Distinct preoperative clinical features predict four histopathological subtypes of high-grade serous carcinoma of the ovary, fallopian tube, and peritoneum.
Distinct preoperative clinical features predict four histopathological subtypes of high-grade serous carcinoma of the ovary, fallopian tube, and peritoneum.
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术前临床特征可预测卵巢，输卵管和腹膜的高级浆液性癌的四种组织病理亚型。
DOI：
10.1186/s12885-017-3573-1
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发表时间：
2017-08-29
期刊：
影响因子：
3.8
通讯作者：
Matsumura N
中科院分区：
文献类型：
--
作者：
Ohsuga T;Yamaguchi K;Kido A;Murakami R;Abiko K;Hamanishi J;Kondoh E;Baba T;Konishi I;Matsumura N
癌症基因组图谱研究网络报道，高级别浆液性癌（HGSC）可以基于基因表达谱分为四种亚型，称为“免疫反应性”、“分化型”、“增殖型”和“间充质型”。我们以前建立了一个新的HGSC的组织病理学分类，对应的基因表达亚型：免疫反应（IR），乳头腺（PG），实体和增殖（SP），和间质转化（MT）。本研究的目的是确定HGSC的四种病理亚型之间的不同临床表现，以及根据术前图像预测病理亚型。我们回顾性评估了65例HGSC（IR：17例，PG：7例，SP：14例，MT：27例）并分析了术前影像学。所有IR病例均起源于卵巢或输卵管（P = 0.0269）。在早期阶段诊断出的IR病例明显更多（P = 0.0013），IR病例显示腹水水平较低（P = 0.0014），腹膜病变较少（P = 0.0080），散发性腹膜病变与其他亚型相比，高血压组网膜饼的发生率低（P = 0.0416），远处转移少（P = 0.0146）。MT病例更可能是腹膜来源（P = 0.0202），出现在晚期，腹水水平较高（分别为P = 0.0008，0.0052），更常见的是弥漫性腹膜病变（P = 0.0059），网膜饼（P = 0.0179）和远处转移（P = 0.0053）。决策树分析根据术前图像估计组织病理学亚型，灵敏度为67.3%。HGSC的病理亚型具有不同的临床表现，术前影像学检查能够更好地预测病理亚型。如果基于HGSC亚型的治疗效果得到阐明，这些发现可能会导致个体化治疗计划。本文的在线版本（10.1186/s12885-017-3573-1）包含补充材料，可供授权用户使用。
The Cancer Genome Atlas Research Network reported that high-grade serous carcinoma (HGSC) can be classified based on gene expression profiles into four subtypes, termed “immunoreactive,” “differentiated,” “proliferative,” and “mesenchymal.” We previously established a novel histopathological classification of HGSC, corresponding to the gene expression subtypes: immune reactive (IR), papillo-glandular (PG), solid and proliferative (SP), and mesenchymal transition (MT). The purpose of this study is to identify distinct clinical findings among the four pathological subtypes of HGSC, as well as to predict pathological subtype based on preoperative images. We retrospectively assessed 65 HGSC cases (IR: 17, PG: 7, SP: 14, MT: 27) and analyzed preoperative images. All IR cases originated from either the ovary or fallopian tube (P = 0.0269). Significantly more IR cases were diagnosed at earlier stages (P = 0.0013), and IR cases displayed lower levels of ascites (P = 0.0014), fewer peritoneal lesions (P = 0.0080), a sporadic pattern of peritoneal lesions (P = 0.0016), a lower incidence of omental cake (P = 0.0416), and fewer distant metastases (P = 0.0146) compared with the other subtypes. MT cases were more likely to be of peritoneal origin (P = 0.0202), presented at advanced stages with higher levels of ascites (P = 0.0008, 0.0052, respectively), and more frequently had a diffuse pattern of peritoneal lesions (P = 0.0059), omental cake (P = 0.0179), and distant metastasis (P = 0.0053). A decision tree analysis estimated the histopathological subtypes based on preoperative images, with a sensitivity of 67.3%. Pathological subtypes of HGSC have distinct clinical behaviors, and preoperative images enable better prediction of pathological subtype. These findings may lead to individualized treatment plans if the effect of treatment based on the HGSC subtype is elucidated. The online version of this article (10.1186/s12885-017-3573-1) contains supplementary material, which is available to authorized users.
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通讯作者：
Thomson, E.