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. 2016 Feb 2:11:17.
doi: 10.1186/s13000-016-0467-5.

Clear cell carcinomas of the ovary: a mono-institutional study of 73 cases in China with an analysis of the prognostic significance of clinicopathological parameters and IMP3 expression

Rui Bi  1   2 , Xuxia Shen  3   4 , Weiwei Zhang  5 , Yufan Cheng  6   7 , Zheng Feng  8   9 , Xu Cai  10   11 , Wentao Yang  12   13
Affiliations

Clear cell carcinomas of the ovary: a mono-institutional study of 73 cases in China with an analysis of the prognostic significance of clinicopathological parameters and IMP3 expression

Rui Bi et al. Diagn Pathol. .

Abstract

Background: Ovarian clear cell carcinoma (CCC) is an uncommon subtype of ovarian epithelial tumor. The prognostic significance of its clinicopathological parameters is discordant, with the exception of stage as the adverse prognostic factor. The present study aimed to evaluate the prognostic significance of its clinicopathological characteristics and the expression of IMP3 (Insulin-like growth factor-II mRNA-binding protein 3, IMP3 or IGF2BP3) in Chinese patients with primary pure CCC.

Methods: We collected clinicopathological data from 73 cases with a minimum of 5 years of follow-up and evaluated the expression of IMP3 by immunohistochemistry.

Results: In total, 49.3 % of the patients were in stage I. Advanced stages were closely related to poor prognosis of disease-free survival (DFS) and overall survival (OS) (P < 0.005). Patients with CCC coexisting with endometriosis tended to be younger and to have unilateral involvement but did not exhibit differences in prognosis compared with patients with CCC without endometriosis. Other histological features such as growth pattern, mitosis, and necrosis did not have prognostic significance. IMP3 was positive in 63 % of patients (46 of 73 cases); Thus, positive expression of IMP3 is an adverse prognostic marker in terms of OS (P = 0.012), even in stage I patients (P = 0.038).

Conclusions: The present study demonstrates that IMP3 expression is a prognostic marker, with the exception of stage. IMP3 represents a biomarker of unfavorable prognosis even in stage I patients.

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Figures

Fig. 1
Fig. 1
a A solid nest is on the right, and the cystic morphology with columnar cells resembles an endometrial gland. b Targetoid bodies are signet ring-like cells contained with eosinophil/basophil secretions. Classic hobnail cells can be observed in the top left corner. c Scattered psammoma bodies. d Open tumor rings consist of a ring of tumor cells without a central fibrovascular stroma (A-D; original magnification, ×200). e Extremely expansive tubulocystic morphology with mucinous secretions similar to a thyroid follicle (original magnification, ×40). f Nuclear pseudoinclusions were observed with severe cell atypia, but mitotic figures were absent (original magnification, ×400)
Fig. 2
Fig. 2
a Focal and moderately positive staining for IMP3 expression. b Diffuse and strong IMP3-positive staining (original magnification, ×200)
Fig. 3
Fig. 3
a The OS of the patients with positive IMP3 expression was worse than that of the negative cases among 73 cases. b The same trend was observed in 36 cases with stage I disease
See this image and copyright information in PMC

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