Immunohistochemical analysis of 147 cases of low-grade
endometrial stromal sarcoma: refining the immunohistochemical
profile of LG-ESS on a large, molecularly confirmed series

J 2025

Immunohistochemical analysis of 147 cases of low-grade endometrial stromal sarcoma: refining the immunohistochemical profile of LG-ESS on a large, molecularly confirmed series

FLIDROVA, Miroslava; Pavel DUNDR; Romana VRANKOVA; Kristyna NEMEJCOVA; David CIBULA et. al.

Základní údaje

Originální název

Immunohistochemical analysis of 147 cases of low-grade endometrial stromal sarcoma: refining the immunohistochemical profile of LG-ESS on a large, molecularly confirmed series

Autoři

FLIDROVA, Miroslava; Pavel DUNDR; Romana VRANKOVA; Kristyna NEMEJCOVA; David CIBULA; Renata PONCOVA; Kvetoslava MICHALOVA; Jiri BOUDA; Jan LACO; Munachiso NDUKWE; Janusz RYS; Mariusz KSIAZEK; Alberto BERJON; Ignacio ZAPARDIEL; Ivan FRANIN; Antonela NJAVRO; Jitka HAUSNEROVÁ; Petra BRETOVÁ; Vladimir ZIDLIK; Jaroslav KLAT; Zoard Tibor KRASZNAI; Robert POKA; Nataliya VOLODKO; Iryna YEZHOVA; Radovan PILKA; Radim MAREK; Georgina KOLNIKOVA; Milan KRKOSKA; Michael HALASKA; Jana DROZENOVA; Dagmar DOLINSKA; Vladimir KALIST; Marcin BOBINSKI; Marta OSTROWSKA-LESKO; Magdalena BIZON; Wlodzimierz SAWICKI; Maciej STUKAN; Karolina GRABOWSKA; Marcin JEDRYKA; Tymoteusz POPRAWSKI; Simona STOLNICU; Mihai Emil CAPILNA; Zuzana SPURKOVA; Michal ZIKAN; Francesca CICCARONE; Giovanni SCAMBIA; Archil SHARASHENIDZE; Miranda GUDADZE; Tetiana PIATNYTSKA; Ihor VARCHAK a Michaela KENDALL BARTU

Vydání

Virchows Archiv, New York, Springer, 2025, 0945-6317

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30109 Pathology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.100 v roce 2024

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1007/s00428-025-04026-4

UT WoS

001401158900001

EID Scopus

999

Klíčová slova anglicky

Low-grade endometrial stromal sarcoma; LG-ESS; Immunohistochemistry; Endometrial stromal markers; Smoothelin

Štítky

14110230, 14110240

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 4. 2. 2025 14:19, Mgr. Tereza Miškechová

Anotace

V originále

Low-grade endometrial stromal sarcoma (LG-ESS) can present diagnostic challenges, due to its overlapping morphological features with other uterine mesenchymal tumors. Misdiagnosis rates remain significant, and immunohistochemical data for LG-ESS are limited to small series and inconsistent antibody panels. This study aimed to refine the IHC profile of LG-ESS by analyzing a large, molecularly confirmed series of 147 cases using a panel of 24 antibodies, including newer markers like transgelin and smoothelin. CD10 and IFITM1, key endometrial stromal markers, were expressed in 86% (92% of those extensively) and 69% (60% of those extensively) of cases, with fusion-positive tumors showing significantly higher expression. Smooth muscle markers (alpha-SMA, desmin, h-caldesmon, calponin, transgelin) were variably expressed, predominantly in focal or low-intensity patterns, with alpha-SMA reaching the highest frequency of expression (44%). However, the intensity of smooth muscle marker expression was usually very low. Smoothelin was rarely expressed. Hormone receptors were frequently positive, with PR showing a higher frequency (92% vs. 83%) and intensity than ER. Markers like S-100, HMB45, and CD117 were largely negative; all tumors were p53 wild-type, with preserved SMARCB1/SMARCA4 expression and ALK and ROS1 negativity. This work represents the largest molecularly validated IHC study on LG-ESS, providing a robust diagnostic profile for routine pathology. By addressing key diagnostic limitations and examining newer markers, our study supports a more standardized approach to diagnosing LG-ESS and underscores the value of immunohistochemical panels, particularly in fusion-negative tumors where diagnosis relies on morphological and immunohistochemical interpretation. These findings contribute critical data for improving diagnostic accuracy.

Návaznosti

LM2023033, projekt VaV

Název: Síť českých biobank

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, BBMRI.cz - Síť českých biobank

Citovat

@article{2474641,
   author = {Flidrova, Miroslava and Dundr, Pavel and Vrankova, Romana and Nemejcova, Kristyna and Cibula, David and Poncova, Renata and Michalova, Kvetoslava and Bouda, Jiri and Laco, Jan and Ndukwe, Munachiso and Rys, Janusz and Ksiazek, Mariusz and Berjon, Alberto and Zapardiel, Ignacio and Franin, Ivan and Njavro, Antonela and Hausnerová, Jitka and Bretová, Petra and Zidlik, Vladimir and Klat, Jaroslav and Krasznai, Zoard Tibor and Poka, Robert and Volodko, Nataliya and Yezhova, Iryna and Pilka, Radovan and Marek, Radim and Kolnikova, Georgina and Krkoska, Milan and Halaska, Michael and Drozenova, Jana and Dolinska, Dagmar and Kalist, Vladimir and Bobinski, Marcin and OstrowskaandLesko, Marta and Bizon, Magdalena and Sawicki, Wlodzimierz and Stukan, Maciej and Grabowska, Karolina and Jedryka, Marcin and Poprawski, Tymoteusz and Stolnicu, Simona and Capilna, Mihai Emil and Spurkova, Zuzana and Zikan, Michal and Ciccarone, Francesca and Scambia, Giovanni and Sharashenidze, Archil and Gudadze, Miranda and Piatnytska, Tetiana and Varchak, Ihor and Kendall Bartu, Michaela},
   article_location = {New York},
   doi = {https://doi.org/10.1007/s00428-025-04026-4},
   keywords = {Low-grade endometrial stromal sarcoma; LG-ESS; Immunohistochemistry; Endometrial stromal markers; Smoothelin},
   language = {eng},
   issn = {0945-6317},
   journal = {Virchows Archiv},
   title = {Immunohistochemical analysis of 147 cases of low-grade endometrial stromal sarcoma: refining the immunohistochemical profile of LG-ESS on a large, molecularly confirmed series},
   url = {https://link.springer.com/article/10.1007/s00428-025-04026-4},
   year = {2025}
}

TY  - JOUR
ID  - 2474641
AU  - Flidrova, Miroslava - Dundr, Pavel - Vrankova, Romana - Nemejcova, Kristyna - Cibula, David - Poncova, Renata - Michalova, Kvetoslava - Bouda, Jiri - Laco, Jan - Ndukwe, Munachiso - Rys, Janusz - Ksiazek, Mariusz - Berjon, Alberto - Zapardiel, Ignacio - Franin, Ivan - Njavro, Antonela - Hausnerová, Jitka - Bretová, Petra - Zidlik, Vladimir - Klat, Jaroslav - Krasznai, Zoard Tibor - Poka, Robert - Volodko, Nataliya - Yezhova, Iryna - Pilka, Radovan - Marek, Radim - Kolnikova, Georgina - Krkoska, Milan - Halaska, Michael - Drozenova, Jana - Dolinska, Dagmar - Kalist, Vladimir - Bobinski, Marcin - Ostrowska-Lesko, Marta - Bizon, Magdalena - Sawicki, Wlodzimierz - Stukan, Maciej - Grabowska, Karolina - Jedryka, Marcin - Poprawski, Tymoteusz - Stolnicu, Simona - Capilna, Mihai Emil - Spurkova, Zuzana - Zikan, Michal - Ciccarone, Francesca - Scambia, Giovanni - Sharashenidze, Archil - Gudadze, Miranda - Piatnytska, Tetiana - Varchak, Ihor - Kendall Bartu, Michaela
PY  - 2025
TI  - Immunohistochemical analysis of 147 cases of low-grade endometrial stromal sarcoma: refining the immunohistochemical profile of LG-ESS on a large, molecularly confirmed series
JF  - Virchows Archiv
PB  - Springer
SN  - 09456317
KW  - Low-grade endometrial stromal sarcoma
KW  - LG-ESS
KW  - Immunohistochemistry
KW  - Endometrial stromal markers
KW  - Smoothelin
UR  - https://link.springer.com/article/10.1007/s00428-025-04026-4
N2  - Low-grade endometrial stromal sarcoma (LG-ESS) can present diagnostic challenges, due to its overlapping morphological features with other uterine mesenchymal tumors. Misdiagnosis rates remain significant, and immunohistochemical data for LG-ESS are limited to small series and inconsistent antibody panels. This study aimed to refine the IHC profile of LG-ESS by analyzing a large, molecularly confirmed series of 147 cases using a panel of 24 antibodies, including newer markers like transgelin and smoothelin. CD10 and IFITM1, key endometrial stromal markers, were expressed in 86% (92% of those extensively) and 69% (60% of those extensively) of cases, with fusion-positive tumors showing significantly higher expression. Smooth muscle markers (alpha-SMA, desmin, h-caldesmon, calponin, transgelin) were variably expressed, predominantly in focal or low-intensity patterns, with alpha-SMA reaching the highest frequency of expression (44%). However, the intensity of smooth muscle marker expression was usually very low. Smoothelin was rarely expressed. Hormone receptors were frequently positive, with PR showing a higher frequency (92% vs. 83%) and intensity than ER. Markers like S-100, HMB45, and CD117 were largely negative; all tumors were p53 wild-type, with preserved SMARCB1/SMARCA4 expression and ALK and ROS1 negativity. This work represents the largest molecularly validated IHC study on LG-ESS, providing a robust diagnostic profile for routine pathology. By addressing key diagnostic limitations and examining newer markers, our study supports a more standardized approach to diagnosing LG-ESS and underscores the value of immunohistochemical panels, particularly in fusion-negative tumors where diagnosis relies on morphological and immunohistochemical interpretation. These findings contribute critical data for improving diagnostic accuracy.
ER  -

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