title: Frequent microsatellite instability in synchronous ovarian and endometrial adenocarcinoma and its usefulness for differential diagnosis.
abstract: Synchronous tumors of the ovary and endometrium are a well-known phenomenon. There are histological criteria for defining double primary tumors or metastasis from one organ to another, but in some cases a precise diagnosis is difficult. In this study we reviewed 17 cases of synchronous ovarian and endometrial adenocarcinoma by previously reported histological criteria and performed a microsatellite analysis, combined with X-linked clonality analysis. We also analyzed 8 cases of endometrial adenocarcinoma with pelvic lymph node metastasis as a control. Five dinucleotide microsatellite markers were selected, and microsatellite analysis was performed by a high-resolution method using fluorescence-labeled polymerase chain reaction and laser scanning. In synchronous tumors, 11 ovarian carcinomas (65%) and 10 endometrial carcinomas (59%)demonstrated microsatellite instability (MSI). In total, 13 of the 17 patients demonstrated MSI in the ovarian tumor, the endometrial tumor, or both. Four cases of endometrial carcinoma with pelvic lymph nodes metastases displayed MSI, and MSI findings of the endometrial tumor and lymph node metastasis were same in all cases. Based on these findings, we considered that similar MSI findings indicate metastatic tumors. According to the MSI findings, 13 of the 17 patients (76%) had single or double clonal tumors, 11 (67%) with double primary tumors and 2 (13%) with metastatic tumors. Using X-linked clonality analysis, 3 patients were diagnosed with double primary tumors. The molecular diagnosis corresponded with the histological criteria in all but 1 case. In conclusion, using both MSI and X-linked clonality analysis, most patients (82%) could be diagnosed as having single or double clonal tumors. The histological criteria are accurate and useful in most cases; however, in some cases where the relationship between the 2 tumors is difficult to determine, high-resolution MSI analysis may be helpful.
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kaneki
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ohishi
authors.forename: Sadafumi
authors.initials: S
authors.lastname: Tamiya
authors.forename: Shinya
authors.initials: S
authors.lastname: Oda
authors.forename: Toshio
authors.initials: T
authors.lastname: Hirakawa
authors.forename: Hitoo
authors.initials: H
authors.lastname: Nakano
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000235:genetics* / Q000556:secondary; D000328:Adult; D041321:Chromosomes, Human, X; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000145:classification / Q000235:genetics* / Q000473:pathology; D005260:Female; D006801:Humans; D018895:Microsatellite Repeats / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000145:classification / Q000235:genetics* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000145:classification / Q000235:genetics* / Q000473:pathology; D015203:Reproducibility of Results
chemical_list: D004273:DNA, Neoplasm