Ovarian tumors of low malignant potential (LMP) are intermediate between adenomas and ovarian carcinomas (OC); however, the relevance of LMP to ovarian carcinogenesis is not clear. We performed a comparative analysis of allelotypes in 50 cases of LMP (42 mucinous and 8 serous) and 23 cases of OC (15 mucinous and 8 serous) to investigate any differences in genetic changes. Analysis of loss of heterozygosity (LOH) using 25 microsatellite markers reportedly associated with OC revealed that the total LOH frequency at each marker was significantly lower in LMP than in OC (p < 0.01). However, 9 (36%) loci showed higher LOH frequency in mucinous LMP than in mucinous OC. A genome-wide scan for LOH using 91 microsatellite markers and fine mapping revealed that LOH at D7S1805 (7q35) is characteristic of mucinous LMP (19.4% in mucinous LMP, 8.3% in mucinous OC). We further studied LOH in 3 cases of mucinous OC that were accompanied by mucinous LMP lesions. In 2 cases, LOH frequency was higher in the carcinoma portion than in the morphologically LMP portion. The other case showed microsatellite instability in the morphologically LMP portion and LOH in the carcinoma portion. Our results suggest the presence of an LMP-to-OC developmental sequence and the existence of a subset of LMP that does not develop into OC in the mucinous subtype of ovarian tumors. © 2001 Wiley-Liss, Inc.
Key words: ovarian carcinogenesis; genome; mucinous LMP; serous LMP; loss of heterozygosity (LOH)Among gynecologic malignancies, ovarian carcinoma (OC) is the leading cause of death. 1,2 Ovarian tumors of low malignant potential (LMP) are a distinctive subtype of ovarian epithelial tumor characterized as an intermediate stage between clearly benign and OC. One of the histologic criteria of LMP or borderline malignancy is atypical epithelial proliferation without ovarian stromal invasion. It remains to be determined whether LMP is a precursor of OC or a unique type of tumor that will not progress to OC.It is well established that carcinogenesis of solid tumors requires a series of genetic changes involving activation of oncogenes and inactivation of tumor suppressor genes. In OC, mutational activation of the K-ras gene, inactivation of the p53 gene and overexpression/amplification of the erb-B2 gene have been reported. [3][4][5] Mutations and loss of heterozygosity (LOH) of the p53 tumor suppressor gene on chromosome 17p13.1 are rare events in LMP. 6 LOH of chromosomes 7p, 7q, 9q and 11q has been reported to be involved in the early stages of ovarian carcinogenesis. 7 The incidence of K-ras mutations is higher in OC than in LMP, especially in the mucinous subtype. 8 These findings suggest that LMP may represent a pathologic continuum between benign tumors and OC. However, the molecular genetic changes in LMP are not well understood compared with OC, as only a few instances have been analyzed of LOH occurring in a small number of cases of LMP. 8 -11 To elucidate the biological relevance of LMP to ovarian carcinogenesis, we compared allelotypes between...