Frontiers in oncology · 2026
Case series analysis of immunophenotypic evolution during recurrence of low-grade endometrial stromal sarcoma: implications for molecular stability and clinical management.
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Li Jing, Zhang Lihong, Chen Tingting
Аннотация
PURPOSE: To investigate the pathological morphology, immunophenotype, and molecular genetic characteristics of recurrent low-grade endometrial stromal sarcoma (LG-ESS) through the analysis of paired primary and recurrent tumor samples.
METHODS: A single-center retrospective analysis was conducted using the clinical data, pathological morphology, immunohistochemical results of estrogen receptor, progesterone receptor (PR), CD10, Ki-67, and fluorescence in situ hybridization findings for JAZF1 and PHF1 gene rearrangements in paired tumor tissues from four patients with LG-ESS.
RESULTS: Patients' ages ranged from 22 to 34 years. All cases showed consistent JAZF1 or PHF1 gene rearrangements in both primary and recurrent tumors. However, immunophenotypic alterations were observed during recurrence: one recurrent lesion showed loss of PR expression accompanied by a decreased Ki-67 index, whereas another demonstrated loss of CD10 expression. The median follow-up time was 84 months (range, 36-144 months). The recurrence interval ranged from 3 to 12 years, and all patients remained alive following comprehensive treatment.
CONCLUSION: This case series indicates that core driver gene rearrangements remain stable during recurrence in LG-ESS, whereas immunophenotypic evolution may occur in some cases. These preliminary findings suggest that the re-evaluation of biomarkers such as hormone receptors at recurrence may provide valuable guidance for individualized treatment selection (e.g., hormonal therapy). Given the characteristic tendency for late recurrence in LG-ESS, long-term follow-up is essential.
METHODS: A single-center retrospective analysis was conducted using the clinical data, pathological morphology, immunohistochemical results of estrogen receptor, progesterone receptor (PR), CD10, Ki-67, and fluorescence in situ hybridization findings for JAZF1 and PHF1 gene rearrangements in paired tumor tissues from four patients with LG-ESS.
RESULTS: Patients' ages ranged from 22 to 34 years. All cases showed consistent JAZF1 or PHF1 gene rearrangements in both primary and recurrent tumors. However, immunophenotypic alterations were observed during recurrence: one recurrent lesion showed loss of PR expression accompanied by a decreased Ki-67 index, whereas another demonstrated loss of CD10 expression. The median follow-up time was 84 months (range, 36-144 months). The recurrence interval ranged from 3 to 12 years, and all patients remained alive following comprehensive treatment.
CONCLUSION: This case series indicates that core driver gene rearrangements remain stable during recurrence in LG-ESS, whereas immunophenotypic evolution may occur in some cases. These preliminary findings suggest that the re-evaluation of biomarkers such as hormone receptors at recurrence may provide valuable guidance for individualized treatment selection (e.g., hormonal therapy). Given the characteristic tendency for late recurrence in LG-ESS, long-term follow-up is essential.