CAJ | 학술논문

上皮性卵巢癌是卵巢恶性肿瘤中最常见的类型，也是恶性程度最高的妇科肿瘤，基于近年来一系列的形态学和分子遗传学研究可将上皮性卵巢癌分为Ⅰ型和Ⅱ型。卵巢低级别浆液性腺癌属Ⅰ型来自交界性肿瘤，主要表现为微乳头形态伴KRAS和BRAF基因的突变，肿瘤呈渐进性发展，惰性病程，诊断时多数处于临床早期，预后较好。高级别浆液性腺癌属Ⅱ型，细胞异型性显著，多伴TP53突变，卵巢自身见不到前驱病变，呈高度侵袭性病程，多数来自输卵管伞端上皮的浆液性病变，确诊时常已处于临床晚期，发病快，生长迅速，侵袭性强，预后差。I型及II型卵巢癌表现出的生物学特性不同，在临床表现、预后等方面的明显差异提示了二者可能具有不同的起源及遗传学改变。本文将从分子遗传学角度对近期研究理论并从“二元”角度来探讨上皮性卵巢癌的起源进行综述。
상피성란소암시란소악성종류중최상견적류형，야시악성정도최고적부과종류，기우근년래일계렬적형태학화분자유전학연구가장상피성란소암분위Ⅰ형화Ⅱ형。란소저급별장액성선암속Ⅰ형래자교계성종류，주요표현위미유두형태반KRAS화BRAF기인적돌변，종류정점진성발전，타성병정，진단시다수처우림상조기，예후교호。고급별장액성선암속Ⅱ형，세포이형성현저，다반TP53돌변，란소자신견불도전구병변，정고도침습성병정，다수래자수란관산단상피적장액성병변，학진시상이처우림상만기，발병쾌，생장신속，침습성강，예후차。I형급II형란소암표현출적생물학특성불동，재림상표현、예후등방면적명현차이제시료이자가능구유불동적기원급유전학개변。본문장종분자유전학각도대근기연구이론병종“이원”각도래탐토상피성란소암적기원진행종술。
Ovarian epithelial carcinomas are the most common lethal gynecological malignancies. Ovarian carcinomas are divid-ed into Types I and II based on different morphologies, genetic alterations, and biomarker expression. Low-grade micropapillary serous carcinoma are Type I tumors. Type I tumors are slow growing, generally confined to the ovary at diagnosis, and with better prognosis. These tumors develop from well established precursor lesions that are termed"borderline"tumors. Type 1 tumors are genetically stable and are characterized by mutations in a number of different genes including KRAS, BRAF, PTEN, and beta-catenin. Type II tumors are rapidly growing and highly aggressive neoplasms, for which well defined precursor lesions have not been described. They may arise in the fimbrial epithelium of the oviduct with advanced stage, more aggressive behavior, and worse prognosis. High-grade serous carcino-ma belongs to Type II tumors. This group of tumors has a high level of genetic instability and is characterized by TP53 mutation. Hence, ovarian cancer comprises a heterogeneous group of tumors with distinctly different histological characteristics, molecular genet-ic features, and clinical course.