Department of Pathology (D.D., R.A.S.), Memorial Sloan-Kettering Cancer Center, New York, New York Sunnybrook Health Sciences Centre (G.H.), Toronto, ON Department of Pathology and Laboratory Medicine (J.A.I., S.L., C.B.G.), University of British Columbia and Vancouver General Hospital, Vancouver, BC Department of Laboratory Medicine and Pathology (C.A.E.), Royal Alexandra Hospital, University of Alberta, Edmonton, AB, Canada Department of Pathology (T.A.L.), Stanford University School of Medicine, Stanford, California.
Int J Gynecol Pathol. 2013 Nov;32(6):541-6. doi: 10.1097/PGP.0b013e318273fd07.
Many ovarian tumors, including high-grade serous carcinoma (HGSC), show clear cell change. Accurate diagnosis is important, however, as ovarian clear cell carcinoma (OCCC) is known to be less responsive to traditional types of ovarian cancer chemotherapies. In a previous study, the clinical, morphologic, and immunohistochemical features of 32 ovarian carcinomas, which had been previously diagnosed as pure OCCC (n=11), pure HGSC (n=11), and mixed serous and clear cell (MSC) (n=10), were analyzed. The immunoreactivities of WT1, ER, and p53, as well as the mitotic indices and stages of presentation of the MSC, were similar to those of HGSC. It was consequently concluded that MSC represented HGSC with clear cell change. Hepatocyte nuclear factor-1β (HNF-1β) is a relatively new immunohistochemical marker that has been shown to be rather sensitive and specific for OCCC. We thus sought to evaluate this marker in this specific group of tumors. One block each of pure HGSC and pure OCCC were stained with HNF-1β. In the cases of MSC, 2 blocks were stained when the serous and clear cell components were not present on the same slide. None (0/11) of the pure HGSC showed immunoreactivity for HNF-1β, whereas all (11/11) of the pure OCCC were positive. In the cases of MSC, both the serous and clear cell components were negative for HNF-1β. HNF-1β seems to be a sensitive and specific marker for OCCC and is not expressed in HGSC with clear cell change. The pattern of immunoreactivity of HNF-1β in tumors with both serous and clear cell change supports the conclusion that MSC are HGSC with clear cells.
许多卵巢肿瘤,包括高级别浆液性癌(HGSC),都表现出透明细胞改变。然而,准确的诊断很重要,因为卵巢透明细胞癌(OCCC)被认为对传统类型的卵巢癌化疗反应较差。在之前的一项研究中,对之前诊断为纯 OCCC(n=11)、纯 HGSC(n=11)和混合浆液性和透明细胞(MSC)(n=10)的 32 例卵巢癌的临床、形态和免疫组织化学特征进行了分析。MSC 的 WT1、ER 和 p53 免疫反应性以及有丝分裂指数和分期与 HGSC 相似。因此,结论认为 MSC 代表伴有透明细胞改变的 HGSC。肝细胞核因子-1β(HNF-1β)是一种相对较新的免疫组织化学标志物,已被证明对 OCCC 具有相当的敏感性和特异性。因此,我们试图在这组特定的肿瘤中评估该标志物。每个纯 HGSC 和纯 OCCC 各取一个块进行 HNF-1β染色。对于 MSC,如果浆液性和透明细胞成分不在同一张幻灯片上,则对 2 个块进行染色。纯 HGSC 中无一例(0/11)显示 HNF-1β 免疫反应性,而纯 OCCC 全部(11/11)均为阳性。在 MSC 的情况下,浆液性和透明细胞成分均对 HNF-1β 呈阴性。HNF-1β 似乎是 OCCC 的一种敏感和特异性标志物,在伴有透明细胞改变的 HGSC 中不表达。同时具有浆液性和透明细胞改变的肿瘤中 HNF-1β 的免疫反应模式支持 MSC 是伴有透明细胞的 HGSC 的结论。