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Cluster analysis of immunohistochemical markers in leiomyosarcoma delineates specific anatomic and gender subgroups
Cancer, 07/31/09
Carvalho JC et al. - In a trial to explore the differential expression of smooth muscle markers, estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor-1 protein (WT1) by anatomic subtype and gender in leiomyosarcoma (LMS), it was concluded that smooth muscle markers demonstrated variable sensitivities in LMS, with a tendency for anatomic subtypes to segregate based on expression patterns of these markers. ER defined a subgroup of uterine and female retroperitoneal tumors, and WT1 was limited to such tumors, suggesting a common line of differentiation as well as potential therapeutic targets.
Methods- 78 LMS comprised of 30 uterine and 48 nonuterine tumors were studied.
- Nonuterine tumors were comprised of 17 soft tissue, 16 retroperitoneal, 7 cutaneous, 5 visceral, and 3 osseous subtypes.
- Immunohistochemical staining intensity on tissue microarray slides was scored as 0, 1+, or 2+, and cluster analysis was performed on the data.
- Smooth muscle actin was the most sensitive antibody (95%), followed by muscle-specific actin (91%), calponin (88%), desmin (73%), caldesmon (66%), and myosin (64%).
- Caldesmon and myosin were usually coexpressed, and were highest in retroperitoneal tumors (94%).
- There was no discernable correlation noted between histologic differentiation and smooth muscle marker expression.
- ER was much more common in women, with the highest frequencies noted in female retroperitoneal (86%) and uterine (63%) tumors.
- Nuclear WT1 was expressed in 11% of all tumors, and was limited to ER-positive uterine and female retroperitoneal tumors.
- Cluster analysis segregated 4 groups, most notably 1 driven by ER and PR, with the vast majority being uterine and female retroperitoneal tumors.
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