title: Endometrial stromal sarcoma: clinicopathological and immunophenotypic study of 16 cases.
abstract: OBJECTIVE
  Endometrial stromal sarcomas (ESSs) are rare tumors and are divided into two groups: low-grade endometrial stromal sarcoma (ESS-LG) and undifferentiated endometrial sarcoma (UES). The purpose of this study was to compare the clinicopathological features and immunophenotypes of ESS-LG and UES.
  
  
  METHODS
  The authors evaluated 16 patients diagnosed with ESS at the Hyogo Cancer Center, reviewed their files and data, and performed an immunohistochemical study for oncogenic proteins (EGFR, PDGFR-α, and PDGFR-β) and cell cycle regulators (cyclin D1, cyclin E, p16(INK4a), p21(cip1), p27(kip1), and p53) to compare ESS-LG and UES using the World Health Organization (WHO) classification.
  
  
  RESULTS
  Four cases (25 %) were classified as ESS-LGs and 12 (75 %) as UES. Patients with UES had a significantly worse overall survival than did those with ESS-LG (p = 0.0445). Although no ESS-LGs showed expression of p16(INK4a), 10 of 12 (83 %) UESs showed expression of p16(INK4a). UESs showed a trend toward higher expression of cyclin D1, p21(cip1), and p53 compared with ESS-LGs.
  
  
  CONCLUSIONS
  Our data emphasize the clinical importance of the WHO classification of ESS. It is of utmost importance to establish a proper classification to increase the consistency of data that may be useful for improving clinical and therapeutic management of patients with ESS.
authors: Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, 6738558, Japan.
authors: Shin-ichi
authors: S
authors: Iwasaki
authors: Tamotsu
authors: T
authors: Sudo
authors: Maiko
authors: M
authors: Miwa
authors: Masayo
authors: M
authors: Ukita
authors: Akemi
authors: A
authors: Morimoto
authors: Masaru
authors: M
authors: Tamada
authors: Sayaka
authors: S
authors: Ueno
authors: Senn
authors: S
authors: Wakahashi
authors: Satoshi
authors: S
authors: Yamaguchi
authors: Kiyoshi
authors: K
authors: Fujiwara
authors: Yoshiko
authors: Y
authors: Sakuma
authors: Yoshiki
authors: Y
authors: Mikami
authors: Ryuichiro
authors: R
authors: Nishimura
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D019938:Cyclin D1 / Q000378:metabolism; D019927:Cyclin E / Q000378:metabolism; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000378:metabolism; D050760:Cyclin-Dependent Kinase Inhibitor p27 / Q000378:metabolism; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D036821:Endometrial Stromal Tumors / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008875:Middle Aged; D060787:Neoplasm Grading; D010052:Ovariectomy; D020796:Receptor, Platelet-Derived Growth Factor alpha / Q000378:metabolism; D020797:Receptor, Platelet-Derived Growth Factor beta / Q000378:metabolism; D058994:Salpingectomy; D012509:Sarcoma / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D018709:Statistics, Nonparametric; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: C493956:CDKN1A protein, human; D019927:Cyclin E; D019941:Cyclin-Dependent Kinase Inhibitor p16; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016159:Tumor Suppressor Protein p53; D019938:Cyclin D1; D050760:Cyclin-Dependent Kinase Inhibitor p27; D066246:ErbB Receptors; D020796:Receptor, Platelet-Derived Growth Factor alpha; D020797:Receptor, Platelet-Derived Growth Factor beta