关键词: biphasic clear cells microglandular morphology papillary spindle cells

来  源:   DOI:10.3390/life14030387   PDF(Pubmed)

Abstract:
The previous endometrial cancer (EC) FIGO staging primarily relied on the extent of the disease spread into the anatomical sites at diagnosis. The most recent one (2023) incorporates clinicopathological features such as histological subtype, tumor grade, the extent of lymphovascular space invasion (LVI), and, when available, molecular subtypes of EC. The emphasis on accurate histological typing, tumor grading, and the molecular features of the cancer is stronger than ever. This review addresses challenging diagnostic patterns in the histologic subtyping and grading EC under five categories: 1. EC with spindle cells, 2. EC with clear cells, 3. EC with a papillary architecture, 4. EC with a biphasic morphology, and 5. EC with a microglandular architecture. The morphological features differentiating low- and high-grade cancers are discussed, along with relevant clinical work-ups. Recent molecular genetic findings regarding the diagnosis and prognosis of the disease and the results of related clinical trials are summarized. The potential challenges in the evaluation of LVI follow these sections. The final section of the review includes an overview of the literature on incorporating molecular subtypes of EC into clinical practice.
摘要:
先前的子宫内膜癌(EC)FIGO分期主要取决于诊断时疾病扩散到解剖部位的程度。最近的一项(2023年)纳入了临床病理特征,如组织学亚型,肿瘤分级,淋巴管间隙侵犯(LVI)的程度,and,当可用时,EC的分子亚型。强调准确的组织学分型,肿瘤分级,癌症的分子特征比以往任何时候都强。这篇综述针对五个类别的组织学亚型和EC分级中具有挑战性的诊断模式:1。带梭形细胞的EC,2.带透明细胞的EC,3.具有乳头状结构的EC,4.具有双相形态的EC,和5.具有微腺结构的EC。讨论了区分低级和高级癌症的形态学特征,以及相关的临床检查。总结了有关该疾病的诊断和预后的最新分子遗传学发现以及相关临床试验的结果。LVI评估中的潜在挑战遵循这些部分。本综述的最后一部分包括将EC的分子亚型纳入临床实践的文献概述。
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