Department of Cellular Pathology, Barts Health NHS Trust, London, UK.
Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK.
Histopathology. 2017 Sep;71(3):339-356. doi: 10.1111/his.13248. Epub 2017 Jul 18.
Extra-uterine high-grade serous carcinoma (HGSC) accounts for most of the morbidity and mortality associated with ovarian carcinoma, and is one of the leading causes of cancer death in women. Until recently our understanding of HGSC was very limited compared to other common cancers, and it has only been during the last 15 years that we have learned how to diagnose this ovarian carcinoma histotype accurately. Since then, however, there has been rapid progress, with identification of a precursor lesion in the fallopian tube, development of prevention strategies for both those with inherited susceptibility (hereditary breast and ovarian cancer syndrome) and without the syndrome, and elucidation of the molecular events important in oncogenesis. This molecular understanding has led to new treatment strategies for HGSC, with the promise of more to come in the near future. In this review we focus on these recent changes, including diagnostic criteria/differential diagnosis, primary site assignment, precursor lesions and the molecular pathology of HGSC.
子宫外高级别浆液性癌(HGSC)是导致卵巢癌发病率和死亡率的主要原因之一,也是女性癌症死亡的主要原因之一。与其他常见癌症相比,直到最近我们对 HGSC 的了解还非常有限,仅在过去 15 年中,我们才学会了如何准确诊断这种卵巢癌组织类型。然而,从那时起,已经取得了快速进展,在输卵管中发现了一个前驱病变,为具有遗传易感性(遗传性乳腺癌和卵巢癌综合征)和没有综合征的人制定了预防策略,并阐明了在肿瘤发生中重要的分子事件。这种分子上的认识导致了针对 HGSC 的新治疗策略,在不久的将来有望有更多的治疗策略出现。在这篇综述中,我们重点介绍了这些最近的变化,包括诊断标准/鉴别诊断、原发部位分配、前驱病变以及 HGSC 的分子病理学。