Molecular-based classification algorithm for endometrial carcinoma categorizes ovarian endometrioid carcinoma into prognostically significant groups.
The Cancer Genome Atlas classification divides endometrial carcinoma in biologically distinct groups, and testing for p53, mismatch repair proteins (MMR), and polymerase ɛ (POLE) exonuclease domain mutations has been shown to predict the molecular subgroup and clinical outcome. While abnormalities i...
| Publicado en: | Modern Pathology Vol. 30; no. 12; pp. 1748 - 1760 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Dec2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126562914&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126562914 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08933952 UNB jtl: Modern Pathology issn: 08933952 maglogo: N pubinfo: dt: Dec2017 vid: 30 iid: 12 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 126562914 126562914 NLM28776572 10.1038/modpathol.2017.81 NLM28776572 126562914 ppf: 1748 ppct: 12 formats: tig: atl: Molecular-based classification algorithm for endometrial carcinoma categorizes ovarian endometrioid carcinoma into prognostically significant groups. aug: au: Parra-Herran, Carlos Lerner-Ellis, Jordan Xu, Bin Khalouei, Sam Bassiouny, Dina Cesari, Matthew Ismiil, Nadia Nofech-Mozes, Sharon affil: Department of Pathology and Laboratory Medicine, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada sug: subj: Endometrial Neoplasms Classification Neoplasms, Glandular and Epithelial Classification Algorithms Ovarian Neoplasms Classification Endometrial Neoplasms Mortality Aged Endometrial Neoplasms Prognosis Middle Age Ovarian Neoplasms Neoplasms, Glandular and Epithelial Mortality Ovarian Neoplasms Mortality Aged, 80 and Over Adult Female Cox Proportional Hazards Model Neoplasms, Glandular and Epithelial Scales Aged: 65+ years Middle Aged: 45-64 years Aged, 80 & over Adult: 19-44 years Female ab: The Cancer Genome Atlas classification divides endometrial carcinoma in biologically distinct groups, and testing for p53, mismatch repair proteins (MMR), and polymerase ɛ (POLE) exonuclease domain mutations has been shown to predict the molecular subgroup and clinical outcome. While abnormalities in these markers have been described in ovarian endometrioid carcinoma, their role in predicting its molecular profile and prognosis is still not fully explored. Patients with ovarian endometrioid carcinomas treated surgically in a 14-year period were selected. Only tumors with confirmation of endometrioid histology and negative WT1 and Napsin-A were included. POLE mutational analysis and immunohistochemistry for p53, MLH1, MSH2, MSH6, and PMS2 was performed in formalin-fixed, paraffin-embedded tissue. Following the molecular classifier proposed for endometrial carcinoma (Br J Cancer2015;113:299-310), cases were classified as POLE mutated, MMR abnormal, p53 abnormal, and p53 wild type. Clinicopathologic information was recorded, including patient outcome. In all, 72 cases were included, distributed as follows: 7 (10%) POLE mutated; 6 (8%) MMR abnormal; 17 (24%) p53 abnormal; and 42 (58%) p53 wild type. The molecular classification correlated with disease-free survival in multivariate analysis (P=0.003), independently of tumor grade and stage. Correlation with overall survival approached statistical significance (P=0.051). POLE-mutated and MMR-abnormal tumors had excellent survival, whereas p53-abnormal tumors had significantly higher rates of recurrence and death. Ovarian endometroid carcinoma can be classified in clinically meaningful subgroups by testing for molecular surrogates, akin to endometrial cancer. MMR and POLE alterations seem to identify a subset of ovarian endometrioid carcinomas with excellent outcome; conversely, abnormal p53 carries a worse prognosis. In the era of personalized medicine, the use of these markers in the routine evaluation of ovarian endometrioid tumors should be considered. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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