiomyoma
/ diagnosis
Leiomyosarcoma
/ diagnosis
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Smooth Muscle Tumor
/ diagnosis
Tumor Suppressor Protein p53
/ metabolism
Uterine Neoplasms
/ diagnosis
Uterus
/ pathology
WT1 Proteins
/ metabolism
Journal
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
ISSN: 1538-7151
Titre abrégé: Int J Gynecol Pathol
Pays: United States
ID NLM: 8214845
Informations de publication
Date de publication:
01 May 2021
01 May 2021
Historique:
pubmed:
9
9
2020
medline:
9
11
2021
entrez:
8
9
2020
Statut:
ppublish
Résumé
The diagnosis of uterine smooth muscle tumors is sometimes difficult, as these tumors may show worrisome features, suspicious for but not diagnostic of malignancy. The recommended immunohistochemical panel in this setting is currently under debate. In this study, we aimed to find a panel of immunohistochemical stains that would be helpful in determining the correct diagnosis in ambiguous uterine smooth muscle tumors, with an emphasis on investigating the possible usefulness of the WT1 antibody. Uterine leiomyomas were found to be immunoreactive with WT1. Since a previous study reported on the lack of immunoreactivity of uterine leiomyosarcomas with WT1, we speculated that WT1 might be useful in this setting. We retrospectively reviewed the medical charts and slides of 91 patients: 22 with leiomyosarcoma, 15 with smooth muscle tumor of uncertain malignant potential, and 54 with leiomyoma. Immunohistochemical stains for WT1, p16, p53, and Ki67 were performed on each case. We found that immunoreactivity with p16 and Ki67 (>40% and >10% of the tumor cells, respectively) and loss of nuclear expression of WT1 (<10% of the tumor cells) were significantly more common in leiomyosarcomas (all P<0.001). Mutated p53 immunohistochemical staining pattern was significantly more prevalent in leiomyosarcomas than in leiomyomas (P<0.001). Thus, in diagnostically challenging uterine smooth muscle tumors, we recommend using an immunohistochemical panel composed of Ki67, p16, p53, and WT1. A positive result in either of the former 2 (p16 >40% and/or Ki67 >10%) has the strongest association with leiomyosarcoma (sensitivity: 95.5%, specificity=88.9%, positive predictive value=77.8%, negative predictive value=98.0%).
Identifiants
pubmed: 32897968
pii: 00004347-202105000-00008
doi: 10.1097/PGP.0000000000000688
doi:
Substances chimiques
Biomarkers, Tumor
0
CDKN2A protein, human
0
Cyclin-Dependent Kinase Inhibitor p16
0
Ki-67 Antigen
0
MKI67 protein, human
0
TP53 protein, human
0
Tumor Suppressor Protein p53
0
WT1 Proteins
0
WT1 protein, human
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
257-262Informations de copyright
Copyright © 2020 by the International Society of Gynecological Pathologists.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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