Candidate molecules as diagnostic biomarker for human uterine mesenchymal tumors

Hayashi T*, Sano K, Ichimura T, Gur G, Yaish P, Zharhary D, Kanai Y, Tonegawa S, Yaegashi N and Konishi I

Unfortunately, uterine leiomyosarcoma still has a poor prognosis. The National Cancer Institute reported that the median overall survival (mOS) at stage I to stage IV of leiomyosarcoma was 31 months. Norwegian reports show that mOS of uterine leiomyosarcoma is as poor as eight years at stage I, four years at stage II, two years at stage III, and one year at stage IV. Preoperative diagnosis of uterine leiomyosarcoma is difficult in clinical practice. Treated as “uterine fibroids”, however, tumors are often differentially diagnosed from uterine leiomyosarcoma by pathological diagnosis with hysterectomy or myomectomy. Histopathological diagnosis may result in a diagnosis of “smooth muscle tumor of unmalignant potential (STUMP)” that cannot be declared as malignant cor benign. In about half of stage I patients, uterine leiomyosarcoma recurs. Postoperative chemotherapy is attempted to prevent recurrence. However, at present, no anticancer drug that has been shown to be effective in preventing postoperative recurrence has not been established. It is almost clear that radiation therapy also does not help control recurrence. For this reason, we monitor patients without postoperative treatment, and start clinical treatment when recurrence is confirmed. Uterine leiomyomas, which occur in about 70% of women aged 40 and over in Japan and overseas, are benign tumors, but are extremely difficult to distinguish from uterine leiomyosarcoma. Although progress in diagnostic imaging such as MRI and PET-CT is remarkable, uterine leiomyosarcoma is difficult to distinguish from uterine leiomyoma. No differential marker has been identified for uterine leiomyoma and uterine leiomyosarcoma in surgical pathological diagnosis or clinical examination. This review describes the current diagnosis and treatment for uterine sarcoma, including new trends in the search for biomarkers for uterine leiomyosarcoma.

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Published on: May 14, 2020 Pages: 54-57

Full Text PDF Full Text HTML DOI: 10.17352/acp.000016
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