Clinicopathological Characteristics And Whole Exome Sequencing Of Primary Mucinous Ovarian Carcinoma

Primary mucinous ovarian carcinoma(pMOC)is a rare subtype of epithelial ovarian carcinoma.Patients are diagnosed at a relatively young age,and the prognosis is favorable when found at an early stage.However,advanced-stage pMOC presents with a worse prognosis,relating to its resistance to platinum.In the first section,we established the pMOC database at Peking Union Medical College Hospital.First,we compared the clinicopathological characteristics and prognosis between pMOC and ovarian clear cell carcinoma(OCCC).We found that pMOC presented with a lower level of preoperative serum CA125,a higher portion of patients undergoing re-staging surgery,and a higher rate of lymph node metastasis.As for the prognosis,early-stage pMOC had a significantly better progression-free survival(PFS)than early-stage OCCC.Second,we evaluated the prognostic significance of preoperative serum carcinoembryonic antigen(CEA)in pMOC,and found that preoperative CEA elevation was an independent prognostic factor for PFS.Third,we clarified the oncological and fertility outcomes of pMOC patients treated with fertility-sparing surgery(FSS).We proved that FSS could be a safe option for stage I patients,and the fertility outcomes were quite good.At last,we investigated the indications of appendectomy in pMOC.Our data supported the performance of appendectomy when the appendix was grossly abnormal or the evidence of other metastatic lesions was found intraoperatively.In the second section,we performed the whole exome sequencing on the formalin-fixed and paraffin-embedded tissues from pMOC patients.We characterized the exome landscapes including the somatic single nucleotide variants,insertion and deletion,significantly mutated genes,known driver genes,and copy number variations.And we uncovered the correlations between the somatic mutations and the clinical data.The present study provides evidence for the future targeted therapy research.