Quang Hiep Bui

Integrating clinicopathological and molecular data to assess the biological behavior of uterine inflammatory myofibroblastic tumors

Assessing the biological behavior of uterine inflammatory myofibroblastic tumors (IMTs) remains challenging. This study evaluated previously proposed risk schemes and features in 9 IMTs (6 indolent, 3 aggressive) by integrating clinicopathological features, immunohistochemistry, and next-generation sequencing (NGS). High-risk features (necrosis, infiltrative growth, nuclear atypia) were present in both groups, with LVSI in 1/3 of aggressive IMTs. Aberrant p16 expression and CDKN2A/2B deletions were noted in 2/3 aggressive cases. All cases harbored ALK fusions, wild-type p53, and lacked pathogenic gene mutations. Aggressive cases harbored arm-level and segmental copy number gains/losses at chr 1, 2, X, and had significantly reduced AR expression. The clinicopathological risk stratification score (CRSS) predicted the biological behavior correctly in cases with complete clinicopathological data (size, mitoses, age, infiltrative growth). Two morcellated cases (one indolent and one aggressive) would have been predicted as low risk based solely on the absence of pathogenic mutations. Hereby, the reliability of the proposed CRSS was confirmed. Aberrant p16 expression predicted malignant behavior in 2/3 aggressive cases. Absence of pathogenic mutations or presence of large scale CNVs does not seem to be a predictor of clinical behavior. Additional studies and NGS analyses of more cases may improve risk stratification for patients with incomplete clinicopathological information and may reveal additional risk stratifiers (such as the suggested large-scale CNVs or AR downregulation) for IMTs.

TRPS1 expression in 451 tubo-ovarian tumours: a potential prognostic marker for high-grade serous carcinoma.

Trichorhinophalangeal syndrome type 1; transcriptional repressor GATA binding 1 (TRPS1), a member of the GATA transcription factor family, functions primarily as a transcriptional repressor. TRPS1 is frequently utilised as a diagnostic marker for breast carcinoma, although its specificity is lower than previously believed. Moreover, TRPS1 is expressed in various solid tumours originating from the skin, salivary glands, soft tissues, prostate, urothelium, and female genital tract. The current study evaluated the diagnostic and prognostic significance of TRPS1 in 451 primary tubo-ovarian tumours. The cohort included 94 high-grade serous carcinomas (HGSCs), 81 low-grade serous carcinomas (LGSCs), 31 micropapillary serous borderline tumours (mSBTs), 92 clear cell carcinomas (CCCs), 52 endometrioid carcinomas (ECs), 31 mucinous carcinomas (MCs), and 70 mucinous borderline tumours (MBTs). Immunohistochemical analysis was performed using tissue microarrays following standardised protocols. Clinical data were analysed to determine the prognostic relevance of TRPS1 expression. TRPS1 expression was detected in 47% of HGSCs, 44% of ECs, 35% of CCCs, 19% of LGSCs, and 29% of mSBTs with complete negativity in MC/MBT. TRPS1-negative HGSC cases had higher recurrence rates than those with positive staining. Furthermore, TRPS1 expression significantly correlated with improved metastasis-free survival in HGSC cases. These findings suggest that TRPS1 may serve as an independent prognostic marker for HGSC. Despite varying expression rates across primary tubo-ovarian carcinomas, the routine use of TRPS1 in the differential diagnosis seems to be limited, ​as other robust immunohistochemical markers are available for distinguishing the individual subgroups. Further research is needed to clarify the specific functions and clinical implications of TRPS1 in tubo-ovarian cancer.