PDF(Pubmed)
Abstract：
Uterine tumors resembling ovarian sex cord tumor (UTROSCT) is a rare neoplasm of unknown etiology and has undetermined malignant potential. The emergence of recurrent UTROSCT case reports has led to its initial identification as a tumor of low malignancy potential. Owing to its low incidence, we currently lack any in-depth studies regarding the subset of UTROSCTs that may be aggressive in nature. Here, we sought to identify unique characteristics in aggressive UTROSCT.
19 cases of UTROSCT were collected. Their histologic and tumor immune microenvironment were evaluated by three gynecologic pathologists. The gene alteration was also detected by RNA sequencing. For later analyses regarding differences between benign and malignant tumors, we supplemented our 19 included cases with additional reports from the literature.
Interestingly, we found PD-L1 expression in stromal tumor-infiltrating immune cells (stromal PD-L1) was markedly higher in aggressive UTROSCT. Patients with high stromal PD-L1 (≥ 22.5 cells/mm2) had worse prognosis. When our cases were added with previous cases identified in the literature, we discovered that aggressive UTROSCT was more likely to have significant mitotic activity and NCOA2 gene alterations than benign UTROSCT. Consistence with those results, patients with significant mitotic activity and gene alteration of NCOA2 had worse prognoses.
Collectively, high expression of stromal PD-L1, significant mitotic activity, and gene alteration of NCOA2 may be useful markers to predict aggressive UTROSCT.
19 cases of UTROSCT were collected. Their histologic and tumor immune microenvironment were evaluated by three gynecologic pathologists. The gene alteration was also detected by RNA sequencing. For later analyses regarding differences between benign and malignant tumors, we supplemented our 19 included cases with additional reports from the literature.
Interestingly, we found PD-L1 expression in stromal tumor-infiltrating immune cells (stromal PD-L1) was markedly higher in aggressive UTROSCT. Patients with high stromal PD-L1 (≥ 22.5 cells/mm2) had worse prognosis. When our cases were added with previous cases identified in the literature, we discovered that aggressive UTROSCT was more likely to have significant mitotic activity and NCOA2 gene alterations than benign UTROSCT. Consistence with those results, patients with significant mitotic activity and gene alteration of NCOA2 had worse prognoses.
Collectively, high expression of stromal PD-L1, significant mitotic activity, and gene alteration of NCOA2 may be useful markers to predict aggressive UTROSCT.
摘要：
背景：类似于卵巢性索肿瘤（UTROSCT）的子宫肿瘤是一种病因不明的罕见肿瘤，具有未知的恶性潜能。复发性UTROSCT病例报告的出现导致其最初被鉴定为恶性潜能低的肿瘤。由于发病率低，我们目前缺乏关于可能具有侵袭性的UTROSCT子集的深入研究.这里,我们试图确定侵袭性UTROSCT的独特特征。
方法：收集19例UTROSCT。由三名妇科病理学家评估了他们的组织学和肿瘤免疫微环境。还通过RNA测序检测基因改变。对于后来关于良性和恶性肿瘤之间差异的分析，我们通过文献中的其他报告补充了我们的19例纳入病例.
结果：有趣的是，我们发现,在侵袭性UTROSCT中,间质肿瘤浸润性免疫细胞(stromalPD-L1)中PD-L1的表达明显增高.高基质PD-L1（≥22.5细胞/mm2）患者预后较差。当我们的病例与文献中确定的以前的病例相加时，我们发现侵袭性UTROSCT比良性UTROSCT更可能具有显著的有丝分裂活性和NCOA2基因改变.与这些结果保持一致，具有明显有丝分裂活性和NCOA2基因改变的患者预后较差。
结论：总的来说，基质PD-L1高表达，显著有丝分裂活性，NCOA2的基因改变可能是预测侵袭性UTROSCT的有用标记。
方法：收集19例UTROSCT。由三名妇科病理学家评估了他们的组织学和肿瘤免疫微环境。还通过RNA测序检测基因改变。对于后来关于良性和恶性肿瘤之间差异的分析，我们通过文献中的其他报告补充了我们的19例纳入病例.
结果：有趣的是，我们发现,在侵袭性UTROSCT中,间质肿瘤浸润性免疫细胞(stromalPD-L1)中PD-L1的表达明显增高.高基质PD-L1（≥22.5细胞/mm2）患者预后较差。当我们的病例与文献中确定的以前的病例相加时，我们发现侵袭性UTROSCT比良性UTROSCT更可能具有显著的有丝分裂活性和NCOA2基因改变.与这些结果保持一致，具有明显有丝分裂活性和NCOA2基因改变的患者预后较差。
结论：总的来说，基质PD-L1高表达，显著有丝分裂活性，NCOA2的基因改变可能是预测侵袭性UTROSCT的有用标记。
