Prognostic importance of atypical endometriosis with architectural hyperplasia versus cytologic atypia in endometriosis-associated ovarian cancer

Prognostic importance of atypical endometriosis with architectural hyperplasia versus cytologic atypia in endometriosis-associated ovarian cancer

Patients with endometriosis are at increased risk of ovarian cancer. It has been suggested that atypical endometriosis is a precursor lesion of endometriosis-associated ovarian cancer (EAOC). The aim of this study is to evaluate if cytologic (cellular) atypia and architectural atypia (hyperplasia),...

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Published in:Journal of gynecologic oncology Vol. 30; no. 4; p. e63
Main Authors: Ñiguez Sevilla, Isabel, Machado Linde, Francisco, Marín Sánchez, Maria Del Pilar, Arense, Julián Jesús, Torroba, Amparo, Nieto Díaz, Anibal, Sánchez Ferrer, Maria Luisa
Format: Journal Article
Language:English
Published: Korea (South) Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 01-07-2019
대한부인종양학회
Subjects:
Biomarkers, Tumor
DNA-Binding Proteins
Endometrial Hyperplasia - diagnosis
Endometrial Hyperplasia - pathology
Endometriosis - diagnosis
Endometriosis - pathology
Female
Humans
Ki-67 Antigen
Original
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - pathology
Precancerous Conditions - pathology
Prospective Studies
Transcription Factors
산부인과학
Ovarian Cancer
Endometriosis
Hyperplasia
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Summary:Patients with endometriosis are at increased risk of ovarian cancer. It has been suggested that atypical endometriosis is a precursor lesion of endometriosis-associated ovarian cancer (EAOC). The aim of this study is to evaluate if cytologic (cellular) atypia and architectural atypia (hyperplasia), histologic findings described as atypical endometriosis, play a different role in patients with EAOC. A prospective study was conducted between January 2014 and April 2017 at our institution with patients undergoing surgery with a histologic diagnosis of endometriosis, ovarian cancer, or EAOC. The prevalence and immunohistologic study (Ki-67, BAF250a, COX-2) of cases of cellular and architectural atypia in endometriosis were analyzed. Two hundred and sixty-six patients were included: the diagnosis was endometriosis alone in 159 cases, ovarian cancer in 81, and EAOC in 26. Atypical endometriosis was reported in 23 cases (12.43%), 39.13% of them found in patients with EAOC. Endometriosis with cellular atypia was found mainly in patients without neoplasm (71.4%), and endometriosis with architectural atypia was seen in patients with ovarian cancer (88.9%) (p=0.009). Ki-67 was significantly higher in endometriosis patients with architectural atypia than those with cellular atypia. The diagnosis of endometriosis with architectural atypia is important because it may be a precursor lesion of ovarian cancer; therefore, pathologists finding endometriosis should carefully examine the surgical specimen to identify any patients with hyperplasia-type endometriosis, as they may be at higher risk of developing EAOC.
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Isabel Ñiguez Sevilla and Francisco Machado Linde contributed equally to this work as the co-first authors.
https://doi.org/10.3802/jgo.2019.30.e63
ISSN:2005-0380
2005-0399
DOI:10.3802/jgo.2019.30.e63