59. 根據 WHO classification (5th edition) of tumors of the uterine cervix, 下列何者錯 誤?
(A) Serous carcinoma of the cervix has been removed because there is no evidence that it occurs as a primary tumor.
(B)Adenofibroma has been omitted because it is a rare and controversial entity.
(C)The p16 immunostaining or HPV testing is required to distinguish HPV-associated and HPV-independent squamous cell carcinomas.
(D)Silva pattern of invasion is applicable to all invasive cervical carcinomas.

55. Which of the following statements about IgA nephropathy (IgAN) is INCORRECT?(A) Dominant or codominant IgA mesangial staining is essential for diagnosis. (B)Antigenic galactose-deficient IgA1 plays a central role in the pathogenesis of IgAN. IgG or IgA autoantibodies form immune complexes with aberrantly galactosylated IgA1 leading to glomerular deposition.(C)The parameters in Oxford classification of IgAN include mesangial hypercellularity (M), endocapillary hypercellularity( E ), segmental sclerosis (S), interstitial fibrosis/tubular atrophy (T) and crescents ( C ). (D)Henoch-Schönlein purpura also has glomerular mesangial IgA deposition, and can be distinguished from IgAN by renal biopsy.

56. Which of the following statements about membranous nephropathy (MN) is INCORRECT?(A)Primary MN (previously called idiopathic MN) is now considered a kidneyspecific, autoimmune glomerular disease due to autoantibodies against certain native podocyte antigens.(B)The phospholipase A2 receptor (PLA2R) is the antigen in about 70% of patients with primary MN. (C)The presence of endothelial tubuloreticular inclusions by electron microscopy would suggest a diagnosis of primary MN. (D)Thrombospondin type 1 domain-containing 7A (THSD7A), another target antigen of primary MN, may be overexpressed by certain malignancies leading to MN.

57. 下列何者正確? (A) The most frequent cause of dysfunctional uterine bleeding is generalized metabolic disturbances.(B)Activation of the PTEN is a common genetic alteration in both endometrial hyperplasia and endometrioid endometrial carcinoma.(C)High-grade endometrial stromal sarcoma usually has a translocation of JAZF1 gene, fused to a second gene, such as SUZ12. (D)Most vulvar cancers are not related to HPV and develop in a background of lichen sclerosus or squamous cell hyperplasia.

58. 根據 staging of cervical carcinoma to the FIGO 2018 staging system, 下列何者正確? (A) The involvement of vascular/lymphatic spaces and presence of isolated tumor cells do change the stage. (B)Stage III excludes lymph node metastases (identified by image or pathology). (C)Assessment of stage IA disease on the basis of depth of stromal invasion only. (D)Subdivision of stage IB into two size categories.

60. 以下關於子宮內膜癌的描述，何者為非？ (A) Low-grade endometrial endometrioid carcinoma shows diffuse strong immunoreactivity for estrogen receptor/progesterone receptor and patchy positive for p16. (B)High-copy number alterations and TP53 mutations endometrial carcinomas are associated with intermediate prognosis. (C)POLE mutations are associated with good prognosis. (D)The morphology of most metastases (~90%) from carcinosarcoma contains the carcinomatous component.

61. 以下關於 microsatellite instability-high (MSI-H) 子宮內膜癌的描述，何者為非？ (A) Mutations in or epigenetic silencing of mismatch repair genes leading to genomic instability and high burden of somatic mutations. (B)Associated with mutations that upregulate signaling through the PI3K/AKT pathway. (C)Prevalent in endometrial carcinomas arising in women with hereditary nonpolyposis colorectal carcinoma syndrome (also referred to as Lynch syndrome).(D)In sporadic endometrioid carcinoma, loss of DNA mismatch repair gene is commonly caused by epigenetic silencing.

62. 下列何者錯誤?(A) The most common molecular alteration of ovarian mucinous carcinomas is ERBB2 (HER2) amplifications. (B)Adult granulosa cell tumors contain somatic FOXL2 mutations in more than 90% of cases. (C)A significant proportion of moderately and poorly differentiated Sertoli-Leydig cell tumors contain DICER1 mutations.(D)Deleterious germline or somatic mutations of SMARCA4 implicated the pathogenesis of small cell carcinoma of the ovary of hypercalcemic type.

63. 以下關於 ovarian high-grade serous carcinoma 的描述，何者為非？(A) Either a defective homologous recombination DNA repair pathway or amplification of CCNE1. (B)Some high-grade serous carcinomas arise from serous tubal intraepithelial carcinoma (STIC). (C) BRCA1 and BRCA2 mutations are common in sporadic high-grade serous carcinoma.(D)The biological behavior depends on the extent and distribution of peritoneal disease and lymph node metastasis.

64. 下列何者錯誤? (A) The most common sites of endometriosis are ovaries, uterine ligaments, rectovaginal septum, cul de sac and pelvic peritoneum. (B)Peritoneal and ovarian endometriosis may be a precursor to endometrioid and clear cell carcinomas.(C)Mutations in KRAS, PIK3CA, PPP2R1A and ARID1A have been identified in the epithelial cells of endometriosis of distant sites. (D)The proposed pathogenesis of endometriosis including regurgitation, benign metastasis, metaplastic and extrauterine stem/progenitor cell theories.

65. 乳癌中的 tubular carcinoma 經常是 ER positive、PR positive、HER2 negative、MIB1 labeling index low (usual ＜10%)，請問 tubular carcinoma 是屬於 intrinsic type 中的哪一型？(A) Luminal A type (B)luminal B type(C)HER2 type(D)Basal type type