Table 1.
Overview of studied protein biomarkers in uterine sarcoma in serum or plasma.
| Marker | Author | Year | Tumor Type (N) | Controls (N) | Results/Conclusions |
|---|---|---|---|---|---|
| CA125 | Juang [18] | 2006 | LMS(42) | UM (84) | Preoperative serum CA125 had a potential role in the differential diagnosis between early stage and advanced-stage uterine leiomyosarcoma. |
| Yilmaz [19] | 2009 | USM * (26); | UM (2382) | In the differential diagnosis of myoma and uterine sarcoma, the preoperative serum CA 125 level did not have any predictivity. | |
| LDH | Song [20] | 2018 | USM (50) | UM (26) | The positivity rates for LDH-A and LDH-D were significantly higher in patients with uterine sarcoma compared with those with uterine myoma. |
| Zhang [21] | 2020 | LMS (45) | UM (180) | LDH ≥ 193 U/L was independent predictors of LMS. | |
| Goto [22] | 2002 | LMS (10) | DLM (130) | The combined use of dynamic MRI and serum measurement of LDH seems to be useful in making a differentiated diagnosis of LMS from DLM. |
|
| Di Cello [24] | 2019 | USM (43) | UM (2211) | UMG, the accuracy of markers in discriminating between benign and suspicious malignant uterine masses was significantly enhanced, sensitivity at 100% and specificity at 99.6%. |
|
| Spivack [25] | 2021 | Null | UM (179) | Specificity of UMG index to exclude uterine sarcoma was 91.1% (163/179) and higher in non-obese (BMI < 30; 95.1%) than obese women (85.5%). |
|
| Nagamatsu [26] | 2010 | USM * (10) | UM (24) | The diagnostic accuracy of FDG-PET combined with serum LDH was 100%. | |
| Kusunoki [27] | 2017 | USC (15) | UM (19) | PET/CT and LDH levels had a sensitivity of 86.6%, specificity of 100%, positive predictive value of 100%, and an NPV of 90.4%. | |
| NLR | Zhang [21] | 2020 | LMS (45) | UM (180) | NLR ≥ 2.8 were independent predictors of LMS. |
| Kim [28] | 2010 | USM * (55) | UM (330) | NLR was more powerful for the preoperative diagnosis of uterine sarcomas than serum CA-125 levels. | |
| Cho [29] | 2016 | USM(31) | UM (93) | NLR > 2.1 was independent risk factors for uterine sarcoma. | |
| GDF-15 | Trovik [30] | 2014 | USM (19) | UM (50) | The median circulating GDF-15 concentration was elevated in the uterine sarcoma group (943 ng/L) compared with the myoma uteri group (647 ng/L). |
| MicroRNA | Yokoi [32] | 2019 | USM (10) | UM (18) | The optimal model consisted of two miRNAs (miR-1246 and miR-191-5p), with an area under the receiver operating characteristic curve (AUC) for identifying LMS of 0.97. |
| CRP+D-dimer | Nishigaya [34] | 2019 | USM (36) | UM (97) | When LDH, D-dimer, and CRP were all positive, specificity and positive predictive value were 100% in differentiating leiomyosarcoma from uterine myoma. |
LMS: leiomyosarcoma; UM: uterine myoma; USM: uterine sarcoma; DLM: degenerated leiomyoma; CA125: Cancer antigen 125; LDH: Lactate dehydrogenase; NLR: Neutrophil-to-lymphocyte ratio; CRP: C-reactive protein; GDF-15: Growth differentiation factor-15; *: including carcinosarcoma.