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An immunohistochemical analysis of stathmin 1 expression in uterine smooth muscle tumors: differential expression in leiomyosarcomas and leiomyomas.
Int J Clin Exp Pathol. 2015; 8(3):2795-801.IJ

Abstract

The oncogenic phosphatidylinositol 3-kinase-AKT-mammlian target of rapamycin pathway (PI3K-AKT-mTOR) pathway is known to be activated in uterine smooth muscle tumors, and Stathmin 1 (STMN1) expression has been identified as a marker of PI3K-AKT-mTOR pathway activation. We hypothesized that STMN1 may have some diagnostic utility and explored how well STMN1 expression correlated with histologic classifications of uterine smooth muscle tumors into benign and malignant groupings. 84 smooth muscle tumors were assessed for STMN1 expression by immunohistochemistry. These included spindle cell leiomyosarcoma (n=32), conventional spindle cell leiomyomas (n=30), atypical (symplastic) leiomyoma (n=5), cellular leiomyoma (n=7), smooth muscle tumor of uncertain malignant potential (n=4), mitotically active leiomyomas (n=2), benign metastasizing leiomyoma (n=3), and cotyledonoid dissecting leiomyoma (n=1). All spindle cell leiomyosarcomas were positive (32/32 positive; 100%) as compared with conventional leiomyomata (11/30; 37%) (P<0.0001). The average immunohistochemical score (0-12+, reflective of intensity and extent) for leiomyosarcomas was 8.7 (±1.43) whereas the conventional leiomyomata average score was 1.6 (±1.07) (P<0.0001). This difference in scores was reflected in the patterns of expression: leiomyosarcomas were predominantly strongly and diffusely positive whereas leiomyomata were predominantly weakly, albeit diffusely positive when expression was present. The sensitivity of STMN1 expression for leiomyosarcomas was 100%. However, the specificity was found to be only 55% (CI=43-68%). The negative and positive predictive values for leiomyosarcomas were 100% and 52% respectively. The odds ratio (OR) for any STMN1 expression in predicting a spindle cell leiomyosarcoma diagnosis from this dataset was highly significant (OR=144, P=0.0006). Thirteen non-smooth muscle tumors that involved the uterus all showed at least focal STMN1 immunoreactivity. In summary, STMN1 is a highly sensitive marker for leiomyosarcoma but is suboptimally specific for diagnostic purposes. The 100% negative predictive value for leiomyosarcoma may offer some diagnostic utility in a small sample, since the absence of STMN1 immunoreactivity in a putative leiomyosarcoma is a strong argument against this diagnostic possibility.

Authors+Show Affiliations

Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine Nashville, TN, United States.Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine Nashville, TN, United States.Department of Pathology and Laboratory Medicine, North Shore-LIJ Health System and Hofstra North Shore-LIJ School of Medicine New Hyde Park, NY, USA.Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine Nashville, TN, United States.Department of Pathology, Yale University School of Medicine New Haven, CT ; Department of Pathology, Bridgeport Hospital Bridgeport, CT, USA.Department of Pathology, University of California San Diego San Diego, CA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26045786

Citation

Allen, Mary-Margaret L., et al. "An Immunohistochemical Analysis of Stathmin 1 Expression in Uterine Smooth Muscle Tumors: Differential Expression in Leiomyosarcomas and Leiomyomas." International Journal of Clinical and Experimental Pathology, vol. 8, no. 3, 2015, pp. 2795-801.
Allen MM, Douds JJ, Liang SX, et al. An immunohistochemical analysis of stathmin 1 expression in uterine smooth muscle tumors: differential expression in leiomyosarcomas and leiomyomas. Int J Clin Exp Pathol. 2015;8(3):2795-801.
Allen, M. M., Douds, J. J., Liang, S. X., Desouki, M. M., Parkash, V., & Fadare, O. (2015). An immunohistochemical analysis of stathmin 1 expression in uterine smooth muscle tumors: differential expression in leiomyosarcomas and leiomyomas. International Journal of Clinical and Experimental Pathology, 8(3), 2795-801.
Allen MM, et al. An Immunohistochemical Analysis of Stathmin 1 Expression in Uterine Smooth Muscle Tumors: Differential Expression in Leiomyosarcomas and Leiomyomas. Int J Clin Exp Pathol. 2015;8(3):2795-801. PubMed PMID: 26045786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An immunohistochemical analysis of stathmin 1 expression in uterine smooth muscle tumors: differential expression in leiomyosarcomas and leiomyomas. AU - Allen,Mary-Margaret L, AU - Douds,Jonathan J, AU - Liang,Sharon X, AU - Desouki,Mohamed M, AU - Parkash,Vinita, AU - Fadare,Oluwole, Y1 - 2015/03/01/ PY - 2014/12/28/received PY - 2015/02/23/accepted PY - 2015/6/6/entrez PY - 2015/6/6/pubmed PY - 2016/3/11/medline KW - Leiomyosarcoma KW - STMN1 KW - immunohistochemistry KW - leiomyoma KW - stathmin SP - 2795 EP - 801 JF - International journal of clinical and experimental pathology JO - Int J Clin Exp Pathol VL - 8 IS - 3 N2 - The oncogenic phosphatidylinositol 3-kinase-AKT-mammlian target of rapamycin pathway (PI3K-AKT-mTOR) pathway is known to be activated in uterine smooth muscle tumors, and Stathmin 1 (STMN1) expression has been identified as a marker of PI3K-AKT-mTOR pathway activation. We hypothesized that STMN1 may have some diagnostic utility and explored how well STMN1 expression correlated with histologic classifications of uterine smooth muscle tumors into benign and malignant groupings. 84 smooth muscle tumors were assessed for STMN1 expression by immunohistochemistry. These included spindle cell leiomyosarcoma (n=32), conventional spindle cell leiomyomas (n=30), atypical (symplastic) leiomyoma (n=5), cellular leiomyoma (n=7), smooth muscle tumor of uncertain malignant potential (n=4), mitotically active leiomyomas (n=2), benign metastasizing leiomyoma (n=3), and cotyledonoid dissecting leiomyoma (n=1). All spindle cell leiomyosarcomas were positive (32/32 positive; 100%) as compared with conventional leiomyomata (11/30; 37%) (P<0.0001). The average immunohistochemical score (0-12+, reflective of intensity and extent) for leiomyosarcomas was 8.7 (±1.43) whereas the conventional leiomyomata average score was 1.6 (±1.07) (P<0.0001). This difference in scores was reflected in the patterns of expression: leiomyosarcomas were predominantly strongly and diffusely positive whereas leiomyomata were predominantly weakly, albeit diffusely positive when expression was present. The sensitivity of STMN1 expression for leiomyosarcomas was 100%. However, the specificity was found to be only 55% (CI=43-68%). The negative and positive predictive values for leiomyosarcomas were 100% and 52% respectively. The odds ratio (OR) for any STMN1 expression in predicting a spindle cell leiomyosarcoma diagnosis from this dataset was highly significant (OR=144, P=0.0006). Thirteen non-smooth muscle tumors that involved the uterus all showed at least focal STMN1 immunoreactivity. In summary, STMN1 is a highly sensitive marker for leiomyosarcoma but is suboptimally specific for diagnostic purposes. The 100% negative predictive value for leiomyosarcoma may offer some diagnostic utility in a small sample, since the absence of STMN1 immunoreactivity in a putative leiomyosarcoma is a strong argument against this diagnostic possibility. SN - 1936-2625 UR - https://www.unboundmedicine.com/medline/citation/26045786/An_immunohistochemical_analysis_of_stathmin_1_expression_in_uterine_smooth_muscle_tumors:_differential_expression_in_leiomyosarcomas_and_leiomyomas_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26045786/ DB - PRIME DP - Unbound Medicine ER -