Rola badań immunohistochemicznych w diagnostyce mięsaka gladkokomórkowego macicy

Abstract

Author(s): Ewelina Wawryk-Gawda, Barbara Jodlowska-Jędrych

Uterine leiomyosarcoma is rare, representing 2- 6% of all uterine neoplasms. Most occur in women over 40 years of age. The histopathologic diagnosis is based on the microscopic constellation of hypercellularity, severe nuclear atypia, coagulative necrosis and high mitotic rate. Leiomyosarcoma is one of the mesenchymal tumors of the uterus. Into this group fall also endometrial stromal sarcoma, leiomyoma, smooth muscle tumour of uncertain malignant potential, malignant mixed Mullerian tumor and carcinosarcoma. The distinction between these tumors may at times be problematic cause of their similar microscopic building. It would be useful to have additional markers to distinguish among these neoplasms. Immunohistochemical studies of oncoproteins will undoubtedly lead to an accurate and prognostically relevant classification of these tumors. A lot of studies were undertaken to evaluate the utility of selected immunohistochemical markers in differentiating mesenchymal tumors. Results demonstrate that the significantly elevated expression of certain antigens (p53, Ki-67, Mdm2, MPM), may be useful to distinguish between cases of malignant smooth muscle tumors and those of borderline histology. Most types of uterine sarcomas have a poor prognosis. The conventional chemotherapy in leiomyosarcomas appears to be ineffective for some patients. In these women, new therapeutic strategies are warranted. Research demonstrate that uterine leiomyosarcomas express c-KIT, so the treatment with tyrosine kinase inhibitors in leiomyosarcoma patients might be hypothesized. Moreover leiomyosarcomas in occasional cases show positive staining for estrogen and progesterone receptors, hormonal manipulation in these cases may be helpful in controlling these tumors. Scientists suggest that clinical trials with innovative therapeutic method are needed in these aggressive and chemoresistant tumors.

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Editors List

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

  • Krzysztof Urbanski

    Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)

  • Andrzej Szawlowski

    Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)

  • Skowronska-Gardas

    Department of Radiotherapy, Oncology Center-Institute (Warsaw, Poland)

  • Serban-Dan Costa

    Head of the Obstetrics and Gynecology Clinic of the University of Otto von Guericke (Magdeburg, Germany)