The Evolution of Ovarian Carcinoma Subclassification
The phenotypically informed histotype classification remains the mainstay of ovarian carcinoma subclassification. Histotypes of ovarian epithelial neoplasms have evolved with each edition of the WHO Classification of Female Genital Tumours. The current fifth edition (2020) lists five principal histo...
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| Format: | Article |
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MDPI AG
2022-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/2/416 |
| _version_ | 1797495306699407360 |
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| author | Martin Köbel Eun Young Kang |
| author_facet | Martin Köbel Eun Young Kang |
| author_sort | Martin Köbel |
| collection | DOAJ |
| description | The phenotypically informed histotype classification remains the mainstay of ovarian carcinoma subclassification. Histotypes of ovarian epithelial neoplasms have evolved with each edition of the WHO Classification of Female Genital Tumours. The current fifth edition (2020) lists five principal histotypes: high-grade serous carcinoma (HGSC), low-grade serous carcinoma (LGSC), mucinous carcinoma (MC), endometrioid carcinoma (EC) and clear cell carcinoma (CCC). Since histotypes arise from different cells of origin, cell lineage-specific diagnostic immunohistochemical markers and histotype-specific oncogenic alterations can confirm the morphological diagnosis. A four-marker immunohistochemical panel (WT1/p53/napsin A/PR) can distinguish the five principal histotypes with high accuracy, and additional immunohistochemical markers can be used depending on the diagnostic considerations. Histotypes are further stratified into molecular subtypes and assessed with predictive biomarker tests. HGSCs have recently been subclassified based on mechanisms of chromosomal instability, mRNA expression profiles or individual candidate biomarkers. ECs are composed of the same molecular subtypes (<i>POLE</i>-mutated/mismatch repair-deficient/no specific molecular profile/p53-abnormal) with the same prognostic stratification as their endometrial counterparts. Although methylation analyses and gene expression and sequencing showed at least two clusters, the molecular subtypes of CCCs remain largely elusive to date. Mutational and immunohistochemical data on LGSC have suggested five molecular subtypes with prognostic differences. While our understanding of the molecular composition of ovarian carcinomas has significantly advanced and continues to evolve, the need for treatment options suitable for these alterations is becoming more obvious. Further preclinical studies using histotype-defined and molecular subtype-characterized model systems are needed to expand the therapeutic spectrum for women diagnosed with ovarian carcinomas. |
| first_indexed | 2024-03-10T01:46:01Z |
| format | Article |
| id | doaj.art-2fa39546142c43c8a6efcbbb3f2e7597 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T01:46:01Z |
| publishDate | 2022-01-01 |
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| series | Cancers |
| spelling | doaj.art-2fa39546142c43c8a6efcbbb3f2e75972023-11-23T13:14:37ZengMDPI AGCancers2072-66942022-01-0114241610.3390/cancers14020416The Evolution of Ovarian Carcinoma SubclassificationMartin Köbel0Eun Young Kang1Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB T2N 2T9, CanadaDepartment of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB T2N 2T9, CanadaThe phenotypically informed histotype classification remains the mainstay of ovarian carcinoma subclassification. Histotypes of ovarian epithelial neoplasms have evolved with each edition of the WHO Classification of Female Genital Tumours. The current fifth edition (2020) lists five principal histotypes: high-grade serous carcinoma (HGSC), low-grade serous carcinoma (LGSC), mucinous carcinoma (MC), endometrioid carcinoma (EC) and clear cell carcinoma (CCC). Since histotypes arise from different cells of origin, cell lineage-specific diagnostic immunohistochemical markers and histotype-specific oncogenic alterations can confirm the morphological diagnosis. A four-marker immunohistochemical panel (WT1/p53/napsin A/PR) can distinguish the five principal histotypes with high accuracy, and additional immunohistochemical markers can be used depending on the diagnostic considerations. Histotypes are further stratified into molecular subtypes and assessed with predictive biomarker tests. HGSCs have recently been subclassified based on mechanisms of chromosomal instability, mRNA expression profiles or individual candidate biomarkers. ECs are composed of the same molecular subtypes (<i>POLE</i>-mutated/mismatch repair-deficient/no specific molecular profile/p53-abnormal) with the same prognostic stratification as their endometrial counterparts. Although methylation analyses and gene expression and sequencing showed at least two clusters, the molecular subtypes of CCCs remain largely elusive to date. Mutational and immunohistochemical data on LGSC have suggested five molecular subtypes with prognostic differences. While our understanding of the molecular composition of ovarian carcinomas has significantly advanced and continues to evolve, the need for treatment options suitable for these alterations is becoming more obvious. Further preclinical studies using histotype-defined and molecular subtype-characterized model systems are needed to expand the therapeutic spectrum for women diagnosed with ovarian carcinomas.https://www.mdpi.com/2072-6694/14/2/416ovarian cancersubclassificationhistotypemolecular subtypeimmunohistochemistry |
| spellingShingle | Martin Köbel Eun Young Kang The Evolution of Ovarian Carcinoma Subclassification Cancers ovarian cancer subclassification histotype molecular subtype immunohistochemistry |
| title | The Evolution of Ovarian Carcinoma Subclassification |
| title_full | The Evolution of Ovarian Carcinoma Subclassification |
| title_fullStr | The Evolution of Ovarian Carcinoma Subclassification |
| title_full_unstemmed | The Evolution of Ovarian Carcinoma Subclassification |
| title_short | The Evolution of Ovarian Carcinoma Subclassification |
| title_sort | evolution of ovarian carcinoma subclassification |
| topic | ovarian cancer subclassification histotype molecular subtype immunohistochemistry |
| url | https://www.mdpi.com/2072-6694/14/2/416 |
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