Skip to main content

Advertisement

Log in

Classification of ovarian carcinomas based on pathology and molecular genetics

  • Educational Series/Blue Series
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Malignant epithelial tumours (carcinomas) are the most common ovarian cancers and the most lethal gynaecological malignancies. Based on light microscopy and molecular genetics, ovarian carcinomas are subdivided into at least five main subtypes that account for over 95% of cases and are inherently different diseases, as indicated by differences in epidemiological and genetic risk factors, precursor lesions, patterns of spread, molecular events during oncogenesis, response to chemotherapy and outcome. For successful subtype-specific treatment, reproducible pathological diagnosis of tumour cell type is critical. Recent investigations have also demonstrated that a significant number of cancers traditionally thought to be primary ovarian tumours (particularly serous, endometrioid and clear cell carcinomas) originate in the fallopian tube and the endometrium and involve the ovary secondarily. In this review we summarise recent advances in the molecular pathology, which have greatly improved our understanding of the biology of ovarian carcinoma and are also relevant to patient management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Prat J (2004) Pathology of the ovary. Saunders, Philadelphia

    Google Scholar 

  2. Lee KR, Tavassoli FA, Prat J et al (2003) Surface epithelial-stromal tumours (in Ch. 2: Tumours of the ovary and peritoneum). In: Tavassoli FA, Devilee P (eds) World Health Organization classification of tumours: pathology and genetics of tumours of the breast and female genital organs. IARC Press, Lyon, pp 117–145

    Google Scholar 

  3. Gilks CB, Prat J (2009) Ovarian carcinoma pathology and genetics: recent advances. Hum Pathol 40:1213–1223

    Article  PubMed  CAS  Google Scholar 

  4. Singer G, Oldt R 3rd, Cohen Y et al (2003) Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. J Natl Cancer Inst 95:484–486

    Article  PubMed  CAS  Google Scholar 

  5. Singer G, Stohr R, Cope L et al (2005) Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis. Am J Surg Pathol 29:218–224

    Article  PubMed  Google Scholar 

  6. Medeiros F, Muto MG, Lee Y et al (2006) The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol 30:230–236

    Article  PubMed  Google Scholar 

  7. Kindelberger DW, Lee Y, Miron A et al (2007) Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: evidence for a causal relationship. Am J Surg Pathol 31:161–169

    Article  PubMed  Google Scholar 

  8. Leitao MM, Boyd J, Hummer A et al (2004) Clinicopathological analysis of early-stage sporadic ovarian carcinoma. Am J Surg Pathol 28:147–159

    Article  PubMed  Google Scholar 

  9. Esteller M, Silva JM, Dominguez G et al (2000) Promoter hypermethylation is a cause of BRCA1 inactivation in sporadic breast and ovarian tumors. J Natl Cancer Inst 92:564–569

    Article  PubMed  CAS  Google Scholar 

  10. Khalique L, Ayhan A, Weale ME et al (2007) Genetic intra-tumour heterogeneity in epithelial ovarian cancer and its implications for molecular diagnosis of tumours. J Pathol 211:286–295

    Article  PubMed  CAS  Google Scholar 

  11. Al-Hussaini M, Stockman A, Foster H, McCluggage WG (2005) WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology 46:468

    Article  Google Scholar 

  12. duBois A, Luck HJ, Meier W et al (2003) A randomized clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel as first-line treatment of ovarian cancer. J Natl Cancer Inst 95:1320–1329

    Article  CAS  Google Scholar 

  13. Farmer H, McCabe N, Lord CJ et al (2005) Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 434:917–921

    Article  PubMed  CAS  Google Scholar 

  14. Gershenson DM, Sun CC, Lu KH et al (2006) Clinical behavior of stage II–IV low-grade serous carcinoma of the ovary. Obstet Gynecol 108:361–368

    Article  PubMed  Google Scholar 

  15. Malpica A, Deavers MT, Lu K et al (2004) Grading ovarian serous carcinoma using a two-tier system. Am J Surg Pathol 28:496–504

    Article  PubMed  Google Scholar 

  16. Crispens MA, Bodurka D, Deavers M et al (2002) Response and survival in patients with progressive or recurrent serous ovarian tumors of low malignant potential. Obstet Gynecol 99:3–10

    Article  PubMed  Google Scholar 

  17. Rodriguez IM, Prat J (2002) Mucinous tumors of the ovary. A clinicopathologic analysis of 75 borderline tumors (of intestinal type) and carcinomas. Am J Surg Pathol 26:139–152

    Article  PubMed  Google Scholar 

  18. Cuatrecasas M, Villanueva A, Matias-Guiu X, Prat J (1997) K-ras mutations in mucinous ovarian tumors. A clinicopathologic and molecular study of 95 cases. Cancer 79:1581–1586

    Article  PubMed  CAS  Google Scholar 

  19. Park SY, Kim HS, Hong EK, Kim WH (2002) Expression of cytokeratins 7 and 20 in primary carcinomas of the stomach and colorectum and their value in the differential diagnosis of metastatic carcinomas to the ovary. Hum Pathol 33:1078–1085

    Article  PubMed  CAS  Google Scholar 

  20. Hess V, A’Hern R, Nasiri N et al (2004) Mucinous epithelial ovarian cancer: a separate entity requiring specific treatment. J Clin Oncol 22:1040–1044

    Article  PubMed  CAS  Google Scholar 

  21. Irving JA, Catasus L, Gallardo A et al (2005) Synchronous endometrioid carcinomas of the uterine corpus and ovary: alterations in the beta-catenin (CTNNB1) pathway are associated with independent primary tumors and favorable prognosis. Hum Pathol 36:605–619

    Article  PubMed  CAS  Google Scholar 

  22. Obata K, Morland SJ, Watson RH et al (1998) Frequent PTEN/MMAC mutations in endometrioid but not serous or mucinous epithelial ovarian tumors. Cancer Res 58:2095–2097

    PubMed  CAS  Google Scholar 

  23. Palacios J, Gamallo C (1998) Mutations in the beta-catenin gene (CTNNB1) in endometrioid ovarian carcinomas. Cancer Res 58:1344–1347

    PubMed  CAS  Google Scholar 

  24. Catasús L, Bussaglia E, RodrÍguez IM et al (2004) Molecular genetic alterations in endometrioid carcinomas of the ovary: similar frequency of beta-catenin abnormalities but lower rate of microsatellite instability and PTEN alterations than in uterine endometrioid carcinomas. Hum Pathol 35:1360–1368

    Article  PubMed  Google Scholar 

  25. Sato N, Tsunoda H, Nishida M et al (2000) Loss of heterozygosity on 10q23.3 and mutation of the tumor suppressor gene PTEN in benign endometrial cyst of the ovary: possible sequence progression from benign endometrial cyst to endometrioid carcinoma and clear cell carcinoma of the ovary. Cancer Res 60:7052–7056

    PubMed  CAS  Google Scholar 

  26. Komiyama S, Aoki D, Tominaga E et al (1999) Prognosis of Japanese patients with ovarian clear cell carcinoma associated with pelvic endometriosis: clinicopathologic evaluation. Gynecol Oncol 72:342–346

    Article  PubMed  CAS  Google Scholar 

  27. Press JZ, de Luca A, Boyd N et al (2008) Ovarian carcinomas with genetic and epigenetic BRCA1 loss have distinct molecular abnormalities. BMC Cancer 8:17

    Article  PubMed  Google Scholar 

  28. Itamochi H, Kigawa J, Sugiyama T et al (2002) Low proliferation activity may be associated with chemoresistance in clear cell carcinoma of the ovary. Obstet Gynecol 100:281–287

    Article  PubMed  Google Scholar 

  29. Nagai Y, Inamine M, Hirakawa M et al (2007) Postoperative whole abdominal radiotherapy in clear cell adenocarcinoma of the ovary. Gynecol Oncol 107:469–473

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jaime Prat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

D’Angelo, E., Prat, J. Classification of ovarian carcinomas based on pathology and molecular genetics. Clin Transl Oncol 12, 783–787 (2010). https://doi.org/10.1007/s12094-010-0599-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-010-0599-0

Keywords

Navigation