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Long‐term survival of patients with mismatch repair protein‐deficient, high‐stage ovarian clear cell carcinoma
Author(s) -
Stewart Colin J R,
Bowtell David D L,
Doherty Dorota A,
Leung Yee C
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13040
Subject(s) - dna mismatch repair , stage (stratigraphy) , medicine , lynch syndrome , immunohistochemistry , ovarian cancer , ovarian carcinoma , carcinoma , oncology , germline mutation , gastroenterology , germline , cancer , pathology , colorectal cancer , mutation , biology , gene , genetics , paleontology
Aims Gynaecological cancer patients with germline mutations appear to have a better prognosis than those with sporadic malignancies. Following the observation of long‐term survival in a patient with stage III ovarian clear cell carcinoma ( CCC ) and possible Lynch syndrome ( LS ), DNA mismatch repair ( MMR ) protein immunohistochemistry was performed in a series of high‐stage CCC and correlated with patient outcomes. Methods and results Thirty‐two consecutive cases of stage III / IV ovarian CCC s accessioned between 1992 and 2015 were examined. The tumours from two patients (6%), including the index case, showed loss of MSH 2/ MSH 6 expression while MLH 1/ PMS 2 staining was retained. The index patient subsequently developed colonic and rectal carcinomas that were also MSH 2/ MSH 6‐deficient, while the second patient had a genetically confirmed germline MSH 2 mutation. All other tumours showed retained expression of the four MMR proteins. The two patients with MMR protein‐deficient tumours were alive 160 months and 124 months following surgery, whereas the median survival of patients with MMR protein‐intact CCC s was 11.8 months (75th and 25th percentiles of 8.1 months and 39.3 months, respectively), with 21 patients deceased due to tumour. Conclusions Larger studies are required but high‐stage, MMR protein‐deficient CCC s may have a relatively favourable prognosis.