首页 > 最新文献

International Journal of Gynecological Pathology最新文献

英文 中文
HER2-low and Overexpression in Mucinous Ovarian Cancer: Analysis of ASCO/CAP and ToGA Immunohistochemical Scoring. 粘液性卵巢癌中的 HER2 低表达和过表达:ASCO/CAP 和 ToGA 免疫组化评分分析。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-04 DOI: 10.1097/PGP.0000000000000972
Rachel Han, Ainhoa Madariaga, Eduardo Gonzalez-Ochoa, Adam C Smith, Lisa Wang, Stephanie Lheureux, Marjan Rouzbahman

Mucinous ovarian carcinoma is an uncommon malignancy characterized by resistance to chemotherapy and poor survival in the metastatic setting. HER2 amplification is a frequent late event in carcinogenesis, yet the incidence of HER2-low in mucinous ovarian carcinoma is unknown. Further, the optimal method for determining overexpression in these tumors is not established. We sought to assess the ASCO/CAP and ToGA trial scoring methods for HER2 IHC with correlation to FISH, p53, and mismatch repair protein status and to determine the incidence of HER2-low in mucinous ovarian carcinoma. A total of 29 tumors from 23 patients were included. Immunohistochemistry for HER2, p53, MLH1, PMS2, MSH2, and MSH6 was performed. Scoring was performed according to the ASCO/CAP and ToGA trial criteria. HER2 FISH was performed and scored according to the ASCO/CAP criteria. The proportion of HER2-low, defined as 1+ or 2+ staining with negative FISH, was determined. Using ASCO/CAP, 26% demonstrated 3+ while 35% demonstrated 2+ staining. Using ToGA, 30% demonstrated 3+ while 57% demonstrated 2+ staining. By FISH, 26% were positive for HER2 amplification. Both systems captured all FISH-positive cases; the use of ASCO/CAP resulted in fewer equivocal and false-positive cases. Among HER2-negative cases, 88% were HER2-low. Aberrant p53 expression was detected in 55% of cases; mismatch repair deficiency was not identified in any cases. ASCO/CAP guidelines are accurate and resource-effective in determining HER2 overexpression in mucinous ovarian carcinoma. HER2-low is common in these tumors; further studies to determine the role of HER2-targeted therapy including antibody-drug conjugates are indicated.

粘液性卵巢癌是一种不常见的恶性肿瘤,其特点是对化疗耐药,转移后生存率低。HER2 扩增是一种常见的晚期癌变,但粘液性卵巢癌中 HER2 低表达的发生率尚不清楚。此外,确定这些肿瘤过表达的最佳方法尚未确定。我们试图评估 ASCO/CAP 和 ToGA 试验的 HER2 IHC 评分方法与 FISH、p53 和错配修复蛋白状态的相关性,并确定粘液性卵巢癌中 HER2 低表达的发生率。研究共纳入了 23 名患者的 29 个肿瘤。对 HER2、p53、MLH1、PMS2、MSH2 和 MSH6 进行了免疫组化。根据 ASCO/CAP 和 ToGA 试验标准进行评分。根据 ASCO/CAP 标准进行 HER2 FISH 检测和评分。确定HER2低的比例,定义为1+或2+染色且FISH阴性。根据 ASCO/CAP 标准,26% 的患者染色结果为 3+,35% 的患者染色结果为 2+。使用 ToGA,30% 显示 3+,57% 显示 2+ 染色。通过 FISH 检测,26% 的患者 HER2 扩增呈阳性。两种系统都能捕捉到所有 FISH 阳性病例;使用 ASCO/CAP 可减少等位和假阳性病例。在HER2阴性病例中,88%为HER2低表达。在 55% 的病例中检测到 p53 表达异常;未在任何病例中发现错配修复缺陷。ASCO/CAP指南在确定粘液性卵巢癌的HER2过表达方面既准确又节省资源。HER2低表达在这些肿瘤中很常见;应进一步研究确定HER2靶向疗法(包括抗体药物共轭物)的作用。
{"title":"HER2-low and Overexpression in Mucinous Ovarian Cancer: Analysis of ASCO/CAP and ToGA Immunohistochemical Scoring.","authors":"Rachel Han, Ainhoa Madariaga, Eduardo Gonzalez-Ochoa, Adam C Smith, Lisa Wang, Stephanie Lheureux, Marjan Rouzbahman","doi":"10.1097/PGP.0000000000000972","DOIUrl":"10.1097/PGP.0000000000000972","url":null,"abstract":"<p><p>Mucinous ovarian carcinoma is an uncommon malignancy characterized by resistance to chemotherapy and poor survival in the metastatic setting. HER2 amplification is a frequent late event in carcinogenesis, yet the incidence of HER2-low in mucinous ovarian carcinoma is unknown. Further, the optimal method for determining overexpression in these tumors is not established. We sought to assess the ASCO/CAP and ToGA trial scoring methods for HER2 IHC with correlation to FISH, p53, and mismatch repair protein status and to determine the incidence of HER2-low in mucinous ovarian carcinoma. A total of 29 tumors from 23 patients were included. Immunohistochemistry for HER2, p53, MLH1, PMS2, MSH2, and MSH6 was performed. Scoring was performed according to the ASCO/CAP and ToGA trial criteria. HER2 FISH was performed and scored according to the ASCO/CAP criteria. The proportion of HER2-low, defined as 1+ or 2+ staining with negative FISH, was determined. Using ASCO/CAP, 26% demonstrated 3+ while 35% demonstrated 2+ staining. Using ToGA, 30% demonstrated 3+ while 57% demonstrated 2+ staining. By FISH, 26% were positive for HER2 amplification. Both systems captured all FISH-positive cases; the use of ASCO/CAP resulted in fewer equivocal and false-positive cases. Among HER2-negative cases, 88% were HER2-low. Aberrant p53 expression was detected in 55% of cases; mismatch repair deficiency was not identified in any cases. ASCO/CAP guidelines are accurate and resource-effective in determining HER2 overexpression in mucinous ovarian carcinoma. HER2-low is common in these tumors; further studies to determine the role of HER2-targeted therapy including antibody-drug conjugates are indicated.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceptions of Controversies and Unresolved Issues in the 2014 FIGO Staging System for Endometrial Cancer: Survey Results From Members of the International Society of Gynecological Pathologists and International Gynecologic Cancer Society. 对 2014 FIGO 子宫内膜癌分期系统中存在的争议和未决问题的看法:国际妇科病理学家协会和国际妇科癌症协会会员调查结果。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2023-08-18 DOI: 10.1097/PGP.0000000000000977
Neslihan Kayraklioglu, Levon Katsakhyan, Paul A Cohen, Naveena Singh, Joseph T Rabban, Xavier Matias-Guiu

Long-standing controversial and unresolved issues in the current "International Federation of Gynecology and Obstetrics" staging system for endometrial cancer are well-recognized by pathologists and clinicians alike and exist primarily as a result of limitations to the existing literature. To guide the design of future outcome-based studies specifically aimed at resolving such gaps, the International Society of Gynecologic Pathologists developed a survey of the current perceptions of pathologists (n = 172) and clinicians (n= 135) from the International Society of Gynecological Pathologists and from the International Gynecologic Cancer Society on areas for potential refinement of the current International Federation of Gynecology and Obstetrics staging system. The highest priority issues for pathologists and clinicians alike were the need to determine whether stage IIIA patients (ovarian/fallopian tube involvement) can be reliably separated into favorable versus unfavorable outcome groups to avoid over-treatment of the former group and to determine whether stage IIIC patients (lymph node metastases) can be separated into favorable versus unfavorable outcome groups based on the size of lymph node metastases. The majority of pathologists and clinicians viewed lymphovascular space invasion as an independent prognostic variable and favored incorporating lymphovascular space invasion into staging, though the level of support did not meet the threshold of 75% in support that we used to define a formal consensus. While pathologists did agree on the prognostic value of reporting the extent of lymphovascular space invasion, there was no consensus on the diagnostic criteria to distinguish focal versus substantial involvement. The majority of pathologists and clinicians viewed that a universally accepted protocol for sentinel lymph node ultra-staging is lacking. Both survey groups conveyed a slight preference for incorporating tumor histotype and molecular classification into staging but the support was short of the 75% threshold for formal consensus. Collectively, this survey permits the International Society of Gynecological Pathologists to develop a pathologist and clinician-driven long-term strategy for prioritizing and designing outcome-based studies specifically targeted to resolving controversial and unresolved issues in the International Federation of Gynecology and Obstetrics staging of endometrial cancer.

病理学家和临床医生都清楚地认识到,目前 "国际妇产科联盟 "子宫内膜癌分期系统中长期存在的争议和未解决的问题,这主要是由于现有文献的局限性造成的。为了指导设计未来以结果为基础的研究,专门解决这些差距,国际妇科病理学家协会对国际妇科病理学家协会和国际妇科癌症协会的病理学家(n=172)和临床医生(n=135)目前对当前国际妇产科联合会分期系统可能改进的领域的看法进行了调查。病理学家和临床医生最优先考虑的问题是,需要确定是否能可靠地将 IIIA 期患者(卵巢/输卵管受累)分为预后良好组和预后不良组,以避免对前者进行过度治疗,以及确定是否能根据淋巴结转移的大小将 IIIC 期患者(淋巴结转移)分为预后良好组和预后不良组。大多数病理学家和临床医生认为淋巴管间隙侵犯是一个独立的预后变量,并赞成将淋巴管间隙侵犯纳入分期,尽管支持率未达到我们用来定义正式共识的 75% 的支持率阈值。虽然病理学家对报告淋巴管间隙受侵程度的预后价值达成了一致,但对区分局灶性和实质性受累的诊断标准却没有达成共识。大多数病理学家和临床医生认为,前哨淋巴结超分期缺乏普遍接受的方案。两个调查组都表示略微倾向于将肿瘤组织型和分子分类纳入分期,但支持率未达到达成正式共识的 75% 临界值。总之,这项调查使国际妇科病理学家协会能够制定一项由病理学家和临床医生主导的长期战略,优先考虑和设计基于结果的研究,专门解决国际妇产科联盟子宫内膜癌分期中存在的争议和未决问题。
{"title":"Perceptions of Controversies and Unresolved Issues in the 2014 FIGO Staging System for Endometrial Cancer: Survey Results From Members of the International Society of Gynecological Pathologists and International Gynecologic Cancer Society.","authors":"Neslihan Kayraklioglu, Levon Katsakhyan, Paul A Cohen, Naveena Singh, Joseph T Rabban, Xavier Matias-Guiu","doi":"10.1097/PGP.0000000000000977","DOIUrl":"10.1097/PGP.0000000000000977","url":null,"abstract":"<p><p>Long-standing controversial and unresolved issues in the current \"International Federation of Gynecology and Obstetrics\" staging system for endometrial cancer are well-recognized by pathologists and clinicians alike and exist primarily as a result of limitations to the existing literature. To guide the design of future outcome-based studies specifically aimed at resolving such gaps, the International Society of Gynecologic Pathologists developed a survey of the current perceptions of pathologists (n = 172) and clinicians (n= 135) from the International Society of Gynecological Pathologists and from the International Gynecologic Cancer Society on areas for potential refinement of the current International Federation of Gynecology and Obstetrics staging system. The highest priority issues for pathologists and clinicians alike were the need to determine whether stage IIIA patients (ovarian/fallopian tube involvement) can be reliably separated into favorable versus unfavorable outcome groups to avoid over-treatment of the former group and to determine whether stage IIIC patients (lymph node metastases) can be separated into favorable versus unfavorable outcome groups based on the size of lymph node metastases. The majority of pathologists and clinicians viewed lymphovascular space invasion as an independent prognostic variable and favored incorporating lymphovascular space invasion into staging, though the level of support did not meet the threshold of 75% in support that we used to define a formal consensus. While pathologists did agree on the prognostic value of reporting the extent of lymphovascular space invasion, there was no consensus on the diagnostic criteria to distinguish focal versus substantial involvement. The majority of pathologists and clinicians viewed that a universally accepted protocol for sentinel lymph node ultra-staging is lacking. Both survey groups conveyed a slight preference for incorporating tumor histotype and molecular classification into staging but the support was short of the 75% threshold for formal consensus. Collectively, this survey permits the International Society of Gynecological Pathologists to develop a pathologist and clinician-driven long-term strategy for prioritizing and designing outcome-based studies specifically targeted to resolving controversial and unresolved issues in the International Federation of Gynecology and Obstetrics staging of endometrial cancer.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive Immunohistochemical Analysis of Mesonephric Marker Expression in Low-grade Endometrial Endometrioid Carcinoma. 低级别子宫内膜样癌中中肾标记物表达的全面免疫组化分析
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2023-08-11 DOI: 10.1097/PGP.0000000000000976
Yurimi Lee, Sangjoon Choi, Hyun-Soo Kim

Immunohistochemical markers shown to be useful in identifying/confirming mesonephric/mesonephric-like differentiation (MLD markers) include thyroid transcription factor (TTF1), GATA-binding protein 3 (GATA3), and cluster of differentiation 10 (CD10). Only a few studies have examined the expression levels of MLD markers in endometrial endometrioid carcinomas (EECs). This study aimed to analyze the frequency and pattern of MLD marker expression in low-grade EECs. We performed immunostaining for the detection of TTF1, GATA3, and CD10 expression in 50 low-grade EEC tissue samples and evaluated their staining proportion and intensity. Nine tumors (18.0%) expressed at least one MLD marker in varying proportions and intensities, and 2 of these tumors were positive for 2 MLD markers (TTF1/GATA3 and GATA3/CD10, respectively). Three (6.0%) tumors showed moderate-to-strong nuclear TTF1 immunoreactivity in ≤5% of the tumor cells. Five tumors (10.0%) had at least moderate nuclear GATA3 staining, and three of them displayed a staining proportion of ≥15%. Three tumors (6.0%) were focal (mean proportion, 15%) but strongly positive for CD10. Our findings indicate that a subset of EEC can express one or more MLD markers with varying staining proportions and intensities. Given that a diagnosis of uterine mesonephric-like adenocarcinoma should be established based on a combination of characteristic histologic features, unique immunophenotypes, and confirmed molecular findings, pathologists should not exclude EEC based only on the presence of focal immunoreactivity for MLD markers. Awareness of the atypical expression patterns of MLD markers in EEC helps pathologists avoid misdiagnosing EEC as a uterine mesonephric-like adenocarcinoma.

免疫组化标记物被证明有助于识别/确认间肾/中肾样分化(MLD标记物),包括甲状腺转录因子(TTF1)、GATA结合蛋白3(GATA3)和分化簇10(CD10)。只有少数研究检测了子宫内膜样癌(EECs)中MLD标记物的表达水平。本研究旨在分析 MLD 标记在低级别 EECs 中的表达频率和模式。我们对50个低分化EEC组织样本进行了免疫染色,检测TTF1、GATA3和CD10的表达,并评估了它们的染色比例和强度。九个肿瘤(18.0%)以不同的比例和强度表达了至少一种 MLD 标记,其中两个肿瘤的两种 MLD 标记(分别为 TTF1/GATA3 和 GATA3/CD10)均呈阳性。3个肿瘤(6.0%)在≤5%的肿瘤细胞中显示出中等至强的核TTF1免疫反应。5个肿瘤(10.0%)至少有中度的核GATA3染色,其中3个肿瘤的染色比例≥15%。三个肿瘤(6.0%)为局灶性(平均比例为 15%),但 CD10 强阳性。我们的研究结果表明,EEC 的一部分可表达一种或多种 MLD 标记,染色比例和强度各不相同。鉴于子宫系膜样腺癌的诊断应根据特征性组织学特征、独特的免疫表型和确证的分子研究结果综合确定,病理学家不应仅根据 MLD 标记的局灶性免疫反应来排除 EEC。认识到 MLD 标记物在 EEC 中的非典型表达模式有助于病理学家避免将 EEC 误诊为子宫间质样腺癌。
{"title":"Comprehensive Immunohistochemical Analysis of Mesonephric Marker Expression in Low-grade Endometrial Endometrioid Carcinoma.","authors":"Yurimi Lee, Sangjoon Choi, Hyun-Soo Kim","doi":"10.1097/PGP.0000000000000976","DOIUrl":"10.1097/PGP.0000000000000976","url":null,"abstract":"<p><p>Immunohistochemical markers shown to be useful in identifying/confirming mesonephric/mesonephric-like differentiation (MLD markers) include thyroid transcription factor (TTF1), GATA-binding protein 3 (GATA3), and cluster of differentiation 10 (CD10). Only a few studies have examined the expression levels of MLD markers in endometrial endometrioid carcinomas (EECs). This study aimed to analyze the frequency and pattern of MLD marker expression in low-grade EECs. We performed immunostaining for the detection of TTF1, GATA3, and CD10 expression in 50 low-grade EEC tissue samples and evaluated their staining proportion and intensity. Nine tumors (18.0%) expressed at least one MLD marker in varying proportions and intensities, and 2 of these tumors were positive for 2 MLD markers (TTF1/GATA3 and GATA3/CD10, respectively). Three (6.0%) tumors showed moderate-to-strong nuclear TTF1 immunoreactivity in ≤5% of the tumor cells. Five tumors (10.0%) had at least moderate nuclear GATA3 staining, and three of them displayed a staining proportion of ≥15%. Three tumors (6.0%) were focal (mean proportion, 15%) but strongly positive for CD10. Our findings indicate that a subset of EEC can express one or more MLD markers with varying staining proportions and intensities. Given that a diagnosis of uterine mesonephric-like adenocarcinoma should be established based on a combination of characteristic histologic features, unique immunophenotypes, and confirmed molecular findings, pathologists should not exclude EEC based only on the presence of focal immunoreactivity for MLD markers. Awareness of the atypical expression patterns of MLD markers in EEC helps pathologists avoid misdiagnosing EEC as a uterine mesonephric-like adenocarcinoma.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11022992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9976723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erythrasma of the Vulva: An Invisible Dermatosis. 外阴红斑:一种隐形皮肤病。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-04-09 DOI: 10.1097/PGP.0000000000001031
Soma Jobbagy, Alvaro C Laga, Jaclyn C Watkins

Erythrasma is a prevalent superficial bacterial infection typically caused by Corynebacteria species and preferentially affecting intertriginous sites including axillary, interdigital, and inguinal skin folds. However, erythrasma of the vulva is uncommon, with only 2 cases previously reported. Although erythrasma can be diagnosed clinically using Woods lamp examination, it may not always be considered in the differential diagnosis for patients presenting with persistent vulvar pruritus. We report 12 cases of vulvar erythrasma identified by histopathology, with a review of clinical and histologic features. The mean patient age was 60.1 yr and the mean patient BMI was 30.5. Five of 12 patients presented with pruritic rash. The time from symptom onset to diagnosis was 9 mo in 1 case, >18 mo in 4 cases, and unknown in the remaining cases. The characteristic histologic features were compact orthokeratosis and mild perivascular chronic inflammation. In all 12 cases, Periodic Acid-Schiff-diastase (PAS-D) staining highlighted intracorneal filamentous rods which were not readily appreciable on H&E. After the diagnosis of erythrasma, 4 patients were treated with topical lincomycin, of whom 3 had clinical improvement in symptoms. One patient was treated with topical macrolide antibiotic and also reported improvement in symptoms. Consideration of erythrasma on the differential for patients presenting with vulvar rash and pruritus may shorten the time to diagnosis and treatment, minimize patient discomfort, and reduce the scope and cost of diagnostic testing.

红斑痤疮是一种常见的浅表细菌感染,通常由棒状杆菌引起,好发于三叉神经间部位,包括腋窝、趾间和腹股沟皮肤皱褶。然而,外阴红斑并不常见,此前仅有 2 例报道。虽然红斑可通过伍德灯检查进行临床诊断,但对于出现持续性外阴瘙痒的患者,可能并不总是将其考虑在鉴别诊断中。我们报告了 12 例经组织病理学鉴定的外阴红斑病例,并回顾了临床和组织学特征。患者的平均年龄为 60.1 岁,平均体重指数为 30.5。12 名患者中有 5 人出现瘙痒性皮疹。从症状出现到确诊的时间,1 例为 9 个月,4 例超过 18 个月,其余病例时间不明。组织学特征为角化不全和轻度血管周围慢性炎症。在所有 12 个病例中,PAS-D 染色可显示角膜内丝状棒状物,但在 H&E 染色中不易观察到。确诊为红斑痤疮后,4 名患者接受了局部林可霉素治疗,其中 3 人的临床症状有所改善。一名患者接受了局部大环内酯类抗生素治疗,症状也有所改善。对于出现外阴皮疹和瘙痒的患者,考虑将红斑病原体列入鉴别诊断,可以缩短诊断和治疗的时间,最大限度地减少患者的不适感,并减少诊断检测的范围和费用。
{"title":"Erythrasma of the Vulva: An Invisible Dermatosis.","authors":"Soma Jobbagy, Alvaro C Laga, Jaclyn C Watkins","doi":"10.1097/PGP.0000000000001031","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001031","url":null,"abstract":"<p><p>Erythrasma is a prevalent superficial bacterial infection typically caused by Corynebacteria species and preferentially affecting intertriginous sites including axillary, interdigital, and inguinal skin folds. However, erythrasma of the vulva is uncommon, with only 2 cases previously reported. Although erythrasma can be diagnosed clinically using Woods lamp examination, it may not always be considered in the differential diagnosis for patients presenting with persistent vulvar pruritus. We report 12 cases of vulvar erythrasma identified by histopathology, with a review of clinical and histologic features. The mean patient age was 60.1 yr and the mean patient BMI was 30.5. Five of 12 patients presented with pruritic rash. The time from symptom onset to diagnosis was 9 mo in 1 case, >18 mo in 4 cases, and unknown in the remaining cases. The characteristic histologic features were compact orthokeratosis and mild perivascular chronic inflammation. In all 12 cases, Periodic Acid-Schiff-diastase (PAS-D) staining highlighted intracorneal filamentous rods which were not readily appreciable on H&E. After the diagnosis of erythrasma, 4 patients were treated with topical lincomycin, of whom 3 had clinical improvement in symptoms. One patient was treated with topical macrolide antibiotic and also reported improvement in symptoms. Consideration of erythrasma on the differential for patients presenting with vulvar rash and pruritus may shorten the time to diagnosis and treatment, minimize patient discomfort, and reduce the scope and cost of diagnostic testing.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Human Papillomavirus-Associated Multiphenotypic Carcinoma: First Description of a Vulval Case. 人类乳头瘤病毒相关多型性癌:外阴病例的首次描述。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-04-09 DOI: 10.1097/PGP.0000000000001034
Charlotte C Currie, Darren Leaning, W Glenn McCluggage, Emma Spoor

Human papillomavirus (HPV)-associated multiphenotypic sinonasal carcinoma is a rare and recently described epithelial neoplasm exhibiting myoepithelial differentiation and morphological overlap with salivary gland neoplasms, especially adenoid cystic carcinoma; it is commonly associated with HPV, especially type 33. It has mainly been reported in the nasal cavity and paranasal sinuses with a single case reported in the breast. Herein, we report the first vulval example in a 47-year-old patient who presented with a large craggy mass in the region of the Bartholin gland. The histologic features were of a high-grade carcinoma composed of basaloid cells arranged in sheets and nests, with occasional ductal formations, surrounded by densely hyalinised basement membrane-type material. There was diffuse block-type immunoreactivity with p16 and HPV genotyping revealed high-risk HPV type 16. In reporting this case, we highlight the propensity for "salivary gland-type" neoplasms to arise in the vulva, especially in the Bartholin gland, and stress that pathologists should consider salivary-type neoplasms when faced with a morphologically unusual vulval tumor.

人乳头状瘤病毒(HPV)相关多型鼻窦癌是一种罕见的上皮性肿瘤,最近才被描述出来,表现为肌上皮分化,形态上与唾液腺肿瘤重叠,尤其是腺样囊性癌;它通常与人乳头状瘤病毒(尤其是 33 型)相关。它主要发生在鼻腔和副鼻窦,乳房也有一例报道。在此,我们报告了第一例外阴癌,患者 47 岁,巴氏腺区域有一个巨大的峭壁状肿块。组织学特征为高级别癌,由成片和成巢排列的类基底细胞组成,偶有导管形成,周围为致密透明的基底膜样物质。p16呈弥漫块状免疫反应,HPV基因分型显示为高危HPV16型。在报告该病例时,我们强调了 "唾液腺型 "肿瘤在外阴,尤其是巴氏腺中出现的倾向,并强调病理学家在遇到形态异常的外阴肿瘤时应考虑唾液腺型肿瘤。
{"title":"Human Papillomavirus-Associated Multiphenotypic Carcinoma: First Description of a Vulval Case.","authors":"Charlotte C Currie, Darren Leaning, W Glenn McCluggage, Emma Spoor","doi":"10.1097/PGP.0000000000001034","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001034","url":null,"abstract":"<p><p>Human papillomavirus (HPV)-associated multiphenotypic sinonasal carcinoma is a rare and recently described epithelial neoplasm exhibiting myoepithelial differentiation and morphological overlap with salivary gland neoplasms, especially adenoid cystic carcinoma; it is commonly associated with HPV, especially type 33. It has mainly been reported in the nasal cavity and paranasal sinuses with a single case reported in the breast. Herein, we report the first vulval example in a 47-year-old patient who presented with a large craggy mass in the region of the Bartholin gland. The histologic features were of a high-grade carcinoma composed of basaloid cells arranged in sheets and nests, with occasional ductal formations, surrounded by densely hyalinised basement membrane-type material. There was diffuse block-type immunoreactivity with p16 and HPV genotyping revealed high-risk HPV type 16. In reporting this case, we highlight the propensity for \"salivary gland-type\" neoplasms to arise in the vulva, especially in the Bartholin gland, and stress that pathologists should consider salivary-type neoplasms when faced with a morphologically unusual vulval tumor.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Premature Classification of Early-stage Endometrioid Ovarian Carcinoma With Mesonephric-like Differentiation as Mesonephric-like Adenocarcinoma 过早将具有中肾样分化的早期子宫内膜样卵巢癌归类为中肾样腺癌
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-03-04 DOI: 10.1097/pgp.0000000000001002
Yukio Miyama, A. Ogasawara, Kosei Hasegawa, Masanori Yasuda
Ovarian mesonephric-like adenocarcinoma (MLA) is a rare tumor with potential origins in endometriosis and Müllerian-type epithelial tumors. The morphologic patterns of MLA overlap with those of endometrioid ovarian carcinoma (EnOC). We speculated that a subset of MLAs would be classified as EnOCs. In this study, we attempted to identify MLAs from malignant endometrioid tumors. Given that the study patients with MLAs had both endometrioid-like and mesonephric-like morphologies, we defined mesonephric-like differentiation (MLD) as an endometrioid tumor with focal or diffuse MLA morphology and immunophenotype. Twelve patients exhibited mesonephric-like morphologic patterns. Immunohistochemistry analysis for CD10, TTF-1, estrogen receptor (ER), GATA3, calretinin, and PAX8 expression was done using whole-section slides. Two patients without the MLA immunophenotype were excluded. Ten patients with EnOCs with MLD (8.3%) were identified from a cohort of 121 patients with malignant endometrioid tumors. All 10 patients were positive for TTF-1 and/or GATA3. Most patients were ER-negative. Morphologically, MLD was associated with papillary thyroid carcinoma-like nuclei, flattened cells, tubular, nested, reticular, or glomeruloid architecture, and infiltrative growth. All 10 patients had pre-existing endometriosis and/or adenofibromas. Among the EnOCs with MLD, 5 had coexisting components such as EnOC grade 1 [(G1), cases 4, 7, and 9], mucinous borderline tumor (case 1), and dedifferentiated carcinoma (case 10), with distinct borders between EnOC with MLD and the other components. Nine of the 10 MLA patients (90%) harbored KRAS hotspot mutations. In addition, 4 patients harboring other components shared common KRAS hotspot mutations. No significant prognostic differences were observed between patients with and without MLD. Based on our findings, we suggest that EnOC with MLD, especially in the early stages and without high-grade components, should be considered a subtype of EnOC. Overtreatment should be avoided in such patients, particularly in the early stages. In this study, as the characteristics between EnOC with MLD and MLA were not distinguishable, we considered both conditions to be on the same spectrum. EnOCs with MLD exhibit the MLA phenotype during disease progression and are prematurely classified as MLA. Nevertheless, more patients with EnOC who have MLD/MLA are required for a more robust comparison between conventional EnOC according to staging and grading.
卵巢间质肾上腺样腺癌(MLA)是一种罕见的肿瘤,可能起源于子宫内膜异位症和穆勒氏型上皮肿瘤。MLA的形态学模式与子宫内膜样卵巢癌(EnOC)重叠。我们推测有一部分 MLA 会被归类为 EnOC。在本研究中,我们试图从恶性子宫内膜样肿瘤中鉴别出 MLA。鉴于研究中的MLA患者同时具有子宫内膜样和间质肾样形态,我们将间质肾样分化(MLD)定义为具有局灶性或弥漫性MLA形态和免疫表型的子宫内膜样肿瘤。12例患者表现出肾间质样形态。使用全切片对 CD10、TTF-1、雌激素受体(ER)、GATA3、钙网素和 PAX8 的表达进行了免疫组化分析。排除了两名没有 MLA 免疫表型的患者。在121名恶性子宫内膜样肿瘤患者中,发现了10名患有MLD的EnOCs患者(8.3%)。所有10名患者的TTF-1和/或GATA3均呈阳性。大多数患者ER阴性。从形态上看,MLD与甲状腺乳头状癌样核、扁平细胞、管状、巢状、网状或团块状结构以及浸润性生长有关。所有10名患者都曾患有子宫内膜异位症和/或腺纤维瘤。在伴有MLD的EnOC中,有5例同时伴有EnOC 1级[(G1),病例4、7和9]、粘液性边界瘤(病例1)和去分化癌(病例10)等成分,伴有MLD的EnOC与其他成分之间的边界明显。10 例 MLA 患者中有 9 例(90%)携带 KRAS 热点突变。此外,4名携带其他成分的患者也有共同的KRAS热点突变。有 MLD 和没有 MLD 的患者在预后方面没有明显差异。根据我们的研究结果,我们认为伴有MLD的EnOC,尤其是早期且无高级别成分的EnOC,应被视为EnOC的一种亚型。对于这类患者,尤其是早期患者,应避免过度治疗。在本研究中,由于伴有MLD的EnOC与MLA的特征无法区分,我们认为这两种情况属于同一谱系。患有MLD的EnOC在疾病进展过程中表现出MLA表型,因此被过早地归类为MLA。尽管如此,还需要更多患有MLD/MLA的EnOC患者,才能根据分期和分级对传统EnOC进行更有力的比较。
{"title":"Premature Classification of Early-stage Endometrioid Ovarian Carcinoma With Mesonephric-like Differentiation as Mesonephric-like Adenocarcinoma","authors":"Yukio Miyama, A. Ogasawara, Kosei Hasegawa, Masanori Yasuda","doi":"10.1097/pgp.0000000000001002","DOIUrl":"https://doi.org/10.1097/pgp.0000000000001002","url":null,"abstract":"Ovarian mesonephric-like adenocarcinoma (MLA) is a rare tumor with potential origins in endometriosis and Müllerian-type epithelial tumors. The morphologic patterns of MLA overlap with those of endometrioid ovarian carcinoma (EnOC). We speculated that a subset of MLAs would be classified as EnOCs. In this study, we attempted to identify MLAs from malignant endometrioid tumors. Given that the study patients with MLAs had both endometrioid-like and mesonephric-like morphologies, we defined mesonephric-like differentiation (MLD) as an endometrioid tumor with focal or diffuse MLA morphology and immunophenotype. Twelve patients exhibited mesonephric-like morphologic patterns. Immunohistochemistry analysis for CD10, TTF-1, estrogen receptor (ER), GATA3, calretinin, and PAX8 expression was done using whole-section slides. Two patients without the MLA immunophenotype were excluded. Ten patients with EnOCs with MLD (8.3%) were identified from a cohort of 121 patients with malignant endometrioid tumors. All 10 patients were positive for TTF-1 and/or GATA3. Most patients were ER-negative. Morphologically, MLD was associated with papillary thyroid carcinoma-like nuclei, flattened cells, tubular, nested, reticular, or glomeruloid architecture, and infiltrative growth. All 10 patients had pre-existing endometriosis and/or adenofibromas. Among the EnOCs with MLD, 5 had coexisting components such as EnOC grade 1 [(G1), cases 4, 7, and 9], mucinous borderline tumor (case 1), and dedifferentiated carcinoma (case 10), with distinct borders between EnOC with MLD and the other components. Nine of the 10 MLA patients (90%) harbored KRAS hotspot mutations. In addition, 4 patients harboring other components shared common KRAS hotspot mutations. No significant prognostic differences were observed between patients with and without MLD. Based on our findings, we suggest that EnOC with MLD, especially in the early stages and without high-grade components, should be considered a subtype of EnOC. Overtreatment should be avoided in such patients, particularly in the early stages. In this study, as the characteristics between EnOC with MLD and MLA were not distinguishable, we considered both conditions to be on the same spectrum. EnOCs with MLD exhibit the MLA phenotype during disease progression and are prematurely classified as MLA. Nevertheless, more patients with EnOC who have MLD/MLA are required for a more robust comparison between conventional EnOC according to staging and grading.","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Well-differentiated Squamous Cell Carcinoma With Sarcomatous Differentiation in Patient With a History of Recurrent Verrucous Carcinoma. 有复发性疣状癌病史的患者体内分化良好的鳞状细胞癌伴有肉瘤。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-11-13 DOI: 10.1097/PGP.0000000000000999
Komal Ijaz, Eric Johannesen, Van Nguyen T

Human papillomavirus-independent vulvar squamous cell carcinoma has a peak incidence in about the eighth decade of life. A variable portion of the vulvar squamous cell carcinoma are human papillomavirus-independent comprising 20% to 80% of all cases. Verrucous carcinoma (VC) is part of the spectrum of human papillomavirus-independent carcinomas and its combination with well-differentiated squamous cell carcinoma with sarcomatous differentiation is an extremely unusual neoplasm. The available literature on VC is currently limited to case reports and small single-institution studies. Here, we present a case concerning an 81-year-old woman with a history of chronic itching, swelling, and lichen sclerosis with variable-sized multiple white-pink plaques of the vulva. The pathologic diagnosis of VC was made. The patient later on developed multiple lesions of biopsy proved VC and most recent biopsy shows well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation. A review of the literature shows the rarity of this lesion of the female genital tract. Clinicians and patients should be aware of the aggressive behavior of cancers and adjust their surgical management together with the follow-up strategy. To the best of our knowledge, this is the first description of a VC and well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation occurring in the vulva.

人类乳头瘤病毒独立型外阴鳞状细胞癌的发病高峰期大约在人的第八个十年。外阴鳞状细胞癌中有一部分与人类乳头状瘤病毒无关,占所有病例的20%至80%。疣状癌(VC)是人类乳头瘤病毒不依赖性癌谱的一部分,它与肉瘤样分化的分化良好的鳞状细胞癌相结合,是一种极为罕见的肿瘤。目前,关于VC的文献仅限于病例报告和单个机构的小型研究。在此,我们介绍一例病例,患者是一名 81 岁的妇女,有慢性瘙痒、肿胀和苔藓样硬化病史,外阴有大小不等的多发性白色粉红色斑块。病理诊断为外阴癌。后来,患者又出现了活组织检查证实的多发性外阴阴道炎病变,最近的活组织检查结果显示为分化良好的鳞状细胞癌,并伴有肉瘤样分化。文献综述显示,这种女性生殖道病变非常罕见。临床医生和患者应认识到癌症的侵袭性,并调整手术治疗和随访策略。据我们所知,这是首次描述发生在外阴的VC和分化良好的鳞状细胞癌伴有突发性肉瘤分化。
{"title":"Well-differentiated Squamous Cell Carcinoma With Sarcomatous Differentiation in Patient With a History of Recurrent Verrucous Carcinoma.","authors":"Komal Ijaz, Eric Johannesen, Van Nguyen T","doi":"10.1097/PGP.0000000000000999","DOIUrl":"10.1097/PGP.0000000000000999","url":null,"abstract":"<p><p>Human papillomavirus-independent vulvar squamous cell carcinoma has a peak incidence in about the eighth decade of life. A variable portion of the vulvar squamous cell carcinoma are human papillomavirus-independent comprising 20% to 80% of all cases. Verrucous carcinoma (VC) is part of the spectrum of human papillomavirus-independent carcinomas and its combination with well-differentiated squamous cell carcinoma with sarcomatous differentiation is an extremely unusual neoplasm. The available literature on VC is currently limited to case reports and small single-institution studies. Here, we present a case concerning an 81-year-old woman with a history of chronic itching, swelling, and lichen sclerosis with variable-sized multiple white-pink plaques of the vulva. The pathologic diagnosis of VC was made. The patient later on developed multiple lesions of biopsy proved VC and most recent biopsy shows well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation. A review of the literature shows the rarity of this lesion of the female genital tract. Clinicians and patients should be aware of the aggressive behavior of cancers and adjust their surgical management together with the follow-up strategy. To the best of our knowledge, this is the first description of a VC and well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation occurring in the vulva.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuroendocrine Marker Expression in Primary Non-neuroendocrine Epithelial Tumors of the Ovary: A Study of 551 Cases. 卵巢原发性非神经内分泌上皮肿瘤中的神经内分泌标记物表达:对 551 例病例的研究。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-06-14 DOI: 10.1097/PGP.0000000000000962
Michaela Kendall Bártů, Kristýna Němejcová, Romana Michálková, Quang Hiep Bui, Jana Drozenová, Pavel Fabian, Oluwole Fadare, Jitka Hausnerová, Jan Laco, Radoslav Matěj, Gábor Méhes, Adam Šafanda, Naveena Singh, Petr Škapa, Zuzana Špůrková, Simona Stolnicu, Marián Švajdler, Sigurd F Lax, W Glenn McCluggage, Pavel Dundr

Expression of neuroendocrine (NE) markers in primary ovarian non-NE epithelial tumors has rarely been evaluated. The aim of our study was to evaluate the expression of the most widely used NE markers in these neoplasms and to determine any prognostic significance of NE marker expression. The cohort consisted of 551 primary ovarian tumors, including serous borderline tumors, low-grade serous carcinomas, high-grade serous carcinomas (HGSC), clear cell carcinomas, endometroid carcinomas, mucinous borderline tumors, and mucinous carcinomas. Immunohistochemical analysis was performed using antibodies against INSM1, synaptophysin, chromogranin, and CD56 on tissue microarray. Positivity for INSM1, synaptophysin, chromogranin, and CD56 was most frequently observed in mucinous tumors (48.7%, 26.0%, 41.5%, and 100%, respectively). The positivity for these NE markers was mostly restricted to nonmucinous elements distributed throughout the tumor. The mucinous borderline tumor and mucinous carcinomas groups had similar proportions of positivity (mucinous borderline tumor: 53%, mucinous carcinomas: 39%). In the other tumor types, except for HGSC, there was only focal expression (5%-10%) or negativity for NE markers. HGSC showed high CD56 expression (in 26% of cases). Survival analysis was only performed for CD56 in HGSC as this was the only group with sufficient positive cases, and it showed no prognostic significance. Except for mucinous tumors, expression of NE markers in non-NE ovarian epithelial tumors is low. CD56 expression in HGSC occurs frequently but is without diagnostic or prognostic value.

神经内分泌(NE)标记物在原发性卵巢非NE上皮性肿瘤中的表达很少得到评估。我们的研究旨在评估这些肿瘤中最广泛使用的神经内分泌标记物的表达情况,并确定神经内分泌标记物表达的预后意义。研究对象包括 551 例原发性卵巢肿瘤,包括浆液性边界瘤、低级别浆液性癌、高级别浆液性癌(HGSC)、透明细胞癌、子宫内膜癌、粘液性边界瘤和粘液腺癌。在组织芯片上使用 INSM1、突触素、嗜铬粒蛋白和 CD56 抗体进行免疫组化分析。INSM1、突触素、嗜铬粒蛋白和CD56的阳性率在粘液腺癌中最高(分别为48.7%、26.0%、41.5%和100%)。这些 NE 标记物的阳性大多局限于分布在肿瘤各处的非黏液成分。粘液性边界瘤和粘液腺癌组的阳性比例相似(粘液性边界瘤:53%;粘液腺癌:39%)。在其他类型的肿瘤中,除间皮瘤外,NE标记物仅有局灶性表达(5%-10%)或阴性。HGSC表现出较高的CD56表达(26%的病例)。只对 HGSC 中的 CD56 进行了生存分析,因为只有这一组有足够多的阳性病例,而且没有显示出预后意义。除粘液性肿瘤外,非 NE 卵巢上皮肿瘤中 NE 标记物的表达量较低。CD56 在 HGSC 中经常表达,但没有诊断或预后价值。
{"title":"Neuroendocrine Marker Expression in Primary Non-neuroendocrine Epithelial Tumors of the Ovary: A Study of 551 Cases.","authors":"Michaela Kendall Bártů, Kristýna Němejcová, Romana Michálková, Quang Hiep Bui, Jana Drozenová, Pavel Fabian, Oluwole Fadare, Jitka Hausnerová, Jan Laco, Radoslav Matěj, Gábor Méhes, Adam Šafanda, Naveena Singh, Petr Škapa, Zuzana Špůrková, Simona Stolnicu, Marián Švajdler, Sigurd F Lax, W Glenn McCluggage, Pavel Dundr","doi":"10.1097/PGP.0000000000000962","DOIUrl":"10.1097/PGP.0000000000000962","url":null,"abstract":"<p><p>Expression of neuroendocrine (NE) markers in primary ovarian non-NE epithelial tumors has rarely been evaluated. The aim of our study was to evaluate the expression of the most widely used NE markers in these neoplasms and to determine any prognostic significance of NE marker expression. The cohort consisted of 551 primary ovarian tumors, including serous borderline tumors, low-grade serous carcinomas, high-grade serous carcinomas (HGSC), clear cell carcinomas, endometroid carcinomas, mucinous borderline tumors, and mucinous carcinomas. Immunohistochemical analysis was performed using antibodies against INSM1, synaptophysin, chromogranin, and CD56 on tissue microarray. Positivity for INSM1, synaptophysin, chromogranin, and CD56 was most frequently observed in mucinous tumors (48.7%, 26.0%, 41.5%, and 100%, respectively). The positivity for these NE markers was mostly restricted to nonmucinous elements distributed throughout the tumor. The mucinous borderline tumor and mucinous carcinomas groups had similar proportions of positivity (mucinous borderline tumor: 53%, mucinous carcinomas: 39%). In the other tumor types, except for HGSC, there was only focal expression (5%-10%) or negativity for NE markers. HGSC showed high CD56 expression (in 26% of cases). Survival analysis was only performed for CD56 in HGSC as this was the only group with sufficient positive cases, and it showed no prognostic significance. Except for mucinous tumors, expression of NE markers in non-NE ovarian epithelial tumors is low. CD56 expression in HGSC occurs frequently but is without diagnostic or prognostic value.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and Prognostic Significance of PIK3CA Mutation and CNV Status and Phosphorylated AKT Expression in Patients With Cervical Cancer Treated With Primary Surgery. 宫颈癌初治手术患者中 PIK3CA 突变和 CNV 状态以及磷酸化 AKT 表达的发生率和预后意义
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-08-25 DOI: 10.1097/PGP.0000000000000978
Kevin Martell, John B McIntyre, Tasnima Abedin, Elizabeth N Kornaga, Angela M Y Chan, Emeka Enwere, Martin Köbel, Michelle L Dean, Tien Phan, Prafull Ghatage, Susan P Lees-Miller, Corinne M Doll

Currently, there are limited and conflicting reports on the prognostic utility of PIK3CA and associated pathway markers for cervical cancers treated with primary surgical management. Moreover, current studies are lacking complete characterization of adjuvant treatment with RT and/or chemotherapy. We aimed to document the prevalence, clinicopathologic, adjuvant treatment details, and prognostic value of PI3K/AKT pathway mutations and copy number variation and phosphorylated AKT status in patients with cervical cancers treated with primary surgery. A clinicopathologic review was performed on a retrospective cohort of 185 patients with cervical cancer, treated with primary surgery at a single tertiary institution. Next-generation sequencing and digital PCR was used to determine PI3K/AKT pathway mutational status and PIK3CA copy number variation, respectively, and fluorescent immunohistochemistry measured phosphorylated AKT expression. In all, 179 of 185 (96.8%) of tumors were successfully sequenced; 48 (26.8%) were positive for PI3K/AKT pathway mutations-the majority (n=37, 77.1%) PIK3CA mutations. PIK3CA mutation was associated with pathologically positive lymph nodes [12 (32%) vs. 22 (16%); P =0.022] and indication for postoperative chemoradiotherapy [17 (45.9%) vs. 32 (22.5%); P =0.004]. On multivariable analysis, PIK3CA status was not associated with overall survival ( P =0.103) or progression-free survival ( P =0.240) at 5 yrs, nor was PIK3CA copy number variation status. phosphorylated AKT ≤ median significantly predicted for progression-free survival [multivariable hazard ratio 0.39 (0.17-0.89; P =0.025)] but not overall survival ( P =0.087). The correlation of PIK3CA with pathologic positive lymph node status yet lack of association with survival outcomes may be due to the use of adjuvant postoperative therapy. PIK3CA assessment before radical hysterectomy may help identify patients with a higher risk of node-positive disease.

目前,关于 PIK3CA 和相关通路标记物对初治手术治疗的宫颈癌的预后作用的报道有限且相互矛盾。此外,目前的研究还缺乏对 RT 和/或化疗辅助治疗的完整描述。我们旨在记录宫颈癌初治手术患者中 PI3K/AKT 通路突变、拷贝数变异和磷酸化 AKT 状态的发生率、临床病理、辅助治疗细节和预后价值。我们对在一家三级医疗机构接受初次手术治疗的 185 例宫颈癌患者进行了临床病理学回顾。下一代测序和数字 PCR 分别用于确定 PI3K/AKT 通路突变状态和 PIK3CA 拷贝数变异,荧光免疫组化则用于测量磷酸化 AKT 的表达。185例肿瘤中有179例(96.8%)成功测序;48例(26.8%)PI3K/AKT通路突变阳性,其中大多数(37例,77.1%)为PIK3CA突变。PIK3CA突变与病理淋巴结阳性[12(32%)vs 22(16%);P =0.022]和术后化放疗指征[17(45.9%)vs 32(22.5%);P =0.004]有关。在多变量分析中,PIK3CA状态与5年的总生存期(P =0.103)或无进展生存期(P =0.240)无关,PIK3CA拷贝数变异状态也与无进展生存期无关。磷酸化AKT≤中位数可显著预测无进展生存期[多变量危险比0.39 (0.17-0.89; P =0.025)],但与总生存期无关(P =0.087)。PIK3CA与病理淋巴结阳性状态相关,但与生存结果无关,这可能与术后辅助治疗的使用有关。在根治性子宫切除术前对PIK3CA进行评估可能有助于识别出结节阳性疾病风险较高的患者。
{"title":"Prevalence and Prognostic Significance of PIK3CA Mutation and CNV Status and Phosphorylated AKT Expression in Patients With Cervical Cancer Treated With Primary Surgery.","authors":"Kevin Martell, John B McIntyre, Tasnima Abedin, Elizabeth N Kornaga, Angela M Y Chan, Emeka Enwere, Martin Köbel, Michelle L Dean, Tien Phan, Prafull Ghatage, Susan P Lees-Miller, Corinne M Doll","doi":"10.1097/PGP.0000000000000978","DOIUrl":"10.1097/PGP.0000000000000978","url":null,"abstract":"<p><p>Currently, there are limited and conflicting reports on the prognostic utility of PIK3CA and associated pathway markers for cervical cancers treated with primary surgical management. Moreover, current studies are lacking complete characterization of adjuvant treatment with RT and/or chemotherapy. We aimed to document the prevalence, clinicopathologic, adjuvant treatment details, and prognostic value of PI3K/AKT pathway mutations and copy number variation and phosphorylated AKT status in patients with cervical cancers treated with primary surgery. A clinicopathologic review was performed on a retrospective cohort of 185 patients with cervical cancer, treated with primary surgery at a single tertiary institution. Next-generation sequencing and digital PCR was used to determine PI3K/AKT pathway mutational status and PIK3CA copy number variation, respectively, and fluorescent immunohistochemistry measured phosphorylated AKT expression. In all, 179 of 185 (96.8%) of tumors were successfully sequenced; 48 (26.8%) were positive for PI3K/AKT pathway mutations-the majority (n=37, 77.1%) PIK3CA mutations. PIK3CA mutation was associated with pathologically positive lymph nodes [12 (32%) vs. 22 (16%); P =0.022] and indication for postoperative chemoradiotherapy [17 (45.9%) vs. 32 (22.5%); P =0.004]. On multivariable analysis, PIK3CA status was not associated with overall survival ( P =0.103) or progression-free survival ( P =0.240) at 5 yrs, nor was PIK3CA copy number variation status. phosphorylated AKT ≤ median significantly predicted for progression-free survival [multivariable hazard ratio 0.39 (0.17-0.89; P =0.025)] but not overall survival ( P =0.087). The correlation of PIK3CA with pathologic positive lymph node status yet lack of association with survival outcomes may be due to the use of adjuvant postoperative therapy. PIK3CA assessment before radical hysterectomy may help identify patients with a higher risk of node-positive disease.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Uterine Leiomyosarcoma With Osteoclast-like Giant Cells: Report of 2 Cases and Review of Literature. 伴有破骨细胞样巨细胞的子宫纵隔肉瘤:2例病例报告及文献综述。
IF 2.4 4区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-06-15 DOI: 10.1097/PGP.0000000000000965
Zhengshan Chen, Jianling Ji, Evan Yung, Sue Ellen Martin, Saloni Walia

Leiomyosarcoma (LMS) with osteoclast-like giant cells (OLGCs) is a rare entity with only 18 reported cases thus far. It is not known whether these OLGCs are a reactive or malignant component of LMS. Herein we describe the clinical, histologic, and molecular characteristics of 2 cases of LMS with OLGCs and perform a brief literature review. In 2 of our cases, the OLGCs, marked with CD68, had a low proliferation index with Ki67 and did not show diffuse positivity for smooth muscle markers by immunohistochemistry. By next-generation sequencing, one case harbored a clinically significant TP53 mutation, which has been reported in a significant subset of conventional LMSs. In this case, based on immunohistochemistry, OLGCs showed different molecular alterations as compared with LMS. Although we did not show a distinct immunophenotype or molecular profile for LMS with OLGCs, this study provides additional data on this rare entity.

伴有破骨细胞样巨细胞(OLGCs)的骨髓肉瘤(LMS)是一种罕见病,迄今仅有18例报道。目前尚不清楚这些破骨细胞样巨细胞是LMS的反应性成分还是恶性成分。在此,我们描述了2例伴有OLGCs的LMS的临床、组织学和分子特征,并对文献进行了简要回顾。在我们的2例病例中,OLGCs以CD68为标记,Ki67增殖指数较低,免疫组化结果显示平滑肌标记物未呈弥漫阳性。通过下一代测序,一个病例发现了具有临床意义的TP53基因突变,据报道,相当一部分传统的LMS都存在这种突变。在该病例中,根据免疫组化结果,OLGCs与LMS相比表现出不同的分子改变。虽然我们没有发现伴有OLGCs的LMS有独特的免疫表型或分子特征,但这项研究为这一罕见病例提供了更多数据。
{"title":"Uterine Leiomyosarcoma With Osteoclast-like Giant Cells: Report of 2 Cases and Review of Literature.","authors":"Zhengshan Chen, Jianling Ji, Evan Yung, Sue Ellen Martin, Saloni Walia","doi":"10.1097/PGP.0000000000000965","DOIUrl":"10.1097/PGP.0000000000000965","url":null,"abstract":"<p><p>Leiomyosarcoma (LMS) with osteoclast-like giant cells (OLGCs) is a rare entity with only 18 reported cases thus far. It is not known whether these OLGCs are a reactive or malignant component of LMS. Herein we describe the clinical, histologic, and molecular characteristics of 2 cases of LMS with OLGCs and perform a brief literature review. In 2 of our cases, the OLGCs, marked with CD68, had a low proliferation index with Ki67 and did not show diffuse positivity for smooth muscle markers by immunohistochemistry. By next-generation sequencing, one case harbored a clinically significant TP53 mutation, which has been reported in a significant subset of conventional LMSs. In this case, based on immunohistochemistry, OLGCs showed different molecular alterations as compared with LMS. Although we did not show a distinct immunophenotype or molecular profile for LMS with OLGCs, this study provides additional data on this rare entity.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Gynecological Pathology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1