中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2015年
2期
118-122
,共5页
王琳琳%董艳光%李青%李红静%孙希印%周晓秋%李新功
王琳琳%董豔光%李青%李紅靜%孫希印%週曉鞦%李新功
왕림림%동염광%리청%리홍정%손희인%주효추%리신공
卵巢肿瘤%癌,移行细胞%免疫组织化学
卵巢腫瘤%癌,移行細胞%免疫組織化學
란소종류%암,이행세포%면역조직화학
Ovarian neoplasms%Carcinoma,transitional cell%Immunohistochemistry
目的 探讨卵巢移行细胞癌的临床病理特点和分类归属.方法 收集14例卵巢移行细胞癌病例,复习临床资料,观察病理形态学特点,并与12例具有移行细胞癌样成分的浆液性癌、4例具有移行细胞癌样成分的子宫内膜样癌、20例单纯性高级别浆液性癌、15例单纯性子宫内膜样癌及6例Brenner肿瘤(2例恶性、4例良性)进行免疫组织化学检测结果对照观察.结果 14例卵巢移行细胞癌患者年龄36 ～ 63岁,中位年龄56岁.均行手术治疗,术后化疗采用TP方案(紫杉醇+卡铂)或CAP方案(环磷酰胺+表阿霉素+卡铂).9例获得随访,2例死亡,7例存活.病理组织学检查显示移行细胞癌的特点,不伴有Brenner瘤结构.13例WT-1阳性,14例细胞角蛋白7、雌激素受体、孕激素受体、CA125阳性,Uroplakin Ⅲ、CK20阴性,与伴移行细胞癌成分的浆液性癌和单纯性高级别浆液性癌表达相似.部分移行细胞癌病例BRCA1广泛阳性,而伴移行细胞癌成分的浆液性癌和单纯性高级别浆液性癌显示WT-1弥漫阳性或异质性表达,异质性表达的病例中阳性和阴性表达成分呈鲜明对比.14例卵巢移行细胞癌均显示p53弥漫型强阳性表达,而高级别浆液性癌16例(16/20)呈高表达,4例(4/20)无表达,伴移行细胞癌成分的浆液性癌p53阳性比例为11/12.卵巢移行细胞癌WT-1表达阳性比例明显高于Brenner肿瘤、子宫内膜样癌和伴有移行细胞癌成分的子宫内膜样癌(P＜0.01),而与伴有移行细胞癌成分的浆液性癌、单纯性高级别浆液性癌阳性率未见差异.BRCA1在卵巢移行细胞癌及伴有移行细胞癌成分的浆液性癌、子宫内膜样癌有阳性表达,而在Brenner肿瘤和子宫内膜样癌未见表达.Brenner肿瘤Ki-67阳性指数率较低,而卵巢移行细胞癌、伴移行细胞癌成分的浆液性癌和单纯性高级别浆液性癌Ki-67阳性指数较高.Uroplakin Ⅲ只在Brenner肿瘤有表达.结论 卵巢移行细胞癌具有特殊的形态学和免疫组织化学染色特点,不同于Brenner肿瘤,而类似于浆液性癌,应看做高级别浆液性癌的形态学变异型.
目的 探討卵巢移行細胞癌的臨床病理特點和分類歸屬.方法 收集14例卵巢移行細胞癌病例,複習臨床資料,觀察病理形態學特點,併與12例具有移行細胞癌樣成分的漿液性癌、4例具有移行細胞癌樣成分的子宮內膜樣癌、20例單純性高級彆漿液性癌、15例單純性子宮內膜樣癌及6例Brenner腫瘤(2例噁性、4例良性)進行免疫組織化學檢測結果對照觀察.結果 14例卵巢移行細胞癌患者年齡36 ～ 63歲,中位年齡56歲.均行手術治療,術後化療採用TP方案(紫杉醇+卡鉑)或CAP方案(環燐酰胺+錶阿黴素+卡鉑).9例穫得隨訪,2例死亡,7例存活.病理組織學檢查顯示移行細胞癌的特點,不伴有Brenner瘤結構.13例WT-1暘性,14例細胞角蛋白7、雌激素受體、孕激素受體、CA125暘性,Uroplakin Ⅲ、CK20陰性,與伴移行細胞癌成分的漿液性癌和單純性高級彆漿液性癌錶達相似.部分移行細胞癌病例BRCA1廣汎暘性,而伴移行細胞癌成分的漿液性癌和單純性高級彆漿液性癌顯示WT-1瀰漫暘性或異質性錶達,異質性錶達的病例中暘性和陰性錶達成分呈鮮明對比.14例卵巢移行細胞癌均顯示p53瀰漫型彊暘性錶達,而高級彆漿液性癌16例(16/20)呈高錶達,4例(4/20)無錶達,伴移行細胞癌成分的漿液性癌p53暘性比例為11/12.卵巢移行細胞癌WT-1錶達暘性比例明顯高于Brenner腫瘤、子宮內膜樣癌和伴有移行細胞癌成分的子宮內膜樣癌(P＜0.01),而與伴有移行細胞癌成分的漿液性癌、單純性高級彆漿液性癌暘性率未見差異.BRCA1在卵巢移行細胞癌及伴有移行細胞癌成分的漿液性癌、子宮內膜樣癌有暘性錶達,而在Brenner腫瘤和子宮內膜樣癌未見錶達.Brenner腫瘤Ki-67暘性指數率較低,而卵巢移行細胞癌、伴移行細胞癌成分的漿液性癌和單純性高級彆漿液性癌Ki-67暘性指數較高.Uroplakin Ⅲ隻在Brenner腫瘤有錶達.結論 卵巢移行細胞癌具有特殊的形態學和免疫組織化學染色特點,不同于Brenner腫瘤,而類似于漿液性癌,應看做高級彆漿液性癌的形態學變異型.
목적 탐토란소이행세포암적림상병리특점화분류귀속.방법 수집14례란소이행세포암병례,복습림상자료,관찰병리형태학특점,병여12례구유이행세포암양성분적장액성암、4례구유이행세포암양성분적자궁내막양암、20례단순성고급별장액성암、15례단순성자궁내막양암급6례Brenner종류(2례악성、4례량성)진행면역조직화학검측결과대조관찰.결과 14례란소이행세포암환자년령36 ～ 63세,중위년령56세.균행수술치료,술후화료채용TP방안(자삼순+잡박)혹CAP방안(배린선알+표아매소+잡박).9례획득수방,2례사망,7례존활.병리조직학검사현시이행세포암적특점,불반유Brenner류결구.13례WT-1양성,14례세포각단백7、자격소수체、잉격소수체、CA125양성,Uroplakin Ⅲ、CK20음성,여반이행세포암성분적장액성암화단순성고급별장액성암표체상사.부분이행세포암병례BRCA1엄범양성,이반이행세포암성분적장액성암화단순성고급별장액성암현시WT-1미만양성혹이질성표체,이질성표체적병례중양성화음성표체성분정선명대비.14례란소이행세포암균현시p53미만형강양성표체,이고급별장액성암16례(16/20)정고표체,4례(4/20)무표체,반이행세포암성분적장액성암p53양성비례위11/12.란소이행세포암WT-1표체양성비례명현고우Brenner종류、자궁내막양암화반유이행세포암성분적자궁내막양암(P＜0.01),이여반유이행세포암성분적장액성암、단순성고급별장액성암양성솔미견차이.BRCA1재란소이행세포암급반유이행세포암성분적장액성암、자궁내막양암유양성표체,이재Brenner종류화자궁내막양암미견표체.Brenner종류Ki-67양성지수솔교저,이란소이행세포암、반이행세포암성분적장액성암화단순성고급별장액성암Ki-67양성지수교고.Uroplakin Ⅲ지재Brenner종류유표체.결론 란소이행세포암구유특수적형태학화면역조직화학염색특점,불동우Brenner종류,이유사우장액성암,응간주고급별장액성암적형태학변이형.
Objective To assess clinical and pathological features of ovarian transitional cell tumors.Methods Fourteen cases of ovarian transitional cell carcinoma (TCC) were selected and investigated for their clinical and pathological features.Their immunohistochemical profiles were compared with 12 cases of serous adenocarcinoma (SC) admixed with TCC and 4 cases of EC admixed with TCC 20 cases of pure high-grade serous adenocarcinoma (HG-SC),15 cases of endometrioid adenocarcinoma (EC),6 cases of Brenner tumor (BT,2 cases of malignant BT and 4 cases of benign BT).Results The patients' age ranged from 36-63 years (mean,56 years).All cases underwent surgery and postoperative chemotherapy with TP or CAP program.Clinical follow-up was available in 9 cases,of which 2 patients died.Histologically,all cases showed features of transitional cell carcinoma without BT component.Immunohistochemically,13 of 14 TCCs were positive for WT-1 and all were positive for CK7,ER,PR and CA125,but negative for Uroplakin Ⅲ and CK20.Similar immunohistochemical staining patterns were seen in SC admixed with TCC and pure HG-SC.Percentage of the 14 TCC cases were also diffusely positive for BRCA1.All SCs admixed with TCC and pure HG-SCs were diffusely or heterogeneously positive for WT-1,with a sharp contrast and mottled distribution pattern in the heterogeneous cases.All TCCs were diffusely and strongly positive for p53,while 16 of 20 cases of pure HG-SC were positive.The positive ratio of p53 in SCs admixed with TCC cases was 11/12.WT-1 expression in TCCs was significantly higher than BTs,ECs and ECs admixed with TCC (P ＜ 0.01),while no obvious difference was seen when compared with SCs admixed with TCC and pure HG-SCs.SCs admixed with TCC,TCCs and EC were positive for BRCA1 except pure ECs and BTs.The positive rate of Ki-67 of BTs was low,while it was higher in TCCs,SCs admixed with TCC and pure HG-SCs.Only BTs expressed Uroplakin Ⅲ.Conclusions Ovarian TCC has characteristic morphological and immunohistochemical features,similar to SC but different from BT.Therefore,TCC should be considered as a morphological variant of HG-SC.
