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Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade?

Publication ,  Journal Article
Feng, W; Malpica, A; Skaland, I; Gudlaugsson, E; Robboy, SJ; Dalen, I; Hua, K; Zhou, X; Baak, JPA
Published in: PLoS One
2013

An estimated 1500-3000 invasive Endometrial Stromal Sarcomas (ESS) cases annually occur worldwide. Before 2003, ESS was divided as low and high grade ESS based on mitotic activity. In 2003 the WHO changed the names, excluded mitoses and made nuclear atypia and necrosis the essential diagnostic criteria to distinguish ESS, Low Grade (ESS-LG, recurrence-free survival >90%) and Undifferentiated Endometrial Sarcoma (UES, poor prognosis). We have evaluated in WHO2003 defined ESS-LG whether proliferation biomarkers predict recurrence. Using survival analysis, the prognostic value of classical mitosis counts (Mitotic Activity Index, MAI) in haematoxyllin-eosin (H&E) sections, and immunohistochemical proliferation biomarkers (Ki-67 and PhosphoHistone-3 (PPH3)) were examined in 24 invasive endometrial stromal sarcomas. Three of 24 (12.5%) ESS-LG recurred. The MAI, PPH3 and Ki-67 were all prognostic (P = 0.001, 0.002 and 0.03). MAI values were >3 in the recurrent cases, but never exceeded 10 (the classical threshold for low and high grade). Non-recurrent cases had 0 ≤ MAI ≤ 3. PPH3 and Ki67 counts can be easier to perform than MAI and therefore helpful in the diagnosis of ESS, Low Grade. In conclusion, in this small study of WHO2003 defined ESS-LG, high levels of proliferation as measured by MAI, PPH3 and Ki-67 are predictive of recurrence. Larger studies are required to confirm these results.

Duke Scholars

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2013

Volume

8

Issue

10

Start / End Page

e75899

Location

United States

Related Subject Headings

  • World Health Organization
  • Survival Analysis
  • Sarcoma, Endometrial Stromal
  • Prognosis
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Mitotic Index
  • Middle Aged
  • Ki-67 Antigen
  • Immunohistochemistry
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Feng, W., Malpica, A., Skaland, I., Gudlaugsson, E., Robboy, S. J., Dalen, I., … Baak, J. P. A. (2013). Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade? PLoS One, 8(10), e75899. https://doi.org/10.1371/journal.pone.0075899
Feng, Weiwei, Anais Malpica, Ivar Skaland, Einar Gudlaugsson, Stanley J. Robboy, Ingvild Dalen, Keqin Hua, Xianrong Zhou, and Jan P. A. Baak. “Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade?PLoS One 8, no. 10 (2013): e75899. https://doi.org/10.1371/journal.pone.0075899.
Feng W, Malpica A, Skaland I, Gudlaugsson E, Robboy SJ, Dalen I, et al. Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade? PLoS One. 2013;8(10):e75899.
Feng, Weiwei, et al. “Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade?PLoS One, vol. 8, no. 10, 2013, p. e75899. Pubmed, doi:10.1371/journal.pone.0075899.
Feng W, Malpica A, Skaland I, Gudlaugsson E, Robboy SJ, Dalen I, Hua K, Zhou X, Baak JPA. Can proliferation biomarkers reliably predict recurrence in World Health Organization 2003 defined endometrial stromal sarcoma, low grade? PLoS One. 2013;8(10):e75899.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2013

Volume

8

Issue

10

Start / End Page

e75899

Location

United States

Related Subject Headings

  • World Health Organization
  • Survival Analysis
  • Sarcoma, Endometrial Stromal
  • Prognosis
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Mitotic Index
  • Middle Aged
  • Ki-67 Antigen
  • Immunohistochemistry