USMTS

AcronymDefinition
USMTSUnited States Modified Touring Series (auto racing)
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Subtyping of USMT is very significant due to the great diversity of clinical behavior and patient morbidity and mortality among those tumors.
The malignant behavior of USMT had been determined by a set of histopathological features called Stanford criteria (Bell et al.) that include: diffuse moderate-to severe nuclear atypia; mitotic count of [greater than or equal to] 10 /10 High Power Fields; and Tumor Coagulative Necrosis.
Immuno histochemical stains (IHCs) as an ancillary diagnostic tool of USMT were used in literature.
studied CD147 expression in USMT and found that CD147 was strongly expressed in 81.8 % (n = 18) of ULMS, significantly higher than that of other uterine smooth muscle tumor types (p = 0.000).
TMN1 and CD147 are sensitive and potentially useful markers (especially when combined) in sub typing of USMT. Although neither is specific for diagnostic purposes, both markers have high negative predictive value for ULMS.
Several studies have reported that p16 is overexpressed in LMS; therefore, p16 may be useful for distinguishing between benign and malignant USMTs (3, 6, 7, 22).
In addition to USMTs, a positive correlation between bcl-2 expression and overall survival was reported in several studies (1, 9, 10).
A Ki-67 positivity rate of >10% (increased proliferation) was statistically significantly higher in the LMS group than in the benign USMT group (p=0.0001).
Bcl-2 expression cannot be used for diagnosing LMS and the prognostic prediction of malignant USMT's prognosis.
In addition to histopathological findings, the presence of diffuse p16 expression and p53 overexpression can be used as evidence to distinguish between benign and malignant USMT. Close monitoring of p53-negative LMS cases should be recommended to detect metastasis.
The most accepted situations in which STUMP can be considered include (1) tumors indeterminate for coagulative necrosis, (2) tumors with significant atypia and mitotic index near the threshold for malignancy, (3) epithelioid and myxoid variants of USMT with mitotic activity or atypia intermediate between the benign and malignant counterparts, and (4) tumors with histologic features worrisome for an epithelioid or myxoid variant of USMT.
Another commonly used hormone therapy for leiomyoma is a gonadotropin-releasing hormone (GnRH) agonist, which down-regulates GnRH receptors in the pituitary gland, decreases the level of luteinizing and folliclestimulation hormones, and thus results in the required hypoestrogenic state that will help reduce USMT size.