Specificity of the lactate dehydrogenase isoenzyme index as a preoperative screen for uterine sarcoma before myomectomy

Spivack, Lauren E.; Glantz, J. Christopher; Lennon, Clare; Bhagavath, Bala

doi:10.1016/j.fertnstert.2020.07.020

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Spivack et al determined the UMG index cutoff of 29 had a high specificity of 91.1% and could be a cost-effective tool for preoperative screening for LMS. 56 However, it should be noted that higher BMI may be related to the increase of UMG index. It is worth noting that liquid biopsies can be very helpful in early diagnosis and differential diagnosis owing to the aggressive nature of LMS.…”

Section: Different Diagnostic Tools For Lbnmentioning

confidence: 99%

Leiomyoma with Bizarre Nuclei: A Current Update

Guo¹,

Li²,

Hu³

et al. 2022

IJWH

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Leiomyoma with bizarre nuclei (LBN), also known as symplastic leiomyoma, is a histological subtype of benign leiomyoma with bizarre cells and nuclear atypia. Differentiating LBN from other benign leiomyoma subtypes, uterine smooth muscle tumors of uncertain malignant potential (STUMP), or leiomyosarcoma (LMS) can be diagnostically challenging owing to overlapping features in clinical presentation and pathologic morphological analysis. The difficulty of distinguishing LBN from other lesions, especially from LMS, and the potential of LBN for subsequent malignant transformation make LBN an important topic of research. Herein, we review the definition, diagnosis, treatment, and prognosis of LBN. Histopathological examination is essential for distinguishing LBN from other diseases. Pathology sampling and morphological examination remain the key to diagnosis. The newly established ancillary immunohistochemical (IHC) and molecular genetic analysis can be useful tools for differential diagnosis. Furthermore, serum biomarkers and imaging examination may also be useful diagnostic tools. Attention should be paid to the differentiation between LBN and LMS because morphological diagnosis may still be challenging in some cases. Some IHC markers of LBN have been identified, which may be helpful for differential diagnosis. Furthermore, the use of IHC panels as diagnostic markers may be advocated. Molecular genetic studies suggest that some genes can aid with the differential diagnosis between LBN and LMS. However, increasing evidence support the idea that LBN and LMS are molecularly related, indicating that LBN may represent a potentially malignant stage of precancerous progression. At present, conservative treatment is recommended for primary LBN, especially for patients desiring to retain fertility, but close follow-up with imaging examinations is required.

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Section: Different Diagnostic Tools For Lbnmentioning

confidence: 99%

Leiomyoma with Bizarre Nuclei: A Current Update

Guo¹,

Li²,

Hu³

et al. 2022

IJWH

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“…Uterine sarcomas likely occur when the UMG index is ≥29. In 2020, Lauren et al [ 25 ] validated the U.M.G. index in 179 patients with uterine fibroids, obtained 91.1% specificity, and found that obese women had a higher false-positivity rate than non-obese women.…”

Section: Laboratory Testsmentioning

confidence: 99%

Advances in the Preoperative Identification of Uterine Sarcoma

Liu

Wang

2022

Cancers

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Uterine sarcomas are rare malignant tumors of the uterus with a high degree of malignancy. Their clinical manifestations, imaging examination findings, and laboratory test results overlap with those of uterine fibroids. No reliable diagnostic criteria can distinguish uterine sarcomas from other uterine tumors, and the final diagnosis is usually only made after surgery based on histopathological evaluation. Conservative or minimally invasive treatment of patients with uterine sarcomas misdiagnosed preoperatively as uterine fibroids will shorten patient survival. Herein, we will summarize recent advances in the preoperative diagnosis of uterine sarcomas, including epidemiology and clinical manifestations, laboratory tests, imaging examinations, radiomics and machine learning-related methods, preoperative biopsy, integrated model and other relevant emerging technologies.

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“…Thus, a combination of a nontypical fibroid on MRI plus an elevated biomarker might be a reason to proceed to surgery when otherwise observation might be counseled. Because much of the diagnostic uncertainty around MRI for sarcomas centers on differentiating a sarcoma from a degenerating fibroid, the fact that the UMG index is not impacted by degenerating fibroids is a particular benefit (2,4). However promising the results of these preliminary works, at present the data supporting the use of UMG index is not robust enough to merit routine application to clinical care.…”

mentioning

confidence: 98%