title: Molecular characterization of a population-based series of endometrial stromal sarcomas in Kuwait.
abstract: Endometrial stromal sarcomas (ESSs) frequently harbor genetic fusions, including JAZF1-SUZ12 and equivalent fusions in low-grade ESS (LGESS) and YWHAE-NUTM2 in high-grade ESS (HGESS). This study aims to classify a population-based series of ESSs in Kuwait based on the 2014 World Health Organization classification system and to assess the diagnostic use of interferon-induced transmembrane protein 1 (IFITM1) immunomarker for ESSs. Twenty ESSs including 19 LGESSs and 1 HGESS treated during the period between 2002 and 2013 were identified, and the cases were reviewed and characterized using fluorescence in situ hybridization and immunohistochemical studies. Thirteen (81.3%) of 16 LGESSs with interpretable results showed JAZF1 and/or PHF1 genetic rearrangements by fluorescence in situ hybridization, and the only HGESS in the series showed YWHAE genetic rearrangement. All LGESSs with interpretable results showed positive immunostaining for CD10 compared with 11 (61%) of 18 that showed positive immunostaining for IFITM1; 4 of 7 IFITM1-negative LGESSs showed JAZF1 and/or PHF1 rearrangements. A series of uterine leiomyomas, leiomyosarcomas, adenosarcomas, and carcinosarcomas were included for comparison, and positive IFITM1 staining was found in 1 of 10 leiomyomas, 3 of 13 leiomyosarcomas, 3 of 4 adenosarcomas, and 3 of 8 carcinosarcomas, compared to 0 of 10 leiomyomas, 9 of 13 leiomyosarcomas, 3 of 4 adenosarcomas, and 5 of 8 carcinosarcomas that were positive for CD10. Our results demonstrated characteristic genetic rearrangements in a high percentage of LGESSs in this Middle Eastern population, and IFITM1 antibody appears to be less sensitive than CD10 for LGESS.
authors.affiliation: Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait. Electronic address: rolapath@hotmail.com.
authors.forename: Rola H
authors.initials: RH
authors.lastname: Ali
authors.affiliation: Department of Pathology, Maternity Hospital, Safat 13001, Kuwait.
authors.forename: Remaa
authors.initials: R
authors.lastname: Al-Safi
authors.affiliation: Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait.
authors.forename: Salah
authors.initials: S
authors.lastname: Al-Waheeb
authors.affiliation: Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait.
authors.forename: Bency
authors.initials: B
authors.lastname: John
authors.affiliation: Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait.
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-Ali
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait.
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-Jassar
authors.affiliation: Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat 13110, Kuwait.
authors.forename: Fahd
authors.initials: F
authors.lastname: Al-Mulla
authors.affiliation: Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, BC V5Z 4E6, Canada.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Melnyk
authors.affiliation: Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, BC V5Z 4E6, Canada.
authors.forename: David G
authors.initials: DG
authors.lastname: Huntsman
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Alberta and Royal Alexandra Hospital, Edmonton, AB T5H 3V9, Canada.
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007730:Kuwait; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000235:genetics / Q000378:metabolism*; D018203:Sarcoma, Endometrial Stromal / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D015514:Oncogene Proteins, Fusion
keywords: Endometrial stromal sarcoma; FISH; Genetic fusion; IFITM1; JAZF1; YWHAE