Abstract |
Uterine leiomyosarcomas (LMS) are difficult to distinguish from benign leiomyomas without surgery. In this study we performed transcervical needle biopsy on 475 patients, 8 LMS patients and 467 patients with non- sarcomas (non-LMS) in a high-risk group for LMS, and evaluated whether examinations performed with Ki-67 and CD34 immunohistochemical analyses in addition to the standard hematoxylin- eosin (H&E)-stained sections would improve preoperative diagnostic precision of the uterine smooth muscle tumors. Histopathologic analysis included three factors: degree of cytologic atypia, mitotic index and coagulative tumor cell necrosis (CTCN). We also evaluated cell proliferation with Ki-67 expression. In cases of suspected CTCN, we examined CD34 expression and counted positive blood vessels in the necrotic area. Three of the 8 LMS cases satisfied the diagnostic criteria of LMS by histopathologic evaluation with H&E-stained sections. We made a score list based on these analyses; scores for LMS specimens ranged from 6-14 points; non-LMS specimens scored 0-2 points. At the cut-off score of 6 points, the positive predictive value to distinguish LMS from non-LMS was 100%, showing that this scoring system, is a useful method for preoperative differentiation between LMS and non-LMS tumors.
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Authors | Chika Yoshida, Tomoyuki Ichimura, Naoki Kawamura, Akemi Nakano, Mari Kasai, Toshiyuki Sumi, Osamu Ishiko |
Journal | Oncology reports
(Oncol Rep)
Vol. 22
Issue 4
Pg. 725-31
(Oct 2009)
ISSN: 1021-335X [Print] Greece |
PMID | 19724849
(Publication Type: Journal Article)
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Chemical References |
- Antigens, CD34
- Ki-67 Antigen
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Topics |
- Antigens, CD34
(metabolism)
- Biopsy, Needle
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- Ki-67 Antigen
(metabolism)
- Leiomyoma
(pathology)
- Leiomyosarcoma
(diagnosis, metabolism)
- Middle Aged
- Mitotic Index
- ROC Curve
- Sensitivity and Specificity
- Uterine Neoplasms
(diagnosis, metabolism)
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