MIB1 as a possible predictor of recurrence in low-grade endometrial stromal sarcoma of the uterus.
OBJECTIVE
Immunohistochemical analysis of MIB1, p53, estrogen, and progesterone receptors can provide prognostic information in endometrial adenocarcinoma. Since predictors of recurrence for low-grade endometrial stromal sarcoma (LESS) are still unknown, a battery of immunostains was performed to find markers, which might be useful to predict prognosis.


METHODS
Eleven patients with an average age of 43.8 years (range 27-76) were identified with stage I LESS. Immunostains, including MIB1, p53, ER, and PR, were evaluated by two pathologists, independently.


RESULTS
All tumors were positive for ER and PR; 1/11 was positive for p53; MIB1 ranged from 0 to 20% positive tumor nuclei. Mitotic counts ranged from 0 to 7/10 hpf. Two patients developed recurrences. One had a pelvic recurrence 7 years after diagnosis. This tumor had a mitotic count of 1/10 hpf, MIB1 expression in 10% of nuclei, and focal p53 expression. A second patient developed pulmonary metastases 10.8 years after diagnosis; the tumor showed a mitotic count of 7/10 hpf and MIB1 expression in 20% of nuclei, but was negative for p53. There was a significant difference in MIB1 reactivity scores between patients who did or did not develop recurrence (P = 0.0303). A marginally significant association was detected between MIB1 (P = 0.0896) or p53 (P = 0.0833) positivity and length of recurrence-free survival.


CONCLUSIONS
Although MIB1 and p53 appear to be useful prognostic markers, a larger study would be necessary to confirm their validity.
Popiolek
Dorota
D
New York University School of Medicine, New York, NY 10016, USA. dorota.popiolek@med.nyu.edu
Yee
Herman
H
Levine
Pascale
P
Vamvakas
Eleftherios
E
Demopoulos
Rita I
RI
D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000096:biosynthesis*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D018203:Sarcoma, Endometrial Stromal / Q000378:metabolism* / Q000473:pathology
D019394:Ki-67 Antigen