Endometrial Stromal Sarcomas and Related High-grade Sarcomas: Immunohistochemical and Molecular Genetic Study of 31 Cases
- 1 August 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Surgical Pathology
- Vol. 32 (8), 1228-1238
- https://doi.org/10.1097/pas.0b013e31816a3b42
Abstract
Classification and terminology of non–low-grade endometrial sarcomas, which show significant nuclear atypia, have been controversial. Currently, these tumors seem to be classified all together into “undifferentiated endometrial sarcoma (UES).” However, it remains unclear whether these non–low-grade sarcomas are universally “undifferentiated.” We divided these sarcomas morphologically into undifferentiated endometrial sarcoma with nuclear uniformity (UES-U) and undifferentiated endometrial sarcoma with nuclear pleomorphism (UES-P), and compared their molecular genetic and immunohistochemical profiles. Eighteen low-grade endometrial stromal sarcomas (ESS-LG), 7 UES-U, and 6 UES-P were examined. All the patients with ESS-LG were still alive, either with or without disease, whereas 4 of the 5 patients with advanced stage UES-U and all 3 of the patients with advanced stage UES-P had died of the disease. JAZF1-JJAZ1 fusion transcript was detected in 6 (50%) out of 12 ESS-LG and in 1 (33%) of 3 UES-U, whereas it was not detected in any of the cases of UES-P. ESS-LG and UES-U frequently showed positive immunoreaction for estrogen receptor (ESS-LG: 94%, UES-U: 57%) and progesterone receptor (ESS-LG: 94%, UES-U: 57%), whereas all the UES-P were negative for these receptors. Nuclear β-catenin expression was more frequently recognized in ESS-LG (47%) and UES-U (85%), compared with UES-P (33%). Moreover, nuclear accumulation of p53 and TP53 gene missense mutations were limited to 3 UES-P cases. Our data suggest that UES-U shares some molecular genetic and immunohistochemical characteristics with ESS-LG, but UES-P considerably differs from ESS-LG.Keywords
This publication has 22 references indexed in Scilit:
- Transition of endometrial stromal sarcoma into high-grade sarcomaGynecologic Oncology, 2006
- JAZF1/JJAZ1 Gene Fusion in Endometrial Stromal Sarcomas: Molecular Analysis by Reverse Transcriptase-Polymerase Chain Reaction Optimized for Paraffin-Embedded TissueThe Journal of Molecular Diagnostics, 2005
- Distinction of endometrial stromal sarcomas from ‘hemangiopericytomatous’ tumors using a panel of immunohistochemical stainsLaboratory Investigation, 2005
- Inverse correlation of secreted frizzled‐related protein 4 and β‐catenin expression in endometrial stromal sarcomasThe Journal of Pathology, 2004
- Expression of Progesterone Receptor A and B Isoforms in Low-grade Endometrial Stromal SarcomaInternational Journal of Gynecological Pathology, 2004
- Mechanisms of sarcoma developmentNature Reviews Cancer, 2003
- Utility of CD10 in Distinguishing between Endometrial Stromal Sarcoma and Uterine Smooth Muscle Tumors: An Immunohistochemical Comparison of 34 CasesLaboratory Investigation, 2001
- Estrogen Receptor Status by Immunohistochemistry Is Superior to the Ligand-Binding Assay for Predicting Response to Adjuvant Endocrine Therapy in Breast CancerJournal of Clinical Oncology, 1999
- Mixed low grade and high grade endometrial stromal sarcoma of uterus: differences on immunohistochemistry and chromosome in situ hybridisation.Journal of Clinical Pathology, 1996
- Primary Uterine Endometrial Stromal NeoplasmsThe American Journal of Surgical Pathology, 1990