Insulin-like growth factor II messenger RNA-binding protein-
3 is an independent prognostic factor in uterine
& Yoshinao Oda
Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University,
Department of Pathology, National Kyushu Cancer Center, Fukuoka,
Department of Pathology, Aso Iizuka
Department of Pathology, Matsuyama Red Cross Hospital, Ehime,
Department of Pathology,
Kyushu Central Hospital, Fukuoka, and
Department of Gynecology and Obstetrics, Graduate School of Medical
Sciences, Kyushu University, Fukuoka, Japan
Date of submission 25 August 2017
Accepted for publication 24 October 2017
Published online Article Accepted 27 October 2017
Yasutake N, Ohishi Y, Taguchi K, Hiraki Y, Oya M, Oshiro Y, Mine M, Iwasaki T, Yamamoto H, Kohashi K,
Sonoda K, Kato K & Oda Y
(2018) Histopathology 72, 739–748. https://doi.org/10.1111/his.13422
Insulin-like growth factor II messenger RNA-binding protein-3 is an independent prognos-
tic factor in uterine leiomyosarcoma
Aims: The aim of this study was to identify the prog-
nostic factors of uterine leiomyosarcoma (ULMS).
Methods and results: We reviewed 60 cases of surgi-
cally resected ULMSs and investigated conventional
clinicopathological factors, together with the expres-
sion of insulin-like growth factor II messenger RNA-
binding protein-3 (IMP3), hormone receptors and cell
cycle regulatory markers by immunohistochemistry.
Mediator complex subunit 12 (MED12) mutation
analysis was also performed. Univariate analyses
revealed that advanced stage (P < 0.0001), older age
(P = 0.0244) and IMP3 expression (P = 0.0011)
were signiﬁcant predictors of a poor outcome. Multi-
variate analysis revealed advanced stage
(P < 0.0001) and IMP3 (P = 0.0373) as independent
predictors of a poor prognosis. Expressions of cell
cycle markers and hormone receptors, and MED12
mutations (12% in ULMSs) were not identiﬁed as
prognostic markers in this study.
Conclusions: IMP3 expression in ULMS could be a
marker of a poor prognosis.
Keywords: IMP3, leiomyosarcoma, MED12, prognosis, uterus
Uterine leiomyosarcoma (ULMS) is an uncommon
smooth muscle tumour, accounting for approximately
1–2% of all uterine malignancies.
survival rates range from 15 to 25% for all stages of
The mechanisms of tumorigenesis, pathogen-
esis and progression have not been well established.
Disease stage has been shown to be the most impor-
tant prognostic factor in ULMSs.
have found older age,
large tumour size,
high mitotic index,
high-grade cytological atypia,
presence of coagula-
tive tumour cell necrosis (CTN),
low expression of
Address for correspondence: Yoshinao Oda MD, PhD, Department
of Anatomic Pathology, Pathological Sciences, Graduate School of
Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku,
Fukuoka 812-8582, Japan. e-mail: firstname.lastname@example.org-
© 2017 John Wiley & Sons Ltd.
Histopathology 2018, 72, 739–748. DOI: 10.1111/his.13422