中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2014年
3期
163-168
,共6页
张和平%孙宇%黄小征%贾玲%白艳花%曹登峰
張和平%孫宇%黃小徵%賈玲%白豔花%曹登峰
장화평%손우%황소정%가령%백염화%조등봉
假粘液瘤,腹膜%腺癌,粘液%预后%形态发生%免疫组织化学
假粘液瘤,腹膜%腺癌,粘液%預後%形態髮生%免疫組織化學
가점액류,복막%선암,점액%예후%형태발생%면역조직화학
Pseudomyxoma peritonei%Adenocarcinoma,mucinous%Prognosis%Morphogenesis%Immunohistochemistry
目的 分析腹膜黏液性肿瘤的临床病理特征及其与预后的关系,并对其起源进行探讨.方法 按照WHO 2010消化系统肿瘤分类标准对34例曾诊断为“腹膜假黏液瘤”的病例重新分类,分为低级别和高级别两类,分析低级别和高级别黏液性肿瘤的临床病理特征及其与预后的关系.采用免疫组织化学EnVision法检测特异性AT序列结合蛋白2(special AT-rich sequence-binding protein 2,SATB2)在腹膜黏液性肿瘤中的表达,并对未明确原发病灶的病例进行CK7、CK20及CDX-2染色对其起源加以探讨.结果 34例腹膜黏液性肿瘤中,低级别黏液性肿瘤25例(其中2例为无细胞型),高级别黏液性肿瘤9例,两者与患者年龄、性别、是否复发及累及周围器官均无相关性(P＞0.05).对30例患者的随访发现,低级别和高级别黏液性肿瘤的总体生存比例分别为13/21(61.9％)和3/9,中位生存时间分别为74和24个月,两者统计学具有相关性,高级别黏液性肿瘤的生存率显著低于低级别黏液性肿瘤(P =0.002).对除去2例为无细胞型病例共32例行免疫组织化学染色,CDX-2、CK20及CK7总的表达比例分别为93.8％ (30/32)、96.9％ (31/32)和3/16;在已明确来源的16例中,表达CDX-2、CK20、CK7的分别为15、16和1例;在未明确原发病灶的16例中,表达CDX-2、CK20、CK7的分别为15、15和2例;表达CDX-2、CK20、CK7的在已明确来源的和未明确来源的肿瘤之间差异无统计学意义(P＞0.05).SATB2在肿瘤中总的表达率为56.3％ (18/32),在低级别和高级别黏液性肿瘤的表达比例分别为15/23 (65.2％)和3/9,二者差异无统计学意义(P=0.102);SATB2的阳性表达与预后也无明显相关性(P =0.786).结论 腹膜黏液性肿瘤其WHO最新分级与预后相关,其中高级别肿瘤患者生存率显著低于低级别肿瘤患者;大部分腹膜黏液性肿瘤起源于阑尾.
目的 分析腹膜黏液性腫瘤的臨床病理特徵及其與預後的關繫,併對其起源進行探討.方法 按照WHO 2010消化繫統腫瘤分類標準對34例曾診斷為“腹膜假黏液瘤”的病例重新分類,分為低級彆和高級彆兩類,分析低級彆和高級彆黏液性腫瘤的臨床病理特徵及其與預後的關繫.採用免疫組織化學EnVision法檢測特異性AT序列結閤蛋白2(special AT-rich sequence-binding protein 2,SATB2)在腹膜黏液性腫瘤中的錶達,併對未明確原髮病竈的病例進行CK7、CK20及CDX-2染色對其起源加以探討.結果 34例腹膜黏液性腫瘤中,低級彆黏液性腫瘤25例(其中2例為無細胞型),高級彆黏液性腫瘤9例,兩者與患者年齡、性彆、是否複髮及纍及週圍器官均無相關性(P＞0.05).對30例患者的隨訪髮現,低級彆和高級彆黏液性腫瘤的總體生存比例分彆為13/21(61.9％)和3/9,中位生存時間分彆為74和24箇月,兩者統計學具有相關性,高級彆黏液性腫瘤的生存率顯著低于低級彆黏液性腫瘤(P =0.002).對除去2例為無細胞型病例共32例行免疫組織化學染色,CDX-2、CK20及CK7總的錶達比例分彆為93.8％ (30/32)、96.9％ (31/32)和3/16;在已明確來源的16例中,錶達CDX-2、CK20、CK7的分彆為15、16和1例;在未明確原髮病竈的16例中,錶達CDX-2、CK20、CK7的分彆為15、15和2例;錶達CDX-2、CK20、CK7的在已明確來源的和未明確來源的腫瘤之間差異無統計學意義(P＞0.05).SATB2在腫瘤中總的錶達率為56.3％ (18/32),在低級彆和高級彆黏液性腫瘤的錶達比例分彆為15/23 (65.2％)和3/9,二者差異無統計學意義(P=0.102);SATB2的暘性錶達與預後也無明顯相關性(P =0.786).結論 腹膜黏液性腫瘤其WHO最新分級與預後相關,其中高級彆腫瘤患者生存率顯著低于低級彆腫瘤患者;大部分腹膜黏液性腫瘤起源于闌尾.
목적 분석복막점액성종류적림상병리특정급기여예후적관계,병대기기원진행탐토.방법 안조WHO 2010소화계통종류분류표준대34례증진단위“복막가점액류”적병례중신분류,분위저급별화고급별량류,분석저급별화고급별점액성종류적림상병리특정급기여예후적관계.채용면역조직화학EnVision법검측특이성AT서렬결합단백2(special AT-rich sequence-binding protein 2,SATB2)재복막점액성종류중적표체,병대미명학원발병조적병례진행CK7、CK20급CDX-2염색대기기원가이탐토.결과 34례복막점액성종류중,저급별점액성종류25례(기중2례위무세포형),고급별점액성종류9례,량자여환자년령、성별、시부복발급루급주위기관균무상관성(P＞0.05).대30례환자적수방발현,저급별화고급별점액성종류적총체생존비례분별위13/21(61.9％)화3/9,중위생존시간분별위74화24개월,량자통계학구유상관성,고급별점액성종류적생존솔현저저우저급별점액성종류(P =0.002).대제거2례위무세포형병례공32례행면역조직화학염색,CDX-2、CK20급CK7총적표체비례분별위93.8％ (30/32)、96.9％ (31/32)화3/16;재이명학래원적16례중,표체CDX-2、CK20、CK7적분별위15、16화1례;재미명학원발병조적16례중,표체CDX-2、CK20、CK7적분별위15、15화2례;표체CDX-2、CK20、CK7적재이명학래원적화미명학래원적종류지간차이무통계학의의(P＞0.05).SATB2재종류중총적표체솔위56.3％ (18/32),재저급별화고급별점액성종류적표체비례분별위15/23 (65.2％)화3/9,이자차이무통계학의의(P=0.102);SATB2적양성표체여예후야무명현상관성(P =0.786).결론 복막점액성종류기WHO최신분급여예후상관,기중고급별종류환자생존솔현저저우저급별종류환자;대부분복막점액성종류기원우란미.
Objective To investigate the clinicopathologic characteristics,prognosis and histologic origin of the mucinous tumor of the peritoneum.Methods According to 2010 WHO classification of tumours of the digestive system,34 cases diagnosed as "pseudomyxoma peritonei (PMP)" were reevaluated and divided into low grade and high grade.Immunohistochemistry was applied to investigate the expression of SATB2 and the histologic origin of the mucinous tumor of the peritoneum,using antibodies against SATB2,CK7,CK20 and CDX-2.The relationship between clinicopathologic characteristics and prognosis of the low grade and high grade tumors were analyzed.Results Twenty five patients had low grade mucinous tumors (two of them were no cell type),nine patients had high grade mucinous tumors.There was no significant difference between low grade and high grade mucinous tumors in age,sex,recurrence and organs involvement (P ＞ 0.05).Thirty patients were followed up,the overall survival rates of patients with low grade and high grade mucinous tumors were 13/21 (61.9％) and 3/9,respectively.The median survival time was 74 and 24 months in low and high grade patients,and the difference was statistically significant (P =0.002).Immunohistochemistry showed the expression rates of CDX-2,CK20,and CK7 in totally 32 cases (excluding 2 cases of no cell type) were 30/32 (93.8％),31/32 (96.9％),and 3/16,respectively; the expression rates of CDX-2,CK20,and CK7 in 16 cases with distinct primary site were 15,16,and 1,respectively; fifteen of 16 cases of tumors of unknown primary site were positive for CDX-2 and CK20,two of the them were positive for CK7.There was no difference in the expression of CDX-2,CK20 and CK7 between tumors with distinct primary site and tumors with unknown primary site (P ＞0.05).The expression rate of SATB2 in the cases was 56.3％ (18/32),excluding 2 cases of no cell type.There was no significant difference between low grade and high grade tumors in the expression of SATB2 [15/23 (65.2％) vs 3/9,P =0.102],also SATB2 was not related to the prognosis of the tumor (P =0.786).Conclusion The prognosis of the mucinous tumor of the peritoneum was significantly different between low grade and high grade according to WHO 2010 classification,and most mucinous tumor of the peritoneum originated from the appendix.
