{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T21:54:57Z","timestamp":1782165297918,"version":"3.54.5"},"reference-count":74,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T00:00:00Z","timestamp":1485216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,4]]},"abstract":"Aims<\/jats:title>Accurate mitosis counting, which is important in the diagnosis of uterine smooth muscle tumours (USMT<\/jats:styled-content>s), is often difficult and subjective. The mitosis\u2010specific immunohistochemical marker phosphohistone\u2010H3 (PHH<\/jats:styled-content>3) has been shown to be diagnostically useful, but its expression, in relation to outcome, has not been thoroughly investigated. The aim of this study is to evaluate PHH<\/jats:styled-content>3 as a diagnostic and prognostic marker in USMT<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Methods and results<\/jats:title>PHH<\/jats:styled-content>3 expression was evaluated in 55 leiomyosarcomas (LMS<\/jats:styled-content>s), 26 smooth muscle tumours of uncertain malignant potential (STUMP<\/jats:styled-content>s), 18 leiomyomas with bizarre nuclei (LBN<\/jats:styled-content>), and 12 leiomyomas (LM<\/jats:styled-content>s). Scores were expressed as counts per 10 high\u2010power fields (HPF<\/jats:styled-content>s). Median follow\u2010up durations of patients with LMS<\/jats:styled-content>, STUMP<\/jats:styled-content>, LBN<\/jats:styled-content> and LM<\/jats:styled-content> were, respectively, 39, 78, 65.5 and 49.5 months. Twenty\u2010eight patients with LMS<\/jats:styled-content>s (50.9%) died, and two (7.7%) patients with STUMP<\/jats:styled-content>s experienced recurrence. The median PHH<\/jats:styled-content>3 scores for LMS<\/jats:styled-content>s were significantly higher than those for other categories of tumour. A score of \u226529\/10 HPF<\/jats:styled-content>s was also independently associated with a poor outcome. To test whether the PHH<\/jats:styled-content>3 score could distinguish between benign USMT<\/jats:styled-content>s with atypical histology and those that were clinically malignant, two biological groups were further delineated. Patients in group 1 (18 LBN<\/jats:styled-content>s and 24 STUMP<\/jats:styled-content>s) all had an uneventful outcome, whereas patients in group 2 (two recurrent STUMP<\/jats:styled-content>s and 32 LMS<\/jats:styled-content>s) all had a recurrence or tumour\u2010related death. Median PHH<\/jats:styled-content>3 scores for the two groups were, respectively, 2\/10 HPF<\/jats:styled-content>s and 27\/10 HPF<\/jats:styled-content>s. A PHH<\/jats:styled-content>3 score of \u22657\/10 HPF<\/jats:styled-content>s was highly associated with malignancy.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>PHH<\/jats:styled-content>3 is useful in evaluation of the biological behaviour of USMT<\/jats:styled-content>s, and may serve as a prognostic indicator for LMS<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13124","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T20:20:55Z","timestamp":1479327655000},"page":"746-755","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The mitosis\u2010specific marker phosphohistone\u2010H3 (PHH<\/scp>3) is an independent prognosticator in uterine smooth muscle tumours: an outcome\u2010based study"],"prefix":"10.1111","volume":"70","author":[{"given":"Kin\u2010Long","family":"Chow","sequence":"first","affiliation":[{"name":"Pathology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka\u2010Yu","family":"Tse","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Lung","family":"Cheung","sequence":"additional","affiliation":[{"name":"Pharmacology and Pharmacy The University of Hong Kong Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka\u2010Wing","family":"Wong","sequence":"additional","affiliation":[{"name":"Pathology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie N Y","family":"Cheung","sequence":"additional","affiliation":[{"name":"Pathology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W C","family":"Wong","sequence":"additional","affiliation":[{"name":"Pathology Pamela Youde Nethersole Eastern Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice N H","family":"Chan","sequence":"additional","affiliation":[{"name":"Pathology Kwong Wah Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy W F","family":"Yuen","sequence":"additional","affiliation":[{"name":"Pathology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hextan Y S","family":"Ngan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip P C","family":"Ip","sequence":"additional","affiliation":[{"name":"Pathology The University of Hong Kong Queen Mary Hospital Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,24]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"135","volume-title":"World Health Organization classification of tumours of female reproductive organs","author":"Oliva E","year":"2014"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2011.07.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199406000-00001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181a02d1c"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31822b44d2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12127"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0320(19980601)32:2<71::AID-CYTO1>3.0.CO;2-H"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPAPH28VHZEKNQ"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000183572.94140.43"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.59"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2012.188"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-016-1925-x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12678"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090642"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-008-9980-x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000341"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1309\/HXUNAG34B3CEFDU8"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2015-202983"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0000000000000137"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0000000000000248"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2005.030452"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2011.01858.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2011.464"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e31823135a3"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13000-016-0484-4"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e3181cf7cc1"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPDXFOPXGEF0RP"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-016-9424-9"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nov002"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10014-009-0249-9"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2014.10.08"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.198"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601660"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.12305"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12383"},{"key":"e_1_2_8_37_1","first-page":"461","article-title":"Anti\u2010phosphohistone H3 as an independent prognostic factor in human esophageal squamous cell carcinoma","volume":"33","author":"Nakashima S","year":"2013","journal-title":"Anticancer Res."},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e318193df97"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318287779c"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2008.12.008"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000249"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182851162"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318032125e"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(92)90313-R"},{"key":"e_1_2_8_45_1","first-page":"7196","article-title":"Diagnostic value of progesterone receptor, p16, p53 and pHH3 expression in uterine atypical leiomyoma","volume":"8","author":"Liang Y","year":"2015","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"e_1_2_8_46_1","first-page":"4418","article-title":"Value of counting positive PHH3 cells in the diagnosis of uterine smooth muscle tumors","volume":"8","author":"Pang SJ","year":"2015","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2015.139"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0b013e3181cfb901"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1996.0185"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1999.5436"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.820114.x"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1159\/000107107"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2005.08.010"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2006.00536.x"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2006.11.012"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/IGC.0b013e3181a1bfbc"},{"key":"e_1_2_8_57_1","first-page":"355","article-title":"Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients","volume":"2009","author":"Abeler VM","year":"1970","journal-title":"Histopathology"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2009.03.018"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-8258(03)00137-9"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.09.026"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/pgp.0b013e3180ca954f"},{"key":"e_1_2_8_62_1","first-page":"513","article-title":"Immunohistochemical analysis of p16 expression in uterine smooth muscle tumors","volume":"32","author":"Hakverdi S","year":"2011","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.01.022"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2007.02699.x"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e3181a2b8d3"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181574d1e"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e31815ea7f5"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26333"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27971"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2003.10.044"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw030"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000370"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.11.009"},{"key":"e_1_2_8_74_1","first-page":"522A","article-title":"A new rabbit monoclonal antibody to serine 10 phosphorylated\u2010histone H3 (PHH3): an immunohistochemical comparison study with a rabbit polyclonal PHH3","volume":"28","author":"Qi W","year":"2015","journal-title":"Mod. Pathol."},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001071"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhis.13124","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.13124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T15:11:34Z","timestamp":1696345894000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.13124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,24]]},"references-count":74,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/his.13124"],"URL":"https:\/\/doi.org\/10.1111\/his.13124","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,24]]},"assertion":[{"value":"2016-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}