Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Validation of biomarkers and clinical scores for the detection of uterine leiomyosarcoma: a case-control study with an update of pLMS,” published in the January 2025 issue of Obstetrics & Gynecology by Vollmer et al.
Diagnosing uterine leiomyosarcoma (uLMS) is challenging due to the high incidence of benign tumors like leiomyoma (LM). Several clinical scores and blood markers have been proposed in recent years to improve detection.
Researchers conducted a retrospective study to validate the pLMS scoring system and assess the discriminatory ability of blood markers like lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in differentiating uLMS from benign tumors.
They conducted a case-control study with 90 uLMS and 659 LM cases. Welch’s t-test and Hedges’ g assessed blood markers and calculated diagnostic odds ratios (OR). pLMS2 was developed using penalized logistic regression based on pooled data from 384 uLMS and 1,485 LM cases.
The results showed that pLMS achieved an AUC of 0.97, with varying sensitivity and specificity at proposed thresholds. Comparison with Zhang’s scoring system (43 uLMS, 578 LM) showed pLMS superiority (AUC 0.960 vs 0.845). LDH, NLR, and PLR had diagnostic OR of 18.03, 8.64, and 4.81, respectively. pLMS2 incorporates subscores for menopausal status, age, tumor diameter, intermenstrual bleeding, hypermenorrhea, dysmenorrhea, postmenstrual bleeding, rapid tumor growth, and suspicious sonography.
Investigators validated pLMS, showing stable discriminatory ability, though sensitivity and specificity varied with cut-off values. The updated pLMS2 remained simple and cost-effective, with LDH, NLR, and PLR providing additional differentiation between uLMS and LM.
Source: pubmed.ncbi.nlm.nih.gov/39773707
