Ayhan Ayse, Kurman Robert J, Yemelyanova Anna, Vang Russell, Logani Sanjay, Seidman Jeffrey D, Shih Ie-Ming
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
Am J Surg Pathol. 2009 Aug;33(8):1220-4. doi: 10.1097/PAS.0b013e3181a24354.
A 2-tier grading system based on nuclear grade divides ovarian serous carcinomas into low (nuclear grade 1) and high grade (nuclear grade 3). In most instances the separation is straightforward but at times, the morphologic distinction between them can be difficult. We studied 11 ovarian serous carcinomas with features that were "intermediate" (nuclear grade 2) between low and high grade. All the cases were high staged and had a poor clinical outcome. None of the tumors showed mutations in KRAS, BRAF, and ERBB2 genes that characterize most low-grade serous carcinomas. In contrast, 10 (90.9%) of 11 cases contained nonsynonymous TP53 mutations characteristic of high-grade serous carcinomas. In summary, the molecular genetic profile and behavior of serous carcinomas with grade 2 nuclei are virtually the same as those of serous carcinomas with grade 3 nuclei, supporting the use of the 2-tier grading system for classifying ovarian serous carcinomas.
基于核分级的两级分级系统将卵巢浆液性癌分为低级别（核分级1级）和高级别（核分级3级）。在大多数情况下，区分很简单，但有时两者之间的形态学差异可能很困难。我们研究了11例具有低级别和高级别之间“中间”特征（核分级2级）的卵巢浆液性癌。所有病例分期都很高，临床预后较差。这些肿瘤均未显示出大多数低级别浆液性癌所特有的KRAS、BRAF和ERBB2基因突变。相反，11例中有10例（90.9%）含有高级别浆液性癌特有的非同义TP53突变。总之，核分级为2级的浆液性癌的分子遗传学特征和行为与核分级为3级的浆液性癌几乎相同，这支持使用两级分级系统对卵巢浆液性癌进行分类。
