Immunohistochemistry (Ki‐67 and p53) as a tool in determining malignancy in smooth muscle neoplasms (exemplified by a myxoid leiomyosarcoma of the uterus)

Abstract

Sprogere-Jakobsen, S. & Herlund, B. Immunohistochemistry (Ki-67 and p53) as a tool in determining malignancy in smooth muscle neoplasms (exemplified by a myxoid leiomyosarcoma of the uterus).Smooth muscle tumours of the uterus at times represent a problem as it may be difficult to distinguish between benign and malignant tumours.The myxoid leiomyosarcoma (a rare type of neoplasm) reported here is an example of this. We present a case history and examine the suitability of Ki-67 and p53 as indicators of malignancy. The two antibodies were tested on seven leiomyomas, three atypical (borderline) leiomyomas, seven leiomyosarcomas and the myxoid leiomyosarcoma using microwave oven antigen retrieval. The leiomyomas had the lowest and the leiomyosarcomas the highest proliferation rate. The leiomyomas had no expression of p53, the atypical leiomyomas had a few scattered positive nuclei, and 517 of the leiomyosarcomas had overexpression of p53. The myxoid leiomyosarcoma had a positive reaction for p53 in clusters. The results suggest that Ki-67 and p53 might be useful as indicators of malignancy.

A new scoring system using multiple immunohistochemical markers for diagnosis of uterine smooth muscle tumors

“…A significant correlation was found between the mitotic rate, the mitotic index and Ki-67 in cases of LMS [14]. Our results are in agreement with other previous studies which report increased Ki-67 expression in uterine LMS in contrast to leiomyomas [1,14,15].…”

“…Proliferation markers AgNOR, Ki-67, p53 protein expression, and expression of the oncogene bcl-2 all have been studied in an attempt to improve prognostication for these neoplasms [12][13][14][15][16][17].…”

“…In general, the proliferation markers AgNOR, and Ki-67 (MIB-1) have shown significant differences between mean values for LMS and benign smooth muscle tumors [1,[12][13][14][15][16]. The results of p53 analysis have been variable with the predominance of data supporting a diagnostic utility for this marker [1,5,14,17].…”

“…The results of p53 analysis have been variable with the predominance of data supporting a diagnostic utility for this marker [1,5,14,17]. There is limited information about bcl-2.…”

Targeted genomic analysis of Müllerian adenosarcoma

“…This suggests that MAs with SO accumulate many, if not most, of the genetic changes relatively early in their natural history, which has both diagnostic and prognostic implications. TP53 mutations are common in sarcomas of the female reproductive tract, particularly uterine carcinosarcoma [32][33][34] and leiomyosarcoma [33][34][35][36]; however, TP53 mutations are uncommon in MA (11%), and when present, are associated with SO and a more aggressive clinical course. In particular, one tumour harbouring a TP53 mutation (case 8) metastasized to the lung.…”