IFITM1, CD10, SMA, and h-caldesmon as a helpful combination in differential diagnosis between endometrial stromal tumor and cellular leiomyoma

BMC Cancer. 2021 Sep 23;21(1):1047. doi: 10.1186/s12885-021-08781-w.

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.

Keywords: CD10; Cellular leiomyoma; Endometrial stromal tumor; H-caldesmon; IFITM1; SMA.

MeSH terms

  • Actins / analysis
  • Adult
  • Aged
  • Antigens, Differentiation / analysis
  • Antigens, Neoplasm / analysis
  • Area Under Curve
  • Biomarkers, Tumor / analysis*
  • Calmodulin-Binding Proteins / analysis
  • Diagnosis, Differential
  • Endometrial Neoplasms / chemistry
  • Endometrial Neoplasms / diagnosis*
  • Endometrial Stromal Tumors / chemistry
  • Endometrial Stromal Tumors / diagnosis*
  • Female
  • Humans
  • Immunohistochemistry
  • Leiomyoma / chemistry
  • Leiomyoma / diagnosis*
  • Middle Aged
  • Muscle, Smooth / chemistry
  • Neprilysin / analysis
  • Sensitivity and Specificity
  • Uterine Neoplasms / chemistry
  • Uterine Neoplasms / diagnosis*

Substances

  • Actins
  • Antigens, Differentiation
  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Calmodulin-Binding Proteins
  • leu-13 antigen
  • Neprilysin