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模式 A 带有卵巢转移的宫内腺瘤是惰性的,并且从分子上与具有破坏性的侵入性腺瘤不同
Alexander J Neil1, Yvonne Y Li2, Ardeshir Hakam3
1Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Histopathology
|November 3, 2023
概括
有卵巢转移的人类乳头瘤病毒相关的宫内腺癌 (HPVA) 显示出基于侵入性模式的独特的生物和基因组概况. 卵巢扩散的HPVA模式表现出惰的行为,这表明保守的管理可能是合适的.
科学领域:
- 妇科瘤学 妇科瘤学
- 病理学 病理学 病理学
- 基因组学就是基因组学.
背景情况:
- 人类乳头瘤病毒相关的宫内腺癌 (HPVA) 侵袭模式具有预后意义.
- 非破坏性 (模式A) 的HPVA通常有很好的预后,类似于在位腺癌 (AIS).
- 罕见的卵巢扩散模式 A HPVA 表明潜在的攻击性在一个子集的病例.
研究的目的:
- 为了研究AIS/模式AHPVA与卵巢转移和具有转移的破坏性侵入性HPVA之间的生物和基因组差异.
- 为了确定卵巢扩散的模式,A的HPVA与更具侵略性的模式不同.
主要方法:
- 来自13名HPVA患者的原发性瘤和转移的综合基因组测序 (447基因小组).
- 评估致病变体,拷贝数变化 (CNA),瘤突变负担和分子特征.
- 在初级和转移性病变之间以及在侵入性模式类别之间比较分子概况.
主要成果:
- 四名患者患有AIS/A型原发性,仅有卵巢转移;九名患者患有B型/C型瘤.
- AIS/A型HPVA显示卵巢中的腺体分化得很好,而C型显示了明显的透特征.
- 与A/B模式相比,C型瘤在初级病变中CNA显著更高.
- 只有一个AIS/模式A转移有新型变异,而在模式B/C转移中只有五个.
- 所有四名AIS/模式A患者均保持无病;九名模式B/C患者中有五人死于癌症.
结论:
- 具有卵巢参与的AIS/模式的HPVA在形态和基因组上与具有破坏性侵入性的HPVA不同.
- 卵巢扩散模式A的HPVA可能通过表面延伸发生,而不是C模式的肌/血管扩散.
- 这些差异解释了在罕见的卵巢转移模式AHPVA的罕见病例中的惰结果.
- 保守的手术管理可能适合模式AHPVA.
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