Requirement for expert histopathological assessment of ovarian cancer and borderline tumours

Sengupta, P S; Shanks, J H; Buckley, C. H.; Ryder, W. David J.; Davies, John R.; Reynolds, Karina; Slade, Richard J; Kitchener, HC; Jayson, Gordon C

doi:10.1054/bjoc.1999.0994

Cited by 14 publications

(7 citation statements)

References 13 publications

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“…9,10 Generally, in community practice pathologists favor more severe pathological diagnoses. 6,7 As a result, BOTs and BOTs associated with implants diagnosed in general practice may be associated with a better prognosis than those reported in the literature. Finally, given the relative rarity of BOTs, many reports are based on cases accumulated over long periods, which raise external validity concerns related to shifts over time in etiologic exposures, detection methods, diagnostic criteria, and treatments that could affect clinical presentations and behavior.…”

Section: Limitations Of Existing Research On Bots: External Validitymentioning

confidence: 98%

“…6 Similarly, an audit of 64 cases of BOT referred to a UK institution with special expertise in gynecologic pathology between 1988 and 1997 found that 27 (42%) were misdiagnosed as ovarian carcinoma. 7 In another review of cases originally diagnosed as stage 1 or 2 ovarian carcinoma at a tertiary center , 29% of cases we reclassified as BOTs. Importantly, only 4.5% of women with tumors reclassified as BOTs died of disease as compared to 25.6% of patients with confirmed diagnoses of carcinoma.…”

Section: Limitations Of Existing Research On Bots: External Validitymentioning

confidence: 99%

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Current challenges and opportunities for research on borderline ovarian tumors

et al. 2004

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Section: Limitations Of Existing Research On Bots: External Validitymentioning

confidence: 98%

Section: Limitations Of Existing Research On Bots: External Validitymentioning

confidence: 99%

Current challenges and opportunities for research on borderline ovarian tumors

et al. 2004

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“…However, LOH analysis revealed several interesting aspects of LMP as discussed above. Because histopathologic examination cannot distinguish between mucinous LMP that will not change into OC from those that are precursors of OC, 26 LOH analysis of 7q35 may be useful to discriminate between them. Conversely, we need to be vigilant in following up cases of mucinous LMP with LOH at 5q14-21 and 17q11.2 (NF1) after surgery.…”

Section: Loh Analysis In Ovarian Tissues From Different Lesionsmentioning

confidence: 99%

Comprehensive allelotype study of ovarian tumors of low malignant potential: Potential differences in pathways between tumors with and without genetic predisposition to invasive carcinoma

Nakayama

Takebayashi

Namiki³

et al. 2001

Int. J. Cancer

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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...

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“…Ovarian tumors are classified as epithelial tumors, germ cell tumors, sex cord-stromal cell tumors, and metastatic tumors on the basis of tumor origin (Koonings et al, 1989).As most patients with ovarian carcinoma have distant or widespread disease at the time of diagnosis, this fact underscores the importance of early detection and improved characterization of ovarian masses and is of paramount and utmost importance in the preoperative evaluation, enabling the surgeon to anticipate carcinoma of the ovary before the operation, so that adequate procedures are planned (Hermann et al, 1987;Mugel et al, 1993;Osmers et al, 1996;Sengupta et al, 2000). Bimanual pelvic examination and serum CA-125 levels have failed to allow consistent detection of ovarian malignancy.…”

Section: Introductionmentioning

confidence: 99%