title: Immunohistochemical panel to differentiate endometrial stromal sarcoma, uterine leiomyosarcoma and leiomyoma: something old and something new.
abstract: OBJECTIVE
  To evaluate an immunohistochemical panel differentiating endometrial stromal sarcoma (ESS) from uterine leiomyosarcoma (ULMS) and leiomyoma (LM).
  
  
  METHODS
  94 cases (28 ESS, 41 ULMS, 25 LM) were retrieved and arrayed. 10 immunomarkers (estrogen receptor (ER), progesterone receptor (PR), CD10, smooth muscle actin, desmin, h-caldesmon, transgelin, GEM, ASC1, stathmin1) were used. A predictive model was constructed and examined by receiver operating characteristics curve analysis to determine area under the curve (AUC).
  
  
  RESULTS
  The combination of ER(+)/PR(+)/CD10(+)/GEM(-)/h-caldesmon(-)/transgelin(-) can predict ESS versus ULMS with AUC predictive value of 0.872 (95% CI 0.784 to 0.961, p<0.0001). The combination of ER(+)/PR(+)/CD10(+)/h-caldesmon(-)/transgelin(-) can predict low grade (LG) ESS from 'LG' ULMS with AUC predictive value of 0.914 (95% CI 0.832 to 0.995, p<0.0001). Finally, ULMS and ESS, including the LGs, were more likely to be stathmin1(+) than LM.
  
  
  CONCLUSIONS
  Due to the different clinical course and management, adding novel antibodies (GEM, transgelin) to the well established immunohistochemistry panel seemed to be useful in distinguishing ESS from ULMS and LG ESS from 'LG' ULMS. Finally, stathmin1 expression could be of value in differentiating LM from uterine sarcomas.
authors.affiliation: Department of Anatomic Pathology, University of Texas at Dallas, Dallas, Texas, USA.
authors.forename: Helena
authors.initials: H
authors.lastname: Hwang
authors.affiliation: Division of Gynecology Oncology, Departments of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Surgical Pathology, University of Southern California, Los Angeles, California, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Duncan
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Elham
authors.initials: E
authors.lastname: Pakzamir
authors.affiliation: Division of Gynecology Oncology, Departments of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.
authors.forename: Huyen Q
authors.initials: HQ
authors.lastname: Pham
authors.affiliation: Department of Surgical Pathology, University of Southern California, Los Angeles, California, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Correa
authors.affiliation: Department of Surgical Pathology, University of Southern California, Los Angeles, California, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Fedenko
authors.affiliation: Department of Surgical Pathology, University of Southern California, Los Angeles, California, USA.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mhawech-Fauceglia
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis* / Q000378:metabolism; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000378:metabolism; D012372:ROC Curve; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000378:metabolism; D046888:Tissue Array Analysis; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor
keywords: DIAGNOSIS; ENDOMETRIUM; IMMUNOCYTOCHEMISTRY; SARCOMAS