TP53 as a Diagnostic Aid in the Distinction of Ovarian Mucinous Borderline Tumors From Mucinous Carcinoma

Kang, EY; Terzic, T; Ghatage, P; Woo, L; Gorringe, KL; Karnezis, AN; Lee, CH; Kobel, M

Author(s): Kang, EY; Terzic, T; Ghatage, P; Woo, L; Gorringe, KL; Karnezis, AN; Lee, CH; Kobel, M;
Details: Publication Year 2024,Volume 43,Issue #2,Page 111-122
Journal Title: International Journal of Gynecological Pathology
Publication Type: Research article
Abstract: Ovarian mucinous borderline tumors (MBTs) are clinically managed as benign neoplasms while the management of ovarian mucinous carcinomas (MC) is dependent on tumor stage. Despite the standardization of sampling of ovarian mucinous neoplasms, limited interobserver reproducibility between MBT and MC persists. Based on our recent finding that abnormal TP53 expression is associated with unfavorable outcome in MBT, we hypothesized that TP53 status might improve the reproducible distinction of MBT from MC. A virtual slide set of 85 consecutive ovarian mucinous neoplasms received at a single institution, with each case represented by 3 full sections, were reviewed by 3 pathologists in 2 iterations. The initial assessment was based solely on morphologic review, while the second iteration was performed with knowledge of TP53 status. The reproducibility of a trinary categorization (MBT, MBT with intraepithelial carcinoma [IEC], MC) significantly improved from a kappa of 0.60 based on the initial morphologic assessment to a kappa of 0.76 (t-test, P =0.0042) after consideration of TP53 immunohistochemistry (IHC) results. Six out of 85 patients died of disease, and in 2 of them, at least 1 pathologist assessed MBT with IEC and not MC even after integration of TP53 IHC. With the integration of TP53 IHC, substantial interobserver agreement for MBT and MC can be reached, particularly in cases with an uncertain degree of confluent growth. TP53 IHC can also be used to highlight and support the presence of IEC in MBT, however, discordances remained in 2 cases with adverse outcome.
Keywords: Female; Humans; Reproducibility of Results; *Ovarian Neoplasms/pathology; *Adenocarcinoma, Mucinous/diagnosis/pathology; Carcinoma, Ovarian Epithelial/diagnosis; *Carcinoma in Situ/pathology; Tumor Suppressor Protein p53/metabolism
Department(s): Laboratory Research
PubMed ID: 37406453
Publisher's Version: https://doi.org/10.1097/PGP.0000000000000967
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-08-20 06:08:29

Last Modified: 2024-08-20 06:56:56