Clinicopathological heterogeneity in ovarian clear cell adenocarcinoma: a study on individual therapy practice.
Ovarian clear cell adenocarcinoma (CCA) has been believed to be a lethal histological subtype of an epithelial ovarian adenocarcinoma (EOA); its precursor has been assumed to be endometriosis. However, it has been reported that CCAs occasionally exhibit different clinical behaviors, suggesting that CCAs might not belong to a single category. We focused on CCAs combined with other histological types of EOAs; we re-evaluated the pathology of 46 CCAs and divided them into two subgroups: 35 CCAs alone (pure-type CCAs); and 11 CCAs with other histological types, endometrioid adenocarcinomas (EAs) or/and serous adenocarcinomas (SAs) (mixed-type CCAs). Immunohistochemical analysis for expression of ARID1A, p53, PTEN, Annexin 4, hepatocyte nuclear factor-1β (HNF-1β), and WT-1 was employed. We identified that patients with endometriosis were younger than those without endometriosis in pure-type CCAs (P < 0.005). In mixed-type CCAs, the immunohistochemical-staining patterns revealed internal transition of each histological component. In pure-type CCAs, expressions of ARID1A and p53 were mutually altered, and altered expression of p53 was associated with worse prognosis than that of ARID1A (P < 0.001). Our results provide evidence that CCAs would have clinicopathological heterogeneity, determining the patient's prognosis. Furthermore, immunohistochemical analysis may shed light on the selection of appropriate treatment, including chemotherapy.
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuou-ku, Kumamoto, 860-8556, Japan.
Yuji
Y
Matsuo
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuou-ku, Kumamoto, 860-8556, Japan.
Hironori
H
Tashiro
Department of Pathology, Okayama University Hospital, Okayama, Japan.
Hiroyuki
H
Yanai
Department of Pathology 2, Kawasaki Medical School, Kurashiki, Japan.
Takuya
T
Moriya
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuou-ku, Kumamoto, 860-8556, Japan. buchi@kumamoto-u.ac.jp.
Hidetaka
H
Katabuchi
D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017314:Annexin A4 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D000077216:Carcinoma, Ovarian Epithelial; D004268:DNA-Binding Proteins; D004715:Endometriosis; D005260:Female; D051539:Hepatocyte Nuclear Factor 1-beta / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D009687:Nuclear Proteins / Q000032:analysis; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D051059:PTEN Phosphohydrolase / Q000032:analysis; D057285:Precision Medicine; D011379:Prognosis; D014157:Transcription Factors / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
C112476:ARID1A protein, human; D017314:Annexin A4; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C496495:HNF1B protein, human; D009687:Nuclear Proteins; C495901:TP53 protein, human; D014157:Transcription Factors; D016159:Tumor Suppressor Protein p53; D051539:Hepatocyte Nuclear Factor 1-beta; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human
Endometriosis; Heterogeneity; Molecular pathology; Ovarian clear cell adenocarcinoma; Prognosis; Therapeutic strategy