{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:12:45Z","timestamp":1791198765361,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T00:00:00Z","timestamp":1404172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Edna Foundation of Hope"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2014,10,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Uterine smooth muscle tumors (USMTs) constitute a group of histologic, genetic, and clinical heterogeneous tumors that include at least 6 major histologically defined tumor types: leiomyoma (ULM), mitotically active leiomyoma (MALM), cellular leiomyoma (CLM), atypical leiomyoma (ALM), uncertain malignant potential (STUMP), and leiomyosarcoma (LMS). Apart from ULM and LMS, the nature of these variants is not well defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 167 cases of different USMT variants were collected, reviewed, and diagnostically confirmed based on the World Health Organization and Stanford schemes. These included 38 cases of LMS, 18 cases of STUMP, 42 cases of ALM, 22 cases of CLM, 7 cases of MALM, and 40 cases of ULM. Molecular analysis included selected microRNAs (miRNAs), oncogenes, and tumor suppressors that are highly relevant to USMT.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Overall, 49% (17\/35) of LMS cases and 7% (1\/14) of STUMP cases died due to their USMT, but no deaths were attributed to ALM. miRNA profiling revealed that ALM and LMS shared similar miRNA signatures. <jats:italic>P53<\/jats:italic> mutations and <jats:italic>PTEN<\/jats:italic> deletions were significantly higher in LMS, ALM, and STUMP compared with other USMT variants (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). In contrast, <jats:italic>MED12<\/jats:italic> mutations were extremely common in ULM and MALM (&gt;74%) but were significantly less common (&lt;15%) in CLM, ALM, STUMP, and LMS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Six types of USMT have different gene mutation fingerprints. ALM shares many molecular alterations with LMS. Our findings suggest that ALM may be a precursor lesion of LMS or have similar genetic changes during its early stage. <jats:bold><jats:italic>Cancer<\/jats:italic> 2014;120:3165\u20133177.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.28900","type":"journal-article","created":{"date-parts":[[2014,7,2]],"date-time":"2014-07-02T01:45:36Z","timestamp":1404265536000},"page":"3165-3177","source":"Crossref","is-referenced-by-count":84,"title":["Molecular analyses of 6 different types of uterine smooth muscle tumors: Emphasis in atypical leiomyoma"],"prefix":"10.1002","volume":"120","author":[{"given":"Qing","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Qilu Hospital, Shandong University Jinan Shandong P.R. China"},{"name":"Department of Pathology Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne","family":"Ubago","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology Qilu Hospital, Shandong University Jinan Shandong P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Guo","sequence":"additional","affiliation":[{"name":"Institute of Genetics Shandong University  China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenan","family":"Qiang","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Department of Obstetrics and Gynecology\u2010Division of Reproductive Science in Medicine Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Julie","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology\u2010Division of Reproductive Science in Medicine Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beihua","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Qilu Hospital, Shandong University Jinan Shandong P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Jun","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Department of Obstetrics and Gynecology\u2010Division of Reproductive Science in Medicine Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Robert H. 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