Emerson Robert E, Wang Mingsheng, Liu Fang, Lawrence W Dwayne, Abdul-Karim Fadi W, Cheng Liang
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Int J Gynecol Pathol. 2007 Oct;26(4):387-94. doi: 10.1097/pgp.0b013e3180336287.
Patients with ovarian serous tumors of low malignant potential (LMP) are commonly found to have peritoneal implants. Less commonly, similar lesions are seen in lymph nodes, sometimes in association with endosalpingiosis. We compared these lesions to the coexisting ovarian LMP tumors to determine whether they are clonally related to the ovarian neoplasm. Seventeen patients with serous LMP tumors present at 2 or more sites were identified. Tissue samples were microdissected from formalin-fixed paraffin-embedded tissue blocks. Samples of normal tissue, the ovarian LMP tumors, peritoneal LMP implants, and LMP inclusions within lymph nodes were obtained. Genomic DNA was extracted from the samples, and polymerase chain reaction and X-chromosome inactivation (human androgen receptor assay) analysis were performed. The pattern of X-chromosome inactivation could be determined in 15 of the 17 cases, and nonrandom X-chromosome inactivation was observed in 13 of these cases. Twelve of these cases included both ovarian and extraovarian LMP tumors. In 9 of these 12 cases, the extraovarian LMP tumor shared a similar pattern of nonrandom X-chromosome inactivation with the ovarian tumor. In these cases, the shared inactivation pattern was seen at 1 extraovarian site (3 cases), 2 extraovarian sites (4 cases), 5 extraovarian sites (1 case), and 7 of 8 extraovarian sites (1 case). In the remaining 3 cases, opposite patterns of nonrandom X-chromosome inactivation were seen. These data suggest that, in most cases, serous LMP tumor implants and lymph node inclusions share a common clonal origin with the associated ovarian tumors. However, in at least some cases, the implants and inclusions seem to arise independently from the associated ovarian serous LMP tumors.
低度恶性潜能（LMP）的卵巢浆液性肿瘤患者通常会出现腹膜种植。较少见的是，在淋巴结中也可见类似病变，有时与输卵管内膜异位症相关。我们将这些病变与共存的卵巢LMP肿瘤进行比较，以确定它们是否与卵巢肿瘤存在克隆相关性。确定了17例浆液性LMP肿瘤出现在2个或更多部位的患者。从福尔马林固定石蜡包埋组织块中进行显微切割获取组织样本。获取正常组织、卵巢LMP肿瘤、腹膜LMP种植体以及淋巴结内LMP包涵体的样本。从样本中提取基因组DNA，并进行聚合酶链反应和X染色体失活（人类雄激素受体检测）分析。17例中有15例可确定X染色体失活模式，其中13例观察到非随机X染色体失活。这13例中有12例同时包括卵巢和卵巢外LMP肿瘤。在这12例中的9例中，卵巢外LMP肿瘤与卵巢肿瘤共享相似的非随机X染色体失活模式。在这些病例中，共享的失活模式出现在1个卵巢外部位（3例）、2个卵巢外部位（4例）、5个卵巢外部位（1例）以及（8个卵巢外部位中的）7个部位（1例）。在其余3例中，观察到相反的非随机X染色体失活模式。这些数据表明，在大多数情况下，浆液性LMP肿瘤种植体和淋巴结包涵体与相关卵巢肿瘤具有共同的克隆起源。然而，至少在某些情况下，种植体和包涵体似乎独立于相关的卵巢浆液性LMP肿瘤而产生。
