上皮性卵巢癌的分型與臨床表徵

Classification and clinical characteristics of epithelial ovarian cancer

上皮性卵巢癌（epithelial ovarian cancer, EOC）涵蓋多種組織型態與分子亞型，各亞型皆具有獨特的臨床行為與分子特徵。近十年來，卵巢癌研究的焦點已由傳統的組織學分類，逐漸轉向以分子分型為核心，期望針對不同亞型提供更精準的治療指引。以高惡性度漿液性卵巢癌（high-grade serous ovarian carcinoma, HGSOC）為例，該亞型為最常見的EOC，約占75%病例，在治療上已有顯著進展，包括聚腺苷二磷酸核糖聚合酶（poly（ADP-ribose）polymerase, PARP）抑制劑的應用。然而，這些治療策略並不適用於所有亞型，特別是罕見組織型，過去大型臨床試驗與分子分析資料相當有限。近年研究突破已揭示罕見亞型（如卵巢透明細胞癌、卵巢黏液癌、低惡性度漿液性卵巢癌）的分子特性，並協助辨識高風險與低風險族群，提供潛在標靶治療的新契機。本文整合目前對卵巢癌分子分型的較新文獻，並總結各組織型的研究進展。

Epithelial ovarian cancer (EOC) encompasses a heterogeneous group of histological types and molecular subtypes, each characterized by distinct clinical behaviors and molecular features. Over the past decade, the research focus has shifted from conventional histopathological classification toward a molecular subtype-oriented framework, with the aim of providing more precise treatment strategies for each subtype. High-grade serous ovarian carcinoma (HGSOC), the most common EOC subtype accounting for approximately 75% of cases, has seen significant therapeutic advancements, including the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors. However, such stratagies are not universally applicable, particularly for rare histotypes, for which large-scale clinical trials and molecular profiling data have historically been limited. Recent breakthroughs have begun to elucidate the molecular characteristics of rare subtypes-such as ovarian clear cell carcinoma, mucinous carcinoma, and low-grade serous ovarian carcinoma-facilitating the identification of high- and low-risk patient groups and offering new opportunities for targeted therapy. This article reviews current understanding of the subtypes of ovarian cancer and summarizes the latest research progress and clinical implications across histotypes.