Tehran University Medical Journal

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Uterine smooth muscle tumors classified as leiomyoma, leiomyosarcoma and tumors with uncertain malignant potential. The leiomyoma and leiomyosarcoma are separated tumors biologically. Uterine smooth muscle tumors with uncertain malignant potential include a group of tumors which are not specifically placed into two others groups which result in a serious problem in a way of their treatment. In the present study expression of marker "p16" in smooth muscle tumors of uterine and normal myometrium has been investigated.
Methods: The entire paraffin blocks related to hysterectomy cases with diagnosis of normal myometrium, leiomyoma and leiomyosarcoma (3768 cases) available in pathology lab. in Shariati Hospital in Tehran, Iran from 1372 to 1387 were investigated. Among them 62 normal myometrium, 62 leiomyoma and 12 leiomyosarcoma had been chosen and after staining for marker "p16" were investigated separately.
Results: There were a statistically significant difference in both intensity and percentage of staining for this marker between leiomyoma and leiomiosarcoma (p< 0.001) and between leiomyosarcoma and normal myometrium (p< 0.001) but not between leiomyoma and normal myometrium (p= 3.6).
Conclusion: Based on this study if strong and more than focal immunoreactivity for marker "p16" suppose as positive then leiomyosarcoma will be positive for this marker but leiomyoma and normal myometrium will not be and this could be considered as a good guide for categorizing the uterine smooth muscle tumors.

Background: Endometrial carcinoma is considered the most common gynecological cancer in the world. Pelvic and para-aortic lymphadenectomy is widely advised based on FIGO staging system. The purpose of this study was to determine whether the biomarker human epididymis protein 4(HE4) correlates with depth of myometrial invasion, histologic grade and metastases in patients with endometrioid adenocarcinoma of the uterus. Methods: This was a cross-sectional study in women with biopsy-proven endometrioid adenocarcinoma in the gynecological ward of Vali-e-Asr Hospital from October 2012 to October 2014. The concentrations of HE4 and CA125 were assessed before surgery and all surgical specimens were reviewed by dedicated gynecologic pathologists. The results were compared with the final histopathology report. Results: A total of 80 patients were initially entered in this study. Twelve patients were excluded because they didn’t have tumor marker. Most of patients (76%) was in stage I disease. Levels of serum HE4 greater than 140 PM and CA125 greater than 35 kU/L observed in 12(17%) and 26(38.2%) of patients, respectively. Of the 52 patients with satge I, 14(26.9%) had CA125&ge35 KU/L, compared with 6(66.7%) of the 9 patients with stage II and 6(85.7%) of the 7 patients with stage III (P<0.002). A significant increase in serum CA125 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.001, P<0.0001, P<0.006, P<0.002). Among the group of patients with early stage disease a significant increase in serum CA125 was noted in patients with deep myometrial invasion. Five out of 52 patients (9.6%) in stage I had HE4 level&ge140 PM, compared with 3 patients (33.3%) with stage II and 4 patients (57.1%) with stage III disease (P<0.003). A significant increase in serum HE4 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.035, P<0.001, P<0.012, P<0.007). Conclusion: Human epididymis protein 4 (HE4) and CA125 may be a useful markers preoperatively in the clinical decision making for determining the need for lymph node dissection in women with endometrial cancer.