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全基因组单核苷酸多态性微阵列作为同步子宫内膜和卵巢癌患者的诊断工具。

Genome-wide single nucleotide polymorphism arrays as a diagnostic tool in patients with synchronous endometrial and ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Int J Gynecol Cancer. 2012 Jun;22(5):725-31. doi: 10.1097/IGC.0b013e31824c6ea6.

Abstract

OBJECTIVE

Synchronous carcinomas in the endometrium and ovaries can be a single primary tumor with metastasis (SPM) or dual primary tumors (DP). Although the prognosis of DP without any metastases is significantly better than that of SPM, pathological diagnosis is difficult in tumors with similar histological features.

MATERIALS AND METHODS

In 10 tumors from 5 patients with synchronous endometrial and ovarian carcinomas, 250K single nucleotide polymorphism arrays were performed. The patients were genetically diagnosed according to the pattern of copy number alterations (CNAs), in addition to microsatellite status and mutational analysis of PIK3CA, PTEN, K-Ras, and CTNNB1.

RESULTS

Of the 5 patients, 3 exhibited identical CNA patterns, including type, loci, and degree of each alteration in the endometrial and ovarian carcinomas. The other 2 exhibited CNAs only in either endometrial or ovarian carcinoma. All 5 tumors had 1 or more genetic mutations in the genes examined. One patient exhibited mutations both in PIK3CA and PTEN at discordant sites between endometrial and ovarian carcinomas, whereas the other 4 exhibited concordant mutations. Overall, 4 of the 5 patients were genetically diagnosed with SPM, and the remaining 1 with DP. The pathological diagnosis was not in agreement with the genetic diagnosis in 4 of the 5 patients.

CONCLUSIONS

Genome-wide genotyping diagnosis may represent a useful approach for distinguishing between SPM and DP in synchronous endometrial and ovarian carcinomas.

摘要

目的

子宫内膜和卵巢的同步癌可能是一种具有转移的单一原发性肿瘤(SPM)或两种原发性肿瘤(DP)。虽然没有任何转移的 DP 的预后明显优于 SPM,但在具有相似组织学特征的肿瘤中,病理诊断较为困难。

材料和方法

在 5 例同步子宫内膜和卵巢癌的 10 个肿瘤中,进行了 250K 单核苷酸多态性微阵列分析。除了微卫星状态和 PIK3CA、PTEN、K-Ras 和 CTNNB1 的突变分析外,根据拷贝数改变(CNAs)的模式对患者进行了基因诊断。

结果

在 5 例患者中,3 例表现出相同的 CNA 模式,包括子宫内膜癌和卵巢癌中每种改变的类型、位置和程度。另外 2 例仅在子宫内膜癌或卵巢癌中存在 CNA。所有 5 例肿瘤在检查的基因中均有 1 个或多个遗传突变。1 例患者在子宫内膜癌和卵巢癌中不相关部位同时存在 PIK3CA 和 PTEN 突变,而其他 4 例患者存在一致性突变。总的来说,5 例患者中有 4 例被基因诊断为 SPM,1 例为 DP。5 例患者中有 4 例的病理诊断与基因诊断不一致。

结论

全基因组基因分型诊断可能是区分同步子宫内膜和卵巢癌中 SPM 和 DP 的一种有用方法。

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