The role of fibroblast growth factor 2 in patients with uterine smooth muscle tumors: an immunohistochemical study.
OBJECTIVE
Fibroblast growth factor 2 (FGF-2) is considered to be a potent stimulator of angiogenesis and seems therefore to play an important role in the growth of tumors. We compared the immunohistochemical profile of FGF-2 in patients with uterine leiomyomas, smooth muscle tumors of uncertain malignant potential (STUMP) and leiomyosarcoma (LMS). Furthermore, we tried to clarify the prognostic role of FGF-2 in uterine leiomyosarcoma.


METHODS
FGF-2 expression was investigated by immunohistochemistry from paraffin-embedded tissue in 26 patients with leiomyoma, in 24 cases with STUMP and in 21 patients with LMS. The immunohistochemical profile of these 3 tumor entities was compared and regarding LMS correlated with different clinicopathologic parameters.


RESULTS
FGF-2 was expressed in 85% of leiomyomas, in 88% of STUMP and in 57% of LMS. Significant differences regarding the frequency of FGF-2 expression were observed between leiomyoma and LMS as well as between STUMP and LMS (p<0.05). In uterine LMS FGF-2 expression was statistically more frequent in cases with high histological grade (p<0.05). Furthermore, FGF-2 positive tumors demonstrated a statistically significant higher rate of recurrence disease and tumor progression (p=0.005). Disease free as well as overall survival was significantly shortened in patients with FGF-2 positive compared to FGF-2 negative tumors (p<0.05).


CONCLUSIONS
The significant correlation between FGF-2 expression and high histological grade indicates that FGF-2 might work as a negative predictive factor. Higher rates of recurrence disease as well as shortened disease free and overall survival among FGF-2 positive LMS support the potential role as prognosticator for poor clinical outcome.
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria. Electronic address: Barbara.Bodner-Adler@meduniwien.ac.at.
Barbara
B
Bodner-Adler
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Klaus
K
Mayerhofer
Department of Gynecopathology, Medical University of Vienna, Vienna, Austria.
Klaus
K
Czerwenka
Department of Anesthesiology, Medical University of Vienna, Vienna, Austria; Outcomes Research Consortium, Cleveland, OH, USA.
Oliver
O
Kimberger
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Heinz
H
Koelbl
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Klaus
K
Bodner
D001317:Austria; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism*; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007044:Hysterectomy; D018231:Leiomyomatosis / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009215:Myometrium / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D060787:Neoplasm Grading; D009363:Neoplasm Proteins / Q000378:metabolism*; D009367:Neoplasm Staging; D009775:Obstetrics and Gynecology Department, Hospital; D010052:Ovariectomy; D011379:Prognosis; D012189:Retrospective Studies; D012489:Salpingostomy; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000378:metabolism / Q000473:pathology
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D016222:Fibroblast Growth Factor 2
Clinicopathologic parameters; FGF-2 expression; Immunohistochemistry; Prognosis; Uterine smooth muscle tumors