Defining the cut point between low-grade and high-grade ovarian serous carcinomas: a clinicopathologic and molecular genetic analysis.
A 2-tier grading system based on nuclear grade divides ovarian serous carcinomas into low (nuclear grade 1) and high grade (nuclear grade 3). In most instances the separation is straightforward but at times, the morphologic distinction between them can be difficult. We studied 11 ovarian serous carcinomas with features that were "intermediate" (nuclear grade 2) between low and high grade. All the cases were high staged and had a poor clinical outcome. None of the tumors showed mutations in KRAS, BRAF, and ERBB2 genes that characterize most low-grade serous carcinomas. In contrast, 10 (90.9%) of 11 cases contained nonsynonymous TP53 mutations characteristic of high-grade serous carcinomas. In summary, the molecular genetic profile and behavior of serous carcinomas with grade 2 nuclei are virtually the same as those of serous carcinomas with grade 3 nuclei, supporting the use of the 2-tier grading system for classifying ovarian serous carcinomas.
Ayhan
Ayse
A
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
Kurman
Robert J
RJ
Yemelyanova
Anna
A
Vang
Russell
R
Logani
Sanjay
S
Seidman
Jeffrey D
JD
Shih
Ie-Ming
IeM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058534:Class I Phosphatidylinositol 3-Kinases; D018284:Cystadenocarcinoma, Serous / Q000235:genetics* / Q000473:pathology*; D004252:DNA Mutational Analysis; D005260:Female; D018734:Genes, erbB-2; D016158:Genes, p53; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology*; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics; D011518:Proto-Oncogene Proteins / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins / Q000235:genetics
C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D019869:Phosphatidylinositol 3-Kinases; D058534:Class I Phosphatidylinositol 3-Kinases; C484760:PIK3CA protein, human; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins