IFITM1, CD10, SMA, and h-caldesmon as a helpful combination in differential diagnosis between endometrial stromal tumor and cellular leiomyoma
Weilin Zhao,
Mei Cui,
Ruiqi Zhang,
Xihua Shen,
Xin Xiong,
Xinhua Ji,
Lin Tao,
Wei Jia,
Lijuan Pang,
Zhenzhu Sun,
Chun Wang,
Hong Zou
Affiliations
Weilin Zhao
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Mei Cui
Department of Pathology, Xinjiang Uygur Autonomous Region People’s Hospital
Ruiqi Zhang
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Xihua Shen
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Xin Xiong
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Xinhua Ji
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Lin Tao
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Wei Jia
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Lijuan Pang
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Zhenzhu Sun
Department of Pathology, Xinjiang Uygur Autonomous Region People’s Hospital
Chun Wang
Department of Pathology, Xinjiang Uygur Autonomous Region People’s Hospital
Hong Zou
Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases
Abstract Background The differential diagnosis of endometrial stromal tumor (EST) and uterine cellular leiomyoma (CL) remains a challenge in clinical practice, especially low grade endometrial stromal sarcoma (ESS) and CL, suggesting the need for novel immunomarkers panels for differential diagnosis. Interferon-induced transmembrane protein 1 (IFITM1) is a novel immunomarker for endometrial stromal cells, h-caldesmon is an immunomarker for smooth muscle cells and has a higher specificity than smooth muscle actin (SMA). So this study aimed to evaluate whether IFITM1, cluster of differentiation 10(CD10), SMA, and h-caldesmon are useful biomarker combinations for the differential diagnosis of EST and CL. Methods Tissue microarrays were used to detect IFITM1, CD10, SMA, and h-caldesmon immunohistochemical staining in 30 EST and 33 CL cases. Results The expressions of IFITM1 and CD10 were high in EST (86.7 and 63.3%, respectively) but low in CL (18.2 and 21.2%), whereas those of h-caldesmon and SMA were high in CL (87.9 and 100%) and low in EST (6.9 and 40%). In diagnosing EST, IFITM1 shows better sensitivity and specificity (86.7 and 81.8%, respectively) than CD10 (63.3 and 78.8%). The specificity of h-caldesmon in diagnosing CL was significantly higher (93.1%) than that of SMA (60%). When all four antibodies were combined for the differential diagnosis, the area-under-the-curve (AUC) predictive value was 0.995. The best combination for diagnosing EST was IFITM1 (+) or CD10 (+) and h-caldesmon (−) (sensitivity 86.7%, specificity 93.9%). Conclusion The best combination for diagnosing CL were h-caldesmon (+) and SMA (+) (sensitivity 87.9%, specificity 100%). IFITM1, CD10, SMA, and h-caldesmon are a good combination for the differential diagnosis of EST and CL.