Infiltrative pattern of invasion is independently associated with shorter survival and desmoplastic stroma markers FAP and THBS2 in mucinous ovarian carcinoma
Details
Publication Year 2024-06,Volume 84,Issue #7,Page 1095-1110
Journal Title
Histopathology
Publication Type
Research article
Abstract
AIMS: Mucinous ovarian carcinoma (MOC) is a rare ovarian cancer histotype with generally good prognosis when diagnosed at an early stage. However, MOC with the infiltrative pattern of invasion has a worse prognosis, although to date studies have not been large enough to control for covariables. Data on reproducibility of classifying the invasion pattern are limited, as are molecular correlates for infiltrative invasion. We hypothesized that the invasion pattern would be associated with an aberrant tumour microenvironment. METHODS AND RESULTS: Four subspecialty pathologists assessed interobserver reproducibility of the pattern of invasion in 134 MOC. Immunohistochemistry on fibroblast activation protein (FAP) and THBS2 was performed on 98 cases. Association with survival was tested using Cox regression. The average interobserver agreement for the infiltrative pattern was moderate (kappa 0.60, agreement 86.3%). After reproducibility review, 24/134 MOC (18%) were determined to have the infiltrative pattern and this was associated with a higher risk of death, independent of FIGO stage, grade, and patient age in a time-dependent manner (hazard ratio [HR] = 10.2, 95% confidence interval [CI] 3.0-34.5). High stromal expression of FAP and THBS2 was more common in infiltrative MOC (FAP: 60%, THBS2: 58%, both P < 0.001) and associated with survival (multivariate HR for FAP: 1.5 [95% CI 1.1-2.1] and THBS2: 1.91 [95% CI 1.1-3.2]). CONCLUSIONS: The pattern of invasion should be included in reporting for MOC due to the strong prognostic implications. We highlight the histological features that should be considered to improve reproducibility. FAP and THBS2 are associated with infiltrative invasion in MOC.
Publisher
Wiley
Keywords
Adult; Aged; Aged, 80 and over; Female; Humans; Middle Aged; *Adenocarcinoma, Mucinous/pathology/mortality/metabolism; *Biomarkers, Tumor/analysis/metabolism; *Endopeptidases; Gelatinases/metabolism/analysis; Immunohistochemistry; Kaplan-Meier Estimate; Membrane Proteins/metabolism; Neoplasm Invasiveness; *Ovarian Neoplasms/pathology/mortality/metabolism; Prognosis; Reproducibility of Results; Serine Endopeptidases/metabolism; *Thrombospondins/metabolism; Tumor Microenvironment
Department(s)
Laboratory Research
Open Access at Publisher's Site
https://doi.org/10.1111/his.15128
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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