[The differential diagnosis between uterine leiomyosarcoma and the special subtypes of leiomyoma].

OBJECTIVE: To explore the more sensitive and specific immunohistochemical markers in differential diagnosis of uterine leiomyosarcoma (ULMS) and the specific subtypes of leiomyoma. METHODS: The routine SP immunohistochemical technique was used to examine the expression of desmin, alpha smooth muscle actin (SMA), calponin h1, h-caldesmon, estrogen receptor (ER), progesterone receptor (PR), proliferating cell nuclear antigen (PCNA), mast cells, and CD44v3 in 82 patients with smooth muscle tumors of the uterus, including 17 patients with leiomyosarcoma (LMS), 25 with cellular leiomyoma (CL), 15 with bizarre leiomyoma (BL) and 25 with ordinary leiomyoma (OL). RESULTS: The expression rates of desmin, SMA, h-caldesmon and CD44v3 in uterine LMS were all lower than those in CL and BL (all P<0.05), but these markers had limited significance in differentiation of ULMS from CL or BL. Compared to those in CL or BL, the expression rates of ER and PR and the number of mast cells were significantly lower in LMS (all P<0.01), while the expression of PCNA in LMS was higher (P<0.01). CONCLUSION: The increase of PCNA and decrease of ER and PR expression help differentiate ULMS from CL and BL. The number of mast cells was helpful in differential diagnosis of ULMS with high sensitivity and specificity.