High-grade Endometrioid Carcinoma of the Ovary
| Autor: | Peter F Rambau, Hisham Assem, Sandra Lee, Linda E. Kelemen, Anna Sienko, Travis Ogilvie, Martin Köbel |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Time Factors endocrine system diseases Serous carcinoma Population Gastroenterology Alberta Pathology and Forensic Medicine 03 medical and health sciences Ovarian tumor 0302 clinical medicine Predictive Value of Tests Internal medicine Biomarkers Tumor medicine Carcinoma Humans Stage (cooking) WT1 Proteins education Aged Retrospective Studies Aged 80 and over Ovarian Neoplasms Univariate analysis education.field_of_study Tissue microarray business.industry Incidence Reproducibility of Results Middle Aged medicine.disease Immunohistochemistry female genital diseases and pregnancy complications Serous fluid Treatment Outcome 030104 developmental biology Tissue Array Analysis 030220 oncology & carcinogenesis Female Surgery Neoplasm Grading Tumor Suppressor Protein p53 Anatomy business Carcinoma Endometrioid |
| Zdroj: | American Journal of Surgical Pathology. 42:534-544 |
| ISSN: | 0147-5185 |
| Popis: | Although infrequently encountered, the diagnosis of ovarian high-grade endometrioid carcinoma remains a diagnostic challenge with potential consequences for targeted therapies and genetic counselling. We studied the clinical, morphologic, and immunohistochemical features of ovarian high-grade endometrioid carcinomas and their diagnostic reproducibility compared with tuboovarian high-grade serous carcinomas. Thirty cases confirmed as International Federation of Gynecology and Obstetrics grade 3 endometrioid carcinomas were identified from 182 ovarian endometrioid carcinomas diagnosed in Alberta, Canada, between 1978 and 2010, from the population-based Alberta Ovarian Tumor Types cohort. Cases of lower grade endometrioid and high-grade serous carcinoma served for comparison. Ten immunohistochemical markers were assessed on tissue microarrays. Clinical data were abstracted and survival analyses performed using Cox regression. Interobserver reproducibility for histologic type was assessed using 1 representative hematoxylin and eosin-stained slide from 25 randomly selected grade 3 endometrioid carcinomas and 25 high-grade serous carcinomas. Histotype was independently assigned by 5 pathologists initially blinded to immunohistochemical WT1/p53 status, with subsequent reassessment unblinded to WT1/p53 status. Patients diagnosed with grade 3 endometrioid carcinoma had a significantly longer survival compared with high-grade serous carcinoma in univariate analysis (hazard ratio [HR]=0.34, 95% confidence interval [CI]=0.16-0.67, P=0.0012) but not after adjusting for age, stage, treatment center, and residual tumor (HR=1.01, 95% CI=0.43-2.16, P=0.98). Grade 3 endometrioid carcinoma cases (N=30) were identical to grade 2 endometrioid carcinoma cases (N=23) with respect to survival in univariate analysis (HR=1.07, 95% CI=0.39-3.21, P=0.89) and immunohistochemical profile. Using histomorphology alone, interobserver agreement for the diagnosis of grade 3 endometrioid or high-grade serous carcinoma was 69%, which significantly increased (P |
| Databáze: | OpenAIRE |
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