The mitosis-specific marker phosphohistone-H3 (PHH3) is an independent prognosticator in uterine smooth muscle tumours: an outcome-based study
| Autor: | Kin Long Chow, Nancy W.F. Yuen, Ching-Lung Cheung, Ka Yu Tse, Richard Wing-Cheuk Wong, Alice N.H. Chan, Ka Wing Wong, Philip P.C. Ip, Annie N.Y. Cheung, Hextan Y.S. Ngan |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Leiomyosarcoma Adult medicine.medical_specialty Pathology Histology Uterus Mitosis Kaplan-Meier Estimate Biology Malignancy Gastroenterology Sensitivity and Specificity Pathology and Forensic Medicine Histones 03 medical and health sciences 0302 clinical medicine Smooth muscle Internal medicine medicine Biomarkers Tumor Humans Smooth Muscle Tumor Aged Proportional Hazards Models Aged 80 and over General Medicine Middle Aged medicine.disease Prognosis 030104 developmental biology medicine.anatomical_structure ROC Curve 030220 oncology & carcinogenesis Area Under Curve Uterine Neoplasms Immunohistochemistry Female Neoplasm Recurrence Local Phosphohistone h3 |
| Zdroj: | Histopathology. 70(5) |
| ISSN: | 1365-2559 |
| Popis: | Aims Accurate mitosis counting, which is important in the diagnosis of uterine smooth muscle tumours (USMTs), is often difficult and subjective. The mitosis-specific immunohistochemical marker phosphohistone-H3 (PHH3) has been shown to be diagnostically useful, but its expression, in relation to outcome, has not been thoroughly investigated. The aim of this study is to evaluate PHH3 as a diagnostic and prognostic marker in USMTs. Methods and results PHH3 expression was evaluated in 55 leiomyosarcomas (LMSs), 26 smooth muscle tumours of uncertain malignant potential (STUMPs), 18 leiomyomas with bizarre nuclei (LBN), and 12 leiomyomas (LMs). Scores were expressed as counts per 10 high-power fields (HPFs). Median follow-up durations of patients with LMS, STUMP, LBN and LM were, respectively, 39, 78, 65.5 and 49.5 months. Twenty-eight patients with LMSs (50.9%) died, and two (7.7%) patients with STUMPs experienced recurrence. The median PHH3 scores for LMSs were significantly higher than those for other categories of tumour. A score of ≥29/10 HPFs was also independently associated with a poor outcome. To test whether the PHH3 score could distinguish between benign USMTs with atypical histology and those that were clinically malignant, two biological groups were further delineated. Patients in group 1 (18 LBNs and 24 STUMPs) all had an uneventful outcome, whereas patients in group 2 (two recurrent STUMPs and 32 LMSs) all had a recurrence or tumour-related death. Median PHH3 scores for the two groups were, respectively, 2/10 HPFs and 27/10 HPFs. A PHH3 score of ≥7/10 HPFs was highly associated with malignancy. Conclusion PHH3 is useful in evaluation of the biological behaviour of USMTs, and may serve as a prognostic indicator for LMSs. |
| Databáze: | OpenAIRE |
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