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Clinicopathologic, Immunohistochemical, and Molecular Characteristics of Ovarian Serous Carcinoma With Mixed Morphologic Features of High-grade and Low-grade Serous Carcinoma.

卵巢浆液性癌的临床病理、免疫组织化学和分子特征,具有高级别和低级别浆液性癌的混合形态特征。

  • 影响因子:6.06
  • DOI:10.1097/PAS.0000000000001419
  • 作者列表:"Zarei S","Wang Y","Jenkins SM","Voss JS","Kerr SE","Bell DA
  • 发表时间:2020-03-01
Abstract

:Despite the current classification of high-grade serous carcinoma (HGSCA) and low-grade serous carcinoma (LGSCA) as mutually exclusive diseases based on morphology and molecular pathogenesis, cases with mixed morphologic features of HGSCA and LGSCA have been reported. Herein we assess the clinicopathologic, immunohistochemical (IHC), and molecular genetic characteristics of a group of these cases, which we termed indeterminate grade serous carcinoma (IGSCA) in comparison with groups of HGSCA and LGSCA. Using the World Health Organization (WHO) classification criteria, we selected 27 LGSCA and 19 IGSCA for detailed morphologic study. Thirteen classic HGSCA, 19 classic LGSCA, and 19 IGSCA were selected for p53 and BRAF V600E IHC and molecular genetic testing by next-generation sequencing. IGSCA showed the architectural patterns of invasion of LGSCA, but with higher grade nuclear features focally and a mitotic index intermediate between LGSCA and HGSCA. Few cases in the IGSCA group showed mutant TP53 by IHC or sequencing (4/18, 22.2%), 1 case had mutant BRAF non-V600E by sequencing, and 1 had an NRAS mutation. When present, the mutations were identical in the low-grade and high-grade areas. The IGSCA group had a long-term survival similar to the classic HGSCA group. IGSCA with mixed morphologic features of HGSCA and LGSCA is a rare and potentially clinically aggressive variant of serous carcinoma. Their distinct morphologic, but heterogenous molecular features, including low frequency of TP53 and BRAF mutations suggest that these rare tumors may have a different pathogenesis pathway compared with classic HGSCA and classic LGSCA.

摘要

: 尽管目前根据形态学和分子发病机制将高级别浆液性癌 (HGSCA) 和低级别浆液性癌 (LGSCA) 分类为相互排斥的疾病,但已经报道了具有HGSCA和LGSCA混合形态特征的病例。在此,我们评估了这些病例组的临床病理、免疫组织化学 (IHC) 和分子遗传学特征,我们将其称为不确定级别浆液性癌 (IGSCA),并与HGSCA和LGSCA组进行比较。使用世卫组织分类标准,我们选择27个LGSCA和19个IGSCA进行详细的形态学研究。通过新一代测序选择13个经典HGSCA、19个经典LGSCA和19个IGSCA进行p53和BRAF V600E IHC和分子遗传学检测。IGSCA显示了LGSCA入侵的结构模式,但具有更高级别的核特征,并且有丝分裂指数介于LGSCA和HGSCA之间。IGSCA组中少数病例经IHC或测序显示突变型TP53 (4/18,22.2%),1例经测序发现突变型BRAF non-V600E,1例有NRAS突变。当存在时,突变在低级和高级区域是相同的。IGSCA组的长期生存率与经典HGSCA组相似.具有HGSCA和LGSCA混合形态特征的IGSCA是浆液性癌的一种罕见且潜在的临床侵袭性变体。它们独特的形态学但异质性的分子特征,包括TP53和BRAF突变的低频率,表明这些罕见肿瘤与经典HGSCA和经典LGSCA相比可能具有不同的发病机制。

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影响因子:3.60
发表时间:2020-01-01
DOI:10.1245/s10434-019-07492-8
作者列表:["Ellis RJ","Schlick CJR","Yang AD","Barber EL","Bilimoria KY","Merkow RP"]

METHODS:INTRODUCTION:Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) is an effective treatment option for selected patients with peritoneal metastases (PM), but national utilization patterns are poorly understood. The objectives of this study were to (1) describe population-based trends in national utilization of CRS/IPC; (2) define the most common indications for the procedure; and (3) characterize the types of hospitals performing the procedure. METHODS:The National Inpatient Sample (NIS) was used to identify patients from 2006 to 2015 who underwent CRS/IPC, and to calculate national estimates of procedural frequency and oncologic indication. Hospitals performing CRS/IPC were classified based on size and teaching status. RESULTS:The estimated annual number of CRS/IPC cases increased significantly from 189 to 1540 (p < 0.001). Overall, appendiceal cancer was the most common indication (25.7%), followed by ovarian cancer (23.3%), colorectal cancer (22.5%), and unspecified PM (15.0%). Remaining cases (13.5%) were performed for other indications. Most cases were performed in large teaching hospitals (65.9%), compared with smaller teaching hospitals (25.1%), large non-teaching hospitals (5.3%), or small non-teaching hospitals (3.2%). Patients were more likely to undergo CRS/IPC without a diagnosis based on level I evidence (appendiceal, ovarian, or colorectal) at large non-academic hospitals (odds ratio 2.00, 95% confidence interval 1.18-3.38, p = 0.010) compared with large academic hospitals. CONCLUSIONS:Utilization of CRS/IPC is increasing steadily in the US, is performed at many types of facilities, and often for a variety of indications that are not supported by high-level evidence. Given associated morbidity of CRS/IPC, a national registry dedicated to cases of IPC is necessary to further evaluate use and outcomes.

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影响因子:6.93
发表时间:2020-04-01
DOI:10.1002/ijc.32513
作者列表:["Grundy A","Ho V","Abrahamowicz M","Parent MÉ","Siemiatycki J","Arseneau J","Gilbert L","Gotlieb WH","Provencher DM","Koushik A"]

METHODS::Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.

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影响因子:0.64
发表时间:2020-01-01
DOI:10.1080/01443615.2019.1604643
作者列表:["Çetin M","Tunçdemir P","Karaman K","Yel S","Karaman E","Özgökçe M","Kömüroğlu AU"]

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