Table I.
Subtypes of epithelial ovarian cancer: histological, molecular and gene mutation characteristics (adapted from Lheureux et al., CA Cancer J Clin 2019;69:280-304).
| Epithelial ovarian cancer (about 90% of all ovarian cancers) | |||||
|---|---|---|---|---|---|
| High-grade serous ovarian cancer | Low-grade serous ovarian cancer | Clear cell | Endometrioid | Mucinous | |
| Occurrence | 70% of all EOCs | 10% of all EOCs | 5% of all EOCs | 10% of all EOCs | <3% of all EOCs |
| Histology | Papillary and solid growth; large mononuclear cells; pleomorphic nuclei with prominent nucleoli and mitotic activity. | Small papillae with cells of uniform nuclei and various amounts of hyalinized stroma; psammoma bodies. | Mixture of tubules, solid areas and complex papillae; cells with prominent nucleoli and clear cytoplasm filled with glycogen. | Cystic or predominantly solid. | Heterogeneous; often composed of benign, borderline, non-invasive, and invasive components. |
| Molecular aberrations | CNA high TP53 BRCA1/2 CDK12 HRD |
CNA low MAPK activation KRAS BRAF NRAS HER2 |
PI3K/AKT activation RTK/Ras activation ARID1A PI3KCA KRAS PTEN TP53 |
Wnt/ß-catenin activation PTEN CTNNB1 PPP2R1α PI3KCA ARID1A KRAS TP53 |
HER2 amplification KRAS |
| Folatereceptor | Yes | - | - | Yes | - |
| Hormone receptor | 30% PR 80% OR |
57% PR 87% OR |
8% PR 19% OR |
67% PR 76% OR |
16% PR 20% OR |
| MMR deficiency | - | - | Yes | Yes | - |
AKT: AKT serine/threonine kinase 1; ARIDA: AT-Rich Interaction Domain 1A; BRAF: carcinoma B-Raf proto-oncogene, serine/ threonine kinase; BRCA1/2: breast cancer 1/2 gene; CDK12: cyclin dependent kinase 12; CNA: copy number alteration; CTNNB1: catenin beta 1; EOC: epithelial ovarian cancer; HER2: human epidermal growth factor receptor 2; HRD: homologous recombina- tion deficiency; KRAS: Kirsten rat sarcoma viral oncogene homologue; MAPK: mitogen-activated protein kinase; MMR: mismatch repair; NRAS: neuroblastoma RAS viral (V-ras) oncogene homologue; OR: oestrogen receptor; PI3K(CA): phosphoinositide-3-ki- nase (catalytic, α polypeptide); PPP2R1α: protein phosphatase 2, subunit A, α isoform; PR: progesterone receptor; PTEN: phosphatase and tensin homologue; RTK: receptor tyrosine kinase; TP53: tumour protein p53; Wnt: wingless-related integration site. Adapted from Lheureux S, Braunstein M, Oza AM. Epithelial ovarian cancer: Evolution of management in the era of precision medicine. CA: A Cancer Journal for Clinicians. 2019;69(4):280-304; distributed under a CC BY-NC 4.0 license [https://doi.org/10.3322/caac.21559]).