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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.
- Source :
-
The American journal of surgical pathology [Am J Surg Pathol] 2020 Mar; Vol. 44 (3), pp. 316-328. - Publication Year :
- 2020
-
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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers, Tumor metabolism
Cystadenocarcinoma, Serous genetics
Cystadenocarcinoma, Serous metabolism
Cystadenocarcinoma, Serous pathology
Databases, Factual
Female
GTP Phosphohydrolases genetics
High-Throughput Nucleotide Sequencing
Humans
Immunohistochemistry
Membrane Proteins genetics
Middle Aged
Mutation
Neoplasm Grading
Ovarian Neoplasms genetics
Ovarian Neoplasms metabolism
Ovarian Neoplasms pathology
Prognosis
Proto-Oncogene Proteins B-raf metabolism
Tumor Suppressor Protein p53 metabolism
Biomarkers, Tumor genetics
Cystadenocarcinoma, Serous diagnosis
Ovarian Neoplasms diagnosis
Proto-Oncogene Proteins B-raf genetics
Tumor Suppressor Protein p53 genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1532-0979
- Volume :
- 44
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of surgical pathology
- Publication Type :
- Academic Journal
- Accession number :
- 31876585
- Full Text :
- https://doi.org/10.1097/PAS.0000000000001419