Best D Hunter, Butz Genelle M, Moller Karen, Coleman William B, Thomas David B
Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA.
Int J Oncol. 2004 Jul;25(1):17-25.
Immature ovarian teratoma is a common germ cell tumor of young women. Patients with immature teratoma often exhibit multiple neoplasms, including tumors outside the ovaries, and occasionally a rare benign condition termed gliomatosis peritonei (GP). These multiple neoplasms are generally believed genetically-linked progeny of the ovarian tumor resulting from local recurrence/spread. In this study, we performed a molecular analysis of a single patient clinically diagnosed with immature ovarian teratoma, GP, and recurrent pelvic mucinous teratoma. Microsatellite PCR and amplicon analysis was performed to genetically characterize tissue samples from omental glial implants and multiple peritoneal tumors. PCR-based amplification of microsatellite markers identifies unique genetic differences (allelic variation) between tumors resulting from divergent natural histories among multiple tumor nodules in a single patient. A total of 21 different microsatellite markers were employed, and seven provided informative results (D3S1744, D6S1056, D7S2846, D14S306, D16S764, D18S858, D22S420). These markers demonstrated mutually exclusive genetic differences among the tumors from this patient, establishing the neoplasms as genetically distinct from each other (non-identical), and that no lineage relationship exists among them. This observation suggests that the multiple tumors arising in this patient with immature ovarian teratoma, GP, and recurrent pelvic mucinous neoplasm represent multiple independent tumors rather than true tumor recurrence/spread. The results of this study suggest strongly that patients with recurrent teratoma may be afflicted with a tumor-prone syndrome where one or more peritoneal cell types or populations are predisposed to neoplastic conversion and formation of tumors as a result of an endogenous or exogenous neoplastic stimuli.
未成熟卵巢畸胎瘤是年轻女性常见的生殖细胞肿瘤。未成熟畸胎瘤患者常表现出多种肿瘤，包括卵巢外的肿瘤，偶尔还会出现一种罕见的良性疾病，称为腹膜胶质瘤病（GP）。这些多种肿瘤通常被认为是卵巢肿瘤因局部复发/扩散而产生的基因相关后代。在本研究中，我们对一名临床诊断为未成熟卵巢畸胎瘤、GP和复发性盆腔黏液性畸胎瘤的患者进行了分子分析。进行了微卫星PCR和扩增子分析，以对来自网膜神经胶质植入物和多个腹膜肿瘤的组织样本进行基因特征分析。基于PCR的微卫星标记扩增可识别单个患者多个肿瘤结节中不同自然病史导致的肿瘤之间独特的基因差异（等位基因变异）。总共使用了21种不同的微卫星标记，其中7种提供了有用的结果（D3S1744、D6S1056、D7S2846、D14S306、D16S764、D18S858、D22S420）。这些标记显示该患者的肿瘤之间存在相互排斥的基因差异，表明这些肿瘤在基因上彼此不同（不相同），且它们之间不存在谱系关系。这一观察结果表明，该患有未成熟卵巢畸胎瘤、GP和复发性盆腔黏液性肿瘤的患者出现的多种肿瘤代表多个独立的肿瘤，而非真正的肿瘤复发/扩散。本研究结果强烈表明，复发性畸胎瘤患者可能患有肿瘤易感性综合征，其中一种或多种腹膜细胞类型或群体由于内源性或外源性肿瘤刺激而易于发生肿瘤转化并形成肿瘤。
