Elsevier

Human Pathology

Volume 32, Issue 9, September 2001, Pages 984-987
Human Pathology

Original Contributions
MIB-1 (Ki-67), p53, estrogen receptor, and progesterone receptor expression in uterine smooth muscle tumors*,**

https://doi.org/10.1053/hupa.2001.27113Get rights and content

Abstract

The diagnosis of benign, uncertain malignant potential, and malignant uterine smooth muscle tumors depends on mitotic counts, nuclear atypia, and other morphologic features. This study was undertaken to evaluate the utility of selected immunohistochemical markers in differentiating these tumors. Fifteen cases of cellular leiomyoma, 7 cases of smooth muscle tumor of uncertain malignant potential (STUMP), and 12 cases of leiomyosarcoma were immunostained for MIB-1 (Ki-67), p53, estrogen receptor and progesterone receptor (PR) using monoclonal antibodies and the avidin-biotin-peroxidase method. The percentage of cells stained was subjectively assessed to the nearest 5%. One percent was used for rare positive cells. MIB-1 expression of ≥15% was seen in 11 and expression of p53 in ≥15% cells was present in 5 of 12 leiomyosarcomas. MIB-1 and/or p53 expression of >15% was seen in all 12 leiomyosarcomas but in none of the 7 STUMP or 15 cellular leiomyomas. PR was absent in 10 of 12 leiomyosarcomas but present in 7 of 7 STUMP and 14 of 15 cellular leiomyomas. MIB-1 of 5% to 10% was seen in 6 of 7 STUMP but in only 1 of 15 cellular leiomyomas. MIB-1, p53, and PR are useful in differentiating leiomyosarcoma from STUMP and cellular leiomyoma. MIB-1 is useful in distinguishing STUMP from cellular leiomyomas. HUM PATHOL 32:984-987. Copyright © 2001 by W.B. Saunders Company

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Materials and methods

Fifteen cases of cellular leiomyomata, 7 cases of smooth muscle tumor of uncertain malignant potential (STUMP), and 12 cases of leiomyosarcoma were retrieved from the files of the division of gynecologic pathology at New York University Medical Center. The diagnosis of leiomyosarcoma and STUMP was based on previously published criteria.2 Tumors with marked nuclear atypia were classified as leiomyosarcoma if they had ≥5 mitoses/10 high-power fields (HPF) and as STUMP if they had 1 to 4

Results

Results are shown in Table 1 and Fig 1 through 4.

. Expression of various markers in uterine smooth muscle tumors

Empty CellMIB-1p53ERPR
Cellular leiomyata0.9 ± 0.3 (0-5)0.1 ± 0.09 (0-1)40 ± 8.8 (0-90)52 ± 8.2 (0-90)
STUMP5.7 ± 1.3 (0-10)0.1 ± 0.1 (0-1)15 ± 9 (0-50)84 ± 7.6 (40-95)
Leiomyosarcoma45.4 ± 8.6 (10-70)*21.9 ± 9 (0-90)*4 ± 4 (0-50)5 ± 4.9 (0-60)*
*P <.00001 v STUMP and cellular leiomyata.

NOTE. Results are presented as means ± SE (range).

. MIB-1 (Ki-67) expression in (A) cellular leiomyoma, (B) STUMP,

Discussion

We chose to measure immunostaining subjectively because this method is fast and does not require any equipment other than a microscope. This method can be used not only in academic settings, but also in private practice settings. Our results are in agreement with previous studies that have used counting of cells to measure the percentage of cells positive for p53, ER, PR, and MIB-1 in leiomyosarcomas. Percentage staining, rather than number of cells stained/10 HPF, was used because it provides

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*

Supported in part by Kaplan Cancer Center grant P30 CA16087.

**

Address correspondence and reprint requests to Khush Mittal, MD, Department of Pathology, 4W35B, Bellevue Hospital, 27th St and 1st Ave, New York, NY 10016.

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