ABSTRACT
ABSTRACT It is not only challenging to distinguish benign from malignant uterine tumors, but also to distinguish between malignant tumors of the same or mixed histological origin. When smooth muscle tumors of uncertain malignant potential (STUMP) are taken into consideration, it becomes more complicated to have a certain diagnosis. The use of routine hematoxylin and eosin sections assists in the diagnosis of uterine tumors. However, immunohistochemistry may further support the diagnosis distinguishing benign from malignant tumors specically for equivocal and borderline cases. Specic markers identify critical cellular events such as differentiation, proliferation, and apoptosis to detect the tendency to malignancy. Most of the biomarkers published in scientic journals focused on differentiating benign (leiomyoma [LM]) and malignant (leiomyosarcoma [LMS]) tumors arising in the myometrium having several histological morphologies such as spindle, epithelioid, and mixed variants. Among the markers, Ki-67 is then most useful diagnostic marker separating benign from malignant uterine tumors but still not precise as to distinguish the variants of LM from LMS. Other markers include p53, p16, and p21, which are promising and may also be good targets for molecular therapies. Moreover, the cell differentiation marker CD10 may also help distinguish smooth muscle tumors from endometrial stromal sarcoma. Since the main cellular component of uterine tumors is from smooth muscles having spindle-shaped cells, precise diagnosis should be done in order to provide the best therapeutic management for the patient. Molecular studies using genetic aberrations have also been identied, which somehow may provide supporting information in the diagnosis of uterine tumors. This chapter provides an insight of the biomarkers that may be used in the diagnosis of uterine tumors based on published literatures.
