Primary sources of pelvic serous cancer in patients with endometrial intraepithelial carcinoma
Primary sources of pelvic serous cancer in patients with endometrial intraepithelial carcinoma
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子宫内膜上皮内癌患者盆腔浆液性癌的主要来源
DOI：
10.1038/modpathol.2014.76
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发表时间：
2015-01-01
期刊：
影响因子：
7.5
通讯作者：
Zheng, Wenxin
中科院分区：
文献类型：
--
作者：
Jia, Lin;Yuan, Zeng;Zheng, Wenxin
浆液性子宫内膜上皮内癌常与宫外疾病相关。目前尚不清楚宫外疾病从何而来。本研究解决了这个问题。总共研究了来自 21 名浆液性子宫内膜上皮内癌患者的 135 个样本。通过TP53突变分析确定宫内和宫外浆液性癌之间的细胞谱系关系，并将其与临床病理特征相关联。造成宫外疾病的因素有3种：浆液性子宫内膜上皮内癌转移（n = 10）显示宫内病变和宫外疾病之间相同的TP53突变，附件起源病例（n = 5）具有不一致的TP53突变，以及混合细胞起源病例（n = 6）具有相同和不一致的突变状态。浆液性子宫内膜上皮内癌转移的宫外疾病患者通常宫外部位肿瘤肿块较小（<2cm），未发现浆液性输卵管上皮内癌，而起源于附件或输卵管的宫外疾病患者通常在宫外部位有较大肿瘤肿块，包括卵巢和大网膜以及浆液性输卵管上皮内癌。大多数与浆液性子宫内膜上皮内癌相关的宫外疾病是从子宫内膜转移的。浆液性子宫内膜上皮内癌经常与附件或输卵管起源的浆液性癌相关，表明子宫内膜和附件或输卵管浆液性癌可能具有相似的病因。 TP53 突变分析为细胞谱系分析提供了强有力的联系。宫外疾病的肿瘤大小以及是否存在浆液性输卵管上皮内癌是确定原发癌症部位的有用临床病理特征，这有助于临床治疗。
Serous endometrial intraepithelial carcinoma is often associated with extrauterine disease. It is currently unclear where does the extrauterine disease come from. This study addressed this issue. A total of 135 samples from 21 serous endometrial intraepithelial carcinoma patients were studied. Cellular lineage relationships between intrauterine and extrauterine serous carcinomas were determined by TP53-mutation analysis and correlated to the clinicopathologic features. There were three conditions contributing the extrauterine disease: metastasis from serous endometrial intraepithelial carcinoma (n=10) showed identical TP53 mutation between intrauterine lesions and extrauterine disease, cases of adnexal origin (n=5) had discordant TP53 mutations, and the mixed cellular origin cases (n=6) with both identical and discordant mutation status. Patients with extrauterine disease from serous endometrial intraepithelial carcinoma metastasis typically had small tumor masses (<2 cm) in extrauterine sites and without finding of serous tubal intraepithelial carcinoma, while extrauterine disease with adnexal or tubal origin commonly had larger tumor masses in extrauterine sites including ovary and omentum and serous tubal intraepithelial carcinoma. The majority of extrauterine diseases associated with serous endometrial intraepithelial carcinoma are metastasized from the endometrium. Serous endometrial intraepithelial carcinoma is frequently associated with serous cancers of adnexal or tubal origin, indicating that endometrial and adnexal or tubal serous cancers may share similar etiologies. TP53-mutation analysis provides a strong linkage for cellular lineage analysis. Tumor size in extrauterine disease and presence of serous tubal intraepithelial carcinoma or not are useful clinicopathologic features to determine primary cancer site, which helps in clinical management.