Department of Pathology (R.H.A.), Health Sciences Center, Faculty of Medicine, Kuwait University, Kuwait Department of Pathology and Laboratory Medicine (S.E.K., C.B.G.), Vancouver General Hospital Cheryl Brown Ovarian Cancer Outcomes Unit (J.L.S., K.D.S.), British Columbia Cancer Agency (BCCA) Department of Medical Oncology and Gynecology Tumour Group (K.D.S.), BCCA, Vancouver BC, Canada.
Int J Gynecol Pathol. 2013 Nov;32(6):529-35. doi: 10.1097/PGP.0b013e31827630eb.
Low-grade serous carcinoma (LGSC) of the ovary has only recently been recognized as a disease entity distinct from the more common high-grade serous carcinoma (HGSC). When confined to the ovary, LGSC is associated with a very favorable prognosis, and chemotherapy is typically not recommended. There is little available information on the prognosis of patients with LGSC with extraovarian spread, from population-based tumor registries where there has been full pathology review. Thirty-two cases of Stage II to IV ovarian LGSC were identified in the Cheryl Brown Ovarian Cancer Outcomes Unit (1984-2000). In 19 cases, blocks were available and immunostaining for p53, p16, Ki-67, WT1, and E-cadherin was performed. Expression of these markers was then compared with a series of >400 cases of HGSC from the outcomes unit. LGSCs presented at Stage II in 10/32 cases, Stage III in 21/32 cases, and Stage IV in 1/32 cases. On follow-up, most patients died of disease, with <30% survival at 10 years. Compared with HGSCs, the LGSCs were significantly less likely to express p16 at high levels, or to show abnormal p53 expression (P=0.049 and <0.0001, respectively). Ki-67 staining indices were lower in the LGSCs (P<0.0001). There were no significant differences between LGSCs and HGSCs with respect to expression of WT1 and E-cadherin (P=0.27 and 0.62, respectively). This population-based series of LGSC with extraovarian spread at presentation had an unfavorable prognosis, similar to that of HGSC. As previously reported, LGSC shows lower tumor proliferation and fewer p53 abnormalities than in HGSC.
卵巢低级别浆液性癌 (LGSC) 最近才被认为是一种不同于更为常见的高级别浆液性癌 (HGSC) 的疾病实体。当局限于卵巢时，LGSC 与非常有利的预后相关，通常不推荐化疗。在有完整病理审查的基于人群的肿瘤登记处，关于卵巢外播散的 LGSC 患者的预后信息很少。在 Cheryl Brown 卵巢癌结局单位 (1984-2000 年) 中确定了 32 例 II 期至 IV 期卵巢 LGSC 病例。在 19 例病例中，有可供使用的组织块，并对 p53、p16、Ki-67、WT1 和 E-钙黏蛋白进行了免疫染色。然后将这些标志物的表达与来自结局单位的 >400 例 HGSC 系列进行比较。LGSCs 在 32 例病例中表现为 II 期 10/32 例，III 期 21/32 例，IV 期 1/32 例。随访时，大多数患者死于疾病，10 年生存率<30%。与 HGSCs 相比，LGSCs 表达高水平的 p16 或显示异常的 p53 表达的可能性显著降低（P=0.049 和 <0.0001）。LGSCs 的 Ki-67 染色指数较低（P<0.0001）。LGSCs 和 HGSCs 在 WT1 和 E-钙黏蛋白的表达方面没有显著差异（P=0.27 和 0.62）。该基于人群的 LGSC 系列在表现时有卵巢外播散，预后不良，与 HGSC 相似。如前所述，LGSC 的肿瘤增殖率较低，p53 异常较少。
