Clinicopathological heterogeneity in ovarian clear cell adenocarcinoma: a study on individual therapy practice

Yuji Matsuo, Hironori Tashiro, Hiroyuki Yanai, Takuya Moriya, Hidetaka Katabuchi

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Ovarian clear cell adenocarcinoma (CCA) has been believed to be a lethal histological subtype of an epithelial ovarian adenocarcinoma (EOA); its precursor has been assumed to be endometriosis. However, it has been reported that CCAs occasionally exhibit different clinical behaviors, suggesting that CCAs might not belong to a single category. We focused on CCAs combined with other histological types of EOAs; we re-evaluated the pathology of 46 CCAs and divided them into two subgroups: 35 CCAs alone (pure-type CCAs); and 11 CCAs with other histological types, endometrioid adenocarcinomas (EAs) or/and serous adenocarcinomas (SAs) (mixed-type CCAs). Immunohistochemical analysis for expression of ARID1A, p53, PTEN, Annexin 4, hepatocyte nuclear factor-1β (HNF-1β), and WT-1 was employed. We identified that patients with endometriosis were younger than those without endometriosis in pure-type CCAs (P < 0.005). In mixed-type CCAs, the immunohistochemical-staining patterns revealed internal transition of each histological component. In pure-type CCAs, expressions of ARID1A and p53 were mutually altered, and altered expression of p53 was associated with worse prognosis than that of ARID1A (P < 0.001). Our results provide evidence that CCAs would have clinicopathological heterogeneity, determining the patient’s prognosis. Furthermore, immunohistochemical analysis may shed light on the selection of appropriate treatment, including chemotherapy.

Original languageEnglish
Pages (from-to)146-154
Number of pages9
JournalMedical Molecular Morphology
Issue number3
Publication statusPublished - Sept 14 2015


  • Endometriosis
  • Heterogeneity
  • Molecular pathology
  • Ovarian clear cell adenocarcinoma
  • Prognosis
  • Therapeutic strategy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology


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