title: Discordant genetic changes in ovarian and endometrial endometrioid carcinomas: a potential pitfall in molecular diagnosis.
abstract: Endometrioid carcinoma simultaneously involving ovaries as well as the uterine corpus may present a diagnostic dilemma because of the difficulty in determining whether the lesions are separate primary tumors or metastases. It has been reported that the detection of clonality using microsatellite markers may be useful in solving this dilemma. To determine the usefulness of this technique, we compared the genetic alterations in microsatellite markers present in matched pairs of ovarian tumors from 12 patients. The study includes four ovarian cancer FIGO stage I and eight stage III/IV patients, and four patients also with independent endometrial carcinoma of the uterus. DNA from paraffin-embedded tissue was extracted and amplified using a multiplex polymerase chain reaction, after which the status of microsatellite instability and loss of heterozygosity in four microsatellite loci (BAT25, BAT26, D17S250, and D5S346) were determined. In the four patients with stage I ovarian cancer, four microsatellite markers were identical in one patient and three were identical in the remaining three patients. In high-stage patients, three markers were identical in at least 4/8 cases. In three of four patients with uterine involvement, three of the four markers were identical in the uterine tumor and one of the corresponding ovarian tumors. These results suggest that genetic discordance does not indicate independent origin or metastasis of the tumor but instead a progression of genetic changes at separate sites probably due to the marked genetic instability existing in these tumors. Because of these discordant genetic changes, great caution should be taken when distinguishing between primary and metastatic tumors on the basis of microsatellite markers.
authors.affiliation: Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA.
authors.forename: K-H
authors.initials: KH
authors.lastname: Chang
authors.forename: C
authors.initials: C
authors.lastname: Albarracin
authors.forename: R
authors.initials: R
authors.lastname: Luthra
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: W
authors.initials: W
authors.lastname: Zheng
authors.forename: A
authors.initials: A
authors.lastname: Malpica
authors.forename: M T
authors.initials: MT
authors.lastname: Deavers
authors.forename: E G
authors.initials: EG
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D043243:DNA Sequence, Unstable; D004273:DNA, Neoplasm / Q000032:analysis; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D018895:Microsatellite Repeats; D008875:Middle Aged; D008967:Molecular Biology; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000235:genetics* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D046509:Tissue Culture Techniques; D051176:beta Catenin / Q000235:genetics
chemical_list: C495270:CTNNB1 protein, human; D004273:DNA, Neoplasm; D051176:beta Catenin