Is Invasive Micropapillary Serous Carcinoma a Low-grade Carcinoma?
Is Invasive Micropapillary Serous Carcinoma a Low-grade Carcinoma?
复制标题
浸润性微乳头状浆液性癌是低度癌吗？
DOI：
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发表时间：
2016
影响因子：
2.4
通讯作者：
Y. Oda
中科院分区：
文献类型：
--
作者：
Y. Ohishi;H. Imamura;Murasaki Aman;Kaai Shida;T. Kaku;Kiyoko Kato;Y. Oda
一些病理学专家提出“浸润性微乳头状浆液性癌”是低级别浆液性癌的同义词。相反，Singer和他的同事报道了一些具有明显侵袭性微乳头状模式（sc - imp）的浆液性癌可以表现出高度的核异型性。然而，这类肿瘤的分子特征并没有很好的文献记载。本研究的目的是证明和强调通过免疫组织化学和分子分析证实的高级别浆液性癌可以表现出明显的浸润性微乳头状模式。我们选择了24个“sc - imp”，研究了：(1)它们的形态学特征；(2) p53蛋白免疫染色模式；(3) KRAS/BRAF/TP53基因突变。24例sc - imp主要根据核异型性细分为低级别和高级别肿瘤，有丝分裂率作为次要特征：低级别（n=5）和高级别（n=19）。低级别sc - imp的特征是有丝分裂活性低，没有异常有丝分裂，存在浆液交界性肿瘤，偶尔发生BRAF突变，不常见TP53突变。高级别sc - imp的特点是有丝分裂活性高，存在异常有丝分裂，常规高级别浆液性癌，TP53突变频繁，缺乏KRAS/BRAF突变。我们证实，通过异常p53免疫染色和分子分析证实的高级别浆液性癌可以表现出明显的浸润性微乳头状模式，证实了Singer和同事的报告。浆液性癌有明显的浸润性微乳头状征象，不应轻易视为低级别浆液性癌。核分级是sc - imp最重要的诊断特征。
“Invasive micropapillary serous carcinoma” has been proposed as a synonym for low-grade serous carcinoma by some expert pathologists. In contrast, Singer and colleagues reported that some serous carcinomas with conspicuous invasive micropapillary pattern (SC-IMPs) can show high-grade nuclear atypia. However, the molecular features of such tumors have not been well documented. The aim of this study was to demonstrate and emphasize the fact that high-grade serous carcinoma confirmed by immunohistochemistry and molecular analysis can show conspicuous invasive micropapillary pattern. We selected 24 “SC-IMPs” and investigated: (1) their morphologic features; (2) the immunostaining pattern of p53 protein; and (3) KRAS/BRAF/TP53 gene mutations. The 24 SC-IMPs were subdivided into low-grade and high-grade tumors based primarily on the nuclear atypia, with the mitotic rate used as a secondary feature: low grade (n=5) and high grade (n=19). Low-grade SC-IMPs were characterized by low-mitotic activity, absence of abnormal mitosis, presence of serous borderline tumor, occasional BRAF mutation, and infrequent TP53 mutation. High-grade SC-IMPs were characterized by high-mitotic activity, presence of abnormal mitosis, conventional high-grade serous carcinoma, frequent TP53 mutation, and lack of KRAS/BRAF mutation. We demonstrated that high-grade serous carcinoma confirmed by aberrant p53 immunostaining and molecular analysis can show conspicuous invasive micropapillary pattern, validating Singer and colleague’s report. Serous carcinoma with conspicuous invasive micropapillary pattern should not be readily regarded as low-grade serous carcinoma. Nuclear grade is the most important diagnostic feature in the SC-IMPs.
DOI：
10.1093/jnci/95.6.484
发表时间：
2003-03-19
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
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作者：
Singer, G;Oldt, R;Shih, IM
通讯作者：
Shih, IM