Zhou Jia-Hui, Zhang Xiang-Ning
Pathology Department, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China.
Pathophysiology Department, Guangdong Medical University, Dongguan 523808, Guangdong Province, China.
World J Clin Cases. 2024 Sep 16;12(26):5854-5858. doi: 10.12998/wjcc.v12.i26.5854.
In this editorial, we commented on the article by Akers published in the recent issue of the . We focused specifically on the role of the transcription factor paired box protein 8 (PAX8) belonging to the family PAX in the carcinogenesis of a gynecologic tumor, endocervical adenocarcinoma, arising from the tissue of mesonephric origin, and the potential diagnostic value for the same type of neoplasms. The global vaccination program of human papillomavirus (HPV) has dramatically reduced the incidence of cervical cancer, including cases of adenocarcinoma. The type of adenoid epithelial origin has a lower frequency of HPV detection but tends to be more aggressive and fatal. Cases of endocervical adenocarcinoma occurring in females of menopause age have been described in the 2023 volume of the and in our study recently published in . The histopathological findings and immunohistochemical assays showed that the lesions had glandular morphology, and the specimens in these two reports were immunohistochemically positive for the transcription factor PAX8, albeit that they had opposing expression profiles of tumor suppressor p16 and estrogen receptor and the presence of the HPV genome. The presence of a mucin protein, MUC 5AC, as revealed in both studies suggested target molecules for the diagnosis of mucinous adenoid type of uterine tumor and other histological origins. The clinical outcome was unfavorable due to metastasis and recurrence. This prompted the improvement of the antitumor modality, with the introduction of precise targeting therapy. Mucin has now been reported to be the therapeutic target for adenocarcinomas.
在这篇社论中,我们对Akers发表于近期某期刊的文章进行了评论。我们特别关注了属于PAX家族的转录因子配对盒蛋白8(PAX8)在源自中肾组织的妇科肿瘤——宫颈管腺癌的致癌过程中的作用,以及对同一类型肿瘤的潜在诊断价值。全球人乳头瘤病毒(HPV)疫苗接种计划已大幅降低了宫颈癌的发病率,包括腺癌病例。腺样上皮起源类型的HPV检测频率较低,但往往更具侵袭性和致命性。绝经年龄女性发生宫颈管腺癌的病例已在2023年的某期刊以及我们最近发表于某期刊的研究中有所描述。组织病理学发现和免疫组化分析表明,病变具有腺管形态,这两篇报告中的标本对转录因子PAX8免疫组化呈阳性,尽管它们在肿瘤抑制因子p16和雌激素受体的表达谱以及HPV基因组的存在方面存在相反情况。两项研究均显示存在粘蛋白MUC 5AC,这提示其为诊断黏液性腺样型子宫肿瘤及其他组织学起源的靶分子。由于转移和复发,临床结局不佳。这促使通过引入精确靶向治疗来改进抗肿瘤方式。现在已有报道称粘蛋白是腺癌的治疗靶点。