Ok Atılgan Alev, Özen Özlem, Haberal Reyhan A Nihan, Ayhan Ali
Department of Pathology, Baskent University, Faculty of Medicine, Ankara, Turkey.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Baskent University, Faculty of Medicine, Ankara, Turkey.
Int J Surg Pathol. 2023 Jun;31(4):398-408. doi: 10.1177/10668969221134695. Epub 2022 Nov 30.
The current study highlighted the ARID1A and SALL4 expression and described histopathologic and immunohistochemical features of ovarian seromucinous tumors (SMTs) including borderline tumors (SMBTs) and seromucinous carcinomas (SMC; namely as endometrioid carcinoma with mucinous differentiation according to WHO 2020 classification). The clinicopathological and immunohistochemical features of 38 SMTs were analyzed, including ARID1A, SALL4, estrogen receptor (ER), progesterone receptor (PR), TP53, keratin 7, keratin 20, CEA, CDX2, WT1, PAX2, and PAX8. SMCs and SMBTs comprised 68.4% (n = 26) and 31.6% (n = 12) of all SMTs, respectively, studied. The mean age of diagnosis was 47.4 years and 41.4 years, and the mean size was 9 cm and 7.45 cm for SMC and SMBT, respectively. There was endometriosis or endometriotic cyst in 61.5% of SMCs and 50% of SMBTs. Immunohistochemically, loss of ARID1A staining was observed in 15 (65.2%) of 26 SMCs, and 3 (33.3%) of the 12 SMBTs. Only one SMC showed focal SALL4 positivity. All SMTs were positive for ER, PR, PAX8, and keratin 7. SMTs were negative for WT1, keratin 20, CDX2, and CEA (negative in 66.7% to 92.3% of the cases). While all SMBTs and 24 (92.3%) of 26 SMCs exhibited "wild-type" TP53 staining, 2 (7.7%) SMCs, both were stage III, showed mutant type TP53 overexpression. We indicate there is a similarity between SMC and SMBT according to the immunohistochemical features. SMBTs are keratin 7, ER, PR positive tumors, and some of them have loss of ARID1A expression and are likely to develop in the background of endometriosis similar to SMC.
本研究着重探讨了ARID1A和SALL4的表达情况，并描述了卵巢浆液性黏液性肿瘤（SMTs）的组织病理学和免疫组化特征，其中包括交界性肿瘤（SMBTs）和浆液性黏液性癌（SMC；根据世界卫生组织2020年分类，即具有黏液分化的子宫内膜样癌）。分析了38例SMTs的临床病理和免疫组化特征，包括ARID1A、SALL4、雌激素受体（ER）、孕激素受体（PR）、TP53、细胞角蛋白7、细胞角蛋白20、癌胚抗原（CEA）、尾型同源盒转录因子2（CDX2）、威尔姆斯瘤蛋白1（WT1）、配对盒基因2（PAX2）和配对盒基因8（PAX8）。在所研究的所有SMTs中，SMC和SMBT分别占68.4%（n = 26）和31.6%（n = 12）。SMC和SMBT的平均诊断年龄分别为47.4岁和41.4岁，平均大小分别为9 cm和7.45 cm。61.5%的SMC和50%的SMBT存在子宫内膜异位症或子宫内膜异位囊肿。免疫组化结果显示，26例SMC中有15例（65.2%）和12例SMBT中有3例（33.3%）观察到ARID1A染色缺失。仅1例SMC显示局灶性SALL4阳性。所有SMTs的ER、PR、PAX8和细胞角蛋白7均呈阳性。SMTs的WT1、细胞角蛋白20、CDX2和CEA均为阴性（66.7%至92.3%的病例为阴性）。虽然所有SMBTs以及26例SMC中的24例（92.3%）表现为“野生型”TP53染色，但2例（7.7%）SMC（均为III期）显示突变型TP53过表达。我们指出，根据免疫组化特征，SMC和SMBT之间存在相似性。SMBTs是细胞角蛋白7、ER、PR阳性的肿瘤，其中一些存在ARID1A表达缺失，并且可能在与SMC相似的子宫内膜异位症背景下发生。
