Benign metastasizing leiomyoma of the lung: clinicopathologic, immunohistochemical, and micro-RNA analyses.
Benign metastasizing leiomyoma of the lung: clinicopathologic, immunohistochemical, and micro-RNA analyses.
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DOI：
10.1097/pdm.0b013e31815aca19
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发表时间：
2008-09
期刊：
影响因子：
--
通讯作者：
Schmittgen TD
中科院分区：
文献类型：
--
作者：
Nuovo GJ;Schmittgen TD
良性转移性平滑肌瘤是一种罕见的肿瘤，通常发生在肺部，因此可能与平滑肌瘤混淆。此外，尚不清楚“良性转移性平滑肌瘤”一词是否用词不当，也不清楚这些病变是否实际上代表具有低增殖指数的低度恶性肿瘤。微小RNA（miRNA）是小型非编码RNA，可抑制翻译。miRNAs表达的改变与恶性表型密切相关。本研究对15例平滑肌瘤（11例原发灶，4例转移灶），8例平滑肌瘤和10例良性转移性平滑肌瘤（9例肺内病灶，1例子宫原发灶）的组织学特征、Ki 67指数、p53、bcl-2和miRNA表达进行了研究。正如预期的那样，良性转移性平滑肌瘤的Ki 67指数与平滑肌瘤相当，但在统计学上低于平滑肌瘤。平滑肌瘤平均指数为2.3%（0.9%~ 8.8%），良性转移性平滑肌瘤平均指数为3.4%（0.7%~ 8.1%），平滑肌瘤平均指数为28.6%（14.4%~ 62.0%）（P < 0.025）。在13/15例平滑肌瘤、0/8例平滑肌瘤和0/10例良性转移性平滑肌瘤中通过原位杂交检测到与多种癌症相关的miRNA，miR-221。总之，良性转移性平滑肌瘤确实最有可能是良性病变，miR-221表达上调是鉴别平滑肌肉瘤和良性转移性平滑肌瘤的准确方法。
Benign metastasizing leiomyomas are rare tumors, which are typically found in the lungs and, thus, might be confused with leiomyosarcomas. Further, it is not clear whether the term “benign metastasizing leiomyoma” is a misnomer and whether these lesions actually represent low-grade malignant tumors that have a low proliferation index. Micro-RNAs (miRNAs) are small noncoding RNAs, which repress translation. The altered expression of miRNAs has been strongly correlated with the malignant phenotype. In this study, the histologic features, Ki67 index, p53, bcl-2, and miRNA expression were studied in 15 leiomyosarcomas (11 primary lesions and 4 metastases), 8 leiomyomas, and 10 cases of benign metastasizing leiomyoma (9 pulmonary lesions and 1 primary uterine lesion). As expected, the Ki67 index for the benign metastasizing leiomyomas was equivalent to that for the leiomyomas and statistically less than that for the leiomyosarcomas. The mean index was 2.3% (range: 0.9% to 8.8%) for the leiomyomas and 3.4% (range: 0.7% to 8.1%) for the benign metastasizing leiomyomas compared with 28.6% (range: 14.4% to 62.0%) for the leiomyosarcomas (P < 0.025). The miRNA, miR-221, which has been associated with a variety of cancers, was detected by in situ hybridization in 13/15 leiomyosarcomas, 0/8 leiomyomas, and 0/10 benign metastasizing leiomyomas. In conclusion, benign metastasizing leiomyomas are indeed most likely benign lesions, and up-regulation of miR-221 expression is an accurate way to differentiate leiomyosarcoma from benign metastasizing leiomyoma.