美国著名的 Memorial Sloan-Kettering癌症中心病理科2009年度的Fred Waldorf Stewart 奖授予Johns Hopkins Hospital妇科病理权威Dr Robert J. Kurman,以表彰他在人类肿瘤疾病认识过程中做出的巨大贡献。

Robert J. Kurman, MD is recipient of the 2009 Fred Waldorf Stewart Award, bestowed annually by the
Department of Pathology at Memorial Sloan-Kettering Cancer Center on an individual who has contributed in
extraordinary fashion to our understanding of human neoplastic disease.
      A New Yorker, Dr Kurman was an undergraduate at Queens College and received his MD from Upstate
Medical Center. His pathology residency training took place in Boston at the Brigham, the Boston Hospital for
Women and the Massachusetts General Hospital. He subsequently trained in Obstetrics and Gynecology at the Boston Hospital for Women and at the Los Angeles County Hospital, affiliated with the University of Southern California. Working first as a staff pathologist at the Armed Forces Institute of Pathology, University of Southern California and then at Georgetown University, Dr Kurman was promoted to Professor of both Pathology and Obstetrics and Gynecology at Georgetown in the mid-80s. Dr Kurman then took a position at Johns Hopkins Hospital as Director of Gynecologic Pathology and Professor of Gynecology-Obstetrics and Pathology. He was appointed the Richard W. TeLinde Distinguished Professor of Gynecologic Pathology in 1998 and a Professor of Oncology at Hopkins in 2003.

Dr Kurman’s contributions to our understanding of gynecologic cancers are considerable. After an initial interest in uterine mesenchymal tumors, ovarian germ cell tumors, and sex cord stromal tumors, Dr Kurman went on to study those subjects for which he is best known today. Kurman and colleagues are responsible for current diagnostic practices that distinguish complex atypical hyperplasia of the endometrium from adenocarcinoma. He and his colleagues described the placental site trophoblastic tumor and epithelioid trophoblastic tumor, both composed of ‘‘intermediate trophoblast’’, and elucidated the cellular constituents of choriocarcinoma as well. His appreciation for the role of human papillomavirus in cervical carcinogenesis led to numerous publications. In this field of study, he is probably best known for his leadership in publication of the seminal ‘‘The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses.’’He and his trainees offered insight into the role of p53 gene mutations in the genesis of uterine serous carcinoma and proposed ‘‘endometrial intraepithelial carcinoma’’as the precursor to invasive serous carcinoma.

Ovarian epithelial tumors have recently provided fertile ground for study. Along with Dr Brigitte Ronnett,a Memorial Hospital alumna, Dr Kurman supplied irrefutable evidence against the ovary as the primary source for most pseudomyxoma peritonei cases. They also focused attention on distinguishing primary and secondary mucinous ovarian tumors and relevant immunohistochemical algorithms used for this purpose, and offered objective criteria to separate benign and malignant primary ovarian mucinous tumors.

Dr Kurman’s group popularized the idea that noninvasive,proliferative serous tumors with micropapillary and cribriform architecture represent the link that joins mostly benign tumors at one end of the spectrum, serous borderline tumors, and invasive, low-grade serous carcinomas at the other. His group reported correlative comparative genomic hybridization data that documented increasing chromosomal imbalances that parallel morphology in these tumor types. They also described a tight,though not invariable, association between micropapillary architecture and the presence of invasive implants that resemble those deriving from invasive, low-grade serous carcinomas and likely have the same clinical significance.These concepts were met with healthy skepticism,but accumulating data have convinced many pathologists of their validity. His most recent proposal of a model of ovarian carcinogenesis builds on these earlier studies.This model posits a group of relatively indolent ovarian carcinomas that occur in association with long-standing precursor lesions (borderline/low malignant potential/atypical proliferative tumors) and a second subset that arises rapidly and disseminates early (high-grade serous carcinomas).
       Gynecologists and pathology trainees the world over know Dr Kurman as the editor of the esteemed
Blaustein’s Pathology of the Female Genital Tract and practicing pathologists have long appreciated his collaboration with Mazur on the Diagnosis of Endometrial Biopsies and Curettings. A Practical Approach. Other
notable contributions include coauthorship of 2 Armed Forces Institute of Pathology fascicles in the Third Series(Tumors of the Uterine Corpus and Gestational Trophoblastic Disease and Tumors of the Cervix, Vagina, and Vulva). Dr Kurman serves on the editorial boards of numerous journals and provides leadership for many national and international societies and committees. Of note is his recent tenure as the president of the International Society of Gynecological Pathologists and his membership on the American Joint Committee on Cancer’s Gynecologic Task Force and the International Federation of Gynecology and Obstetrics Committee. An inspiring mentor, Dr Kurman’s trainees constitute a who’s who in the field of gynecologic pathology.

Dr Kurman has devoted decades of professional life to the pathologic analysis of neoplasms arising in the female genital tract. A colleague has commented that,‘‘like a fine wine, Dr Kurman has only improved with age,even though he himself resists signs of aging.’’ His efforts have shaped the field, have greatly extended our understanding of these tumors as morphologic and biologic entities, and, without question, have improved the care of affected women. He stands firmly in the tradition of Dr Stewart. We congratulate Dr Kurman on this much deserved honor.