Ovarialkarzinom ist nicht gleich Ovarialkarzinom

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• 作者：Prof. Dr. med. Doris Mayr
• 关键词：SchlüsselwörterMolekularpathologie ; Invasives Ovarialkarzinom ; Borderlinetumoren ; Tumorigenese ; Vorläuferläsionen
• 刊名：Der Gyn?kologe
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：49
• 期：10
• 页码：746-753
• 全文大小：1,774 KB
• 刊物主题：Gynecology; Obstetrics/Perinatology; Endocrinology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1433-0393
• 卷排序：49

文摘

Most tumors of the ovary are of epithelial origin. Due to unspecific symptoms and lack of screening systems most patients present in advanced stage and the 10-year survival is low. Until now, little was known of the aetiology or mechanisms of malignant transformation, but variable prognosis pointed to different ways of tumorigenesis. In the last two decades clinical and molecular results initiated the dual theory of tumorigenesis, but did not apply for all histological types. Over the last few years further clinical observations, research and in particular the genetic analyses of carriers with BRCA mutation resulted in further development of the tumorigenesis model: TP53 mutation forms the basis of the HGSC (high-grade serous carcinoma); in contrast LGSC (low-grade serous carcinoma) and mucinous carcinoma mostly show mutation of BRAF or KRAS. Atypical endometriosis is the cause of at least a portion of endometrioid, clear cell and seromucinous carcinomas. Precursor lesions of the fallopian tubes are the origin of ovarian cancer for at least carriers with BRCA mutation. How far this model applies for other carcinomas remains unclear. The new classification of ovarian carcinomas is based not only on histomorphology but also on molecular pathology results and leads to a subclassification which is important for prognosis, standard therapy and as a potential starting point for individual therapy.