State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
Department of Pathology, Sun Yat-sen University Cancer Center, 651# Dong Feng Road East, Guangzhou, 510060, China.
J Ovarian Res. 2023 May 23;16(1):102. doi: 10.1186/s13048-023-01183-5.
Uterine tumors resembling ovarian sex cord tumor (UTROSCT) is a rare neoplasm of unknown etiology and has undetermined malignant potential. The emergence of recurrent UTROSCT case reports has led to its initial identification as a tumor of low malignancy potential. Owing to its low incidence, we currently lack any in-depth studies regarding the subset of UTROSCTs that may be aggressive in nature. Here, we sought to identify unique characteristics in aggressive UTROSCT.
19 cases of UTROSCT were collected. Their histologic and tumor immune microenvironment were evaluated by three gynecologic pathologists. The gene alteration was also detected by RNA sequencing. For later analyses regarding differences between benign and malignant tumors, we supplemented our 19 included cases with additional reports from the literature.
Interestingly, we found PD-L1 expression in stromal tumor-infiltrating immune cells (stromal PD-L1) was markedly higher in aggressive UTROSCT. Patients with high stromal PD-L1 (≥ 22.5 cells/mm) had worse prognosis. When our cases were added with previous cases identified in the literature, we discovered that aggressive UTROSCT was more likely to have significant mitotic activity and NCOA2 gene alterations than benign UTROSCT. Consistence with those results, patients with significant mitotic activity and gene alteration of NCOA2 had worse prognoses.
Collectively, high expression of stromal PD-L1, significant mitotic activity, and gene alteration of NCOA2 may be useful markers to predict aggressive UTROSCT.
类似于卵巢性索肿瘤的子宫肿瘤（UTROSCT）是一种罕见的病因不明的肿瘤，其恶性潜能尚未确定。由于反复出现的 UTROSCT 病例报告，最初将其鉴定为恶性潜能低的肿瘤。由于其发病率低，我们目前缺乏任何关于可能具有侵袭性本质的 UTROSCT 亚组的深入研究。在这里，我们试图确定侵袭性 UTROSCT 的独特特征。
收集了 19 例 UTROSCT。三位妇科病理学家评估了它们的组织学和肿瘤免疫微环境。还通过 RNA 测序检测了基因改变。为了以后分析良性和恶性肿瘤之间的差异，我们在我们的 19 例包含病例中补充了来自文献的其他报告。
有趣的是，我们发现侵袭性 UTROSCT 中基质肿瘤浸润免疫细胞（基质 PD-L1）中的 PD-L1 表达明显更高。高基质 PD-L1（≥22.5 个细胞/mm）的患者预后更差。当我们的病例与文献中先前确定的病例相加时，我们发现侵袭性 UTROSCT 比良性 UTROSCT 更有可能具有明显的有丝分裂活性和 NCOA2 基因改变。与这些结果一致，具有明显有丝分裂活性和 NCOA2 基因改变的患者预后更差。
总的来说，基质 PD-L1 的高表达、明显的有丝分裂活性和 NCOA2 基因改变可能是预测侵袭性 UTROSCT 的有用标志物。
