论文部分内容阅读
目的探讨卵巢低级别浆液性腺癌的诊断及鉴别诊断要点,以提高该类肿瘤的病理诊断水平。方法收集并分析26例卵巢低级别浆液性腺癌的临床及病理资料,采用HE染色及免疫组织化学方法,分析其组织形态学及免疫组织化学特点,总结其诊断及鉴别诊断要点。结果 26例患者平均年龄41.7岁,分别因盆腔包块、阴道流血、腹胀等就诊,22例患者术前肿瘤标记物检查有不同程度的升高。巨检显示肿瘤为囊性或囊实性,囊内为细脆乳头状结构。镜检见肿瘤主要由微乳头结构及筛孔状结构组成,肿瘤间质内可见不规则的实性细胞巢或腺样结构的浸润灶。免疫表型显示26例肿瘤细胞WT-1弥漫核阳性,P16胞核及胞浆灶性阳性,4例肿瘤细胞P53局灶核阳性,22例肿瘤细胞Ki67增殖指数≥10%。随访患者23例,随访时间3~156月,随访期间无患者死亡。结论卵巢低级别浆液性腺癌具有独特的临床特征、组织形态学特点及分子生物学特点,在临床工作中主要与交界性浆液性肿瘤、高级别浆液性腺癌等相鉴别。该类肿瘤总体预后较好,但仍有转化为高级别浆液性腺癌的风险。
Objective To explore the diagnosis and differential diagnosis of low grade serous ovarian cancer in order to improve the pathological diagnosis of this kind of tumor. Methods The clinical and pathological data of 26 cases of low grade serous adenocarcinoma of the ovary were collected and analyzed. The histological and immunohistochemical characteristics of 26 cases of ovarian low grade serous adenocarcinoma were analyzed by HE staining and immunohistochemistry. The diagnostic and differential diagnosis points were summarized. Results The average age of 26 patients was 41.7 years old. The pelvic mass, vaginal bleeding and bloating were observed respectively. Twenty-two patients had different degrees of preoperative tumor markers. Macroscopic examination showed cystic or cystic solid tumors, cysts for the fine crisp papillary structure. Microscopic examination of the tumor mainly by the structure of the micro-nipple and sieve-like structure, the tumor stroma can be seen irregular solid cell nests or adenoid-like infiltration stove. The immunophenotype showed that 26 cases of tumor cells were positive for diffuse nuclei of WT-1, positive in P16 nucleus and cytoplasm, 4 were positive in P53 foci, and 22 were Ki ≥ 10% in 22 cases. Twenty-three patients were followed up for 3 ~ 156 months. No patients died during follow-up. Conclusion Low grade serous adenocarcinoma of the ovary has unique clinical features, histomorphological features and molecular biological characteristics. It is mainly differentiated from borderline serous tumors and high grade serous adenocarcinoma in clinical work. The overall prognosis of these tumors is good, but there is still a risk of conversion to high-grade serous adenocarcinoma.