Liquid Biopsy as a Tool for Differentiation of Leiomyomas and Sarcomas of Corpus Uteri

Abstract

Utilization of liquid biopsy in the management of cancerous diseases is becoming more attractive. This method can overcome typical limitations of tissue biopsies, especially invasiveness, no repeatability, and the inability to monitor responses to medication during treatment as well as condition during follow-up. Liquid biopsy also provides greater possibility of early prediction of cancer presence. Corpus uteri mesenchymal tumors are comprised of benign variants, which are mostly leiomyomas, but also a heterogenous group of malignant sarcomas. Pre-surgical differentiation between these tumors is very difficult and the final description of tumor characteristics usually requires excision and histological examination. The leiomyomas and malignant leiomyosarcomas are especially difficult to distinguish and can, therefore, be easily misdiagnosed. Because of the very aggressive character of sarcomas, liquid biopsy based on early diagnosis and differentiation of these tumors would be extremely helpful. Moreover, after excision of the tumor, liquid biopsy can contribute to an increased knowledge of sarcoma behavior at the molecular level, especially on the formation of metastases which is still not well understood. In this review, we summarize the most important knowledge of mesenchymal uterine tumors, the possibilities and benefits of liquid biopsy utilization, the types of molecules and cells that can be analyzed with this approach, and the possibility of their isolation and capture. Finally, we review the typical abnormalities of leiomyomas and sarcomas that can be searched and analyzed in liquid biopsy samples with the final aim to pre-surgically differentiate between benign and malignant mesenchymal tumors.

The Role of miRNA and Related Pathways in Pathophysiology of Uterine Fibroids—From Bench to Bedside

“…Dvorska et al (2019) [118] found it intriguing that there is no great interest in developing good quality techniques that could differentiate benign UFs and malignant LMSs. The main reason could be related to the very low incidence of these malignant lesions [118].…”

“…Dvorska et al (2019) [118] found it intriguing that there is no great interest in developing good quality techniques that could differentiate benign UFs and malignant LMSs. The main reason could be related to the very low incidence of these malignant lesions [118]. Nowadays, one of the biggest concerns for surgeons operating on women with UFs is the potential intra-operative fragmentation of LMS during laparoscopic surgery, which may cause intraabdominal spread of malignant cells [119].…”

Identification of Subtype-Specific Metastasis-Related Genetic Signatures in Sarcoma

“…Accurate identification and classification are crucial for successful treatment as responses to specific therapies vary widely among tumor types of different origin and misdiagnosis may lead to poor treatment outcomes ( 5 ). However, due to overlap in histopathological features among sarcoma and the existence of multiple subtypes or variations in a single histology, pathologists and clinicians increasingly rely on molecular diagnostic methods ( 6 , 7 ).…”

Cell-Free Nucleic Acids

“…This Special Issue contains eight original research studies [20,21,22,23,24,25,26,27], and five review papers [28,29,30,31,32]; the diversity of the papers demonstrates how many different topics are covered by cell-free nucleic acid research.…”

“…Dvorska et al reviewed the utility of liquid biopsy as a tool for the differentiation of leiomyomas and sarcomas of corpus uteri [30]. They collected the most important knowledge of mesenchymal uterine tumors and showed the benefits of liquid biopsy [30].…”