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What Is New on Ovarian Carcinoma: Integrated Morphologic and Molecular Analysis Following the New 2020 World Health Organization Classification of Female Genital Tumors
oleh: Antonio De Leo, Donatella Santini, Claudio Ceccarelli, Giacomo Santandrea, Andrea Palicelli, Giorgia Acquaviva, Federico Chiarucci, Francesca Rosini, Gloria Ravegnini, Annalisa Pession, Daniela Turchetti, Claudio Zamagni, Anna Myriam Perrone, Pierandrea De Iaco, Giovanni Tallini, Dario de Biase
| Format: | Article |
|---|---|
| Diterbitkan: | MDPI AG 2021-04-01 |
Deskripsi
Ovarian carcinomas represent a heterogeneous group of neoplasms consisting of separate entities with distinct risk factors, precursor lesions, pathogenesis, patterns of spread, molecular profiles, clinical course, response to chemotherapy, and outcomes. The histologic subtype and the related molecular features are essential for individualized clinical decision-making. The fifth edition of the World Health Organization classification of tumors of the female genital tract divides ovarian carcinomas into at least five main and distinct types of ovarian carcinomas: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, clear cell carcinoma, and mucinous carcinoma. Molecular pathology has improved the knowledge of genomic landscape of ovarian carcinomas identifying peculiar alterations for every histologic subtype. It is well-known that high-grade and low-grade serous carcinomas are separate entities with entirely different morphologic and molecular characteristics. <i>TP53</i> and <i>BRCA</i> mutations are typical of high-grade serous carcinoma, whereas <i>BRAF</i> and <i>KRAS</i> mutations frequently occur in low-grade serous carcinoma. Endometrioid and clear cell carcinomas are frequently associated with endometriosis. Endometrioid tumors are characterized by β-catenin alterations, microsatellite instability, and <i>PTEN</i> and <i>POLE</i> mutations, while <i>ARID1A</i> mutations occur in both endometrioid and clear cell carcinomas. Mucinous carcinomas are uncommon tumors associated with copy-number loss of <i>CDKN2A</i> and <i>KRAS</i> alterations and metastasis from other sites should always be considered in the differential diagnosis.