Pal Tuya, Permuth-Wey Jenny, Kumar Ambuj, Sellers Thomas A
H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
Clin Cancer Res. 2008 Nov 1;14(21):6847-54. doi: 10.1158/1078-0432.CCR-08-1387.
A meta-analytic approach was used to estimate the frequency of: (a) microsatellite instability-high (MSI-H) phenotype in unselected ovarian cancers and (b) various histologic subtypes of mismatch repair (MMR)-deficient epithelial ovarian cancers.
A systematic search of the Medline electronic database was conducted to identify articles published between January 1, 1966, and December 31, 2007, that examined MMR deficiency in ovarian cancers. Data were extracted on the study population, sample size, MSI-H frequency, and histology of MMR-deficient ovarian tumors.
The pooled proportion of MSI-H ovarian cancers was 0.12 [95% confidence interval (CI), 0.08-0.17] from 18 studies with 977 cases. The proportion of histologic subtypes in the pooled analysis from 15 studies with 159 cases was serous at 0.32 (95% CI, 0.20-0.44), mucinous at 0.19 (95% CI, 0.12-0.27), endometrioid at 0.29 (95% CI, 0.22-0.36), clear cell at 0.18 (95% CI, 0.09-0.28), and mixed at 0.24 (95% CI, 0.07-0.47). There was significant heterogeneity between studies.
The frequency of the MSI-H phenotype in unselected ovarian cancers approximates 12%. MMR-deficient ovarian cancers also seem to be characterized by an overrepresentation of nonserous histologic subtypes. Knowledge of histologic subtype may aid clinicians in identifying the relatively large proportion of ovarian cancers due to MMR defects; such knowledge has potential implications for medical management.
采用荟萃分析方法估计：（a）未选择的卵巢癌中微卫星高度不稳定（MSI-H）表型的频率，以及（b）错配修复（MMR）缺陷型上皮性卵巢癌的各种组织学亚型的频率。
对Medline电子数据库进行系统检索，以识别1966年1月1日至2007年12月31日期间发表的研究卵巢癌中MMR缺陷的文章。提取有关研究人群、样本量、MSI-H频率以及MMR缺陷型卵巢肿瘤组织学的数据。
来自18项研究共977例病例的汇总分析显示，MSI-H卵巢癌的合并比例为0.12[95%置信区间（CI），0.08 - 0.17]。来自15项研究共159例病例的汇总分析中，组织学亚型的比例为：浆液性0.32（95%CI，0.20 - 0.44），黏液性0.19（95%CI，0.12 - 0.27），子宫内膜样0.29（95%CI，0.22 - 0.36），透明细胞0.18（95%CI，0.09 - 0.28），混合型0.24（95%CI，0.07 - 0.47）。研究之间存在显著异质性。
未选择的卵巢癌中MSI-H表型的频率约为12%。MMR缺陷型卵巢癌似乎也以非浆液性组织学亚型的比例过高为特征。了解组织学亚型可能有助于临床医生识别因MMR缺陷导致的相对较大比例的卵巢癌；此类知识对医疗管理具有潜在意义。
