女性腹膜原发癌临床病理分析

Clinicopathologic Study of Female primary carcinoma of the peritoneum

目的 :分析 1 2例女性腹膜原发癌 (FPCP) (1 0例浆液癌、1例黏液癌、1例子宫内膜样癌 )的临床病理及免疫组化特征 ,以引起临床医师重视。 方法 :复习我院 1 992至 2 0 0 2年间 1 2例FPCP患者临床资料及病理切片 ,收集随访资料 ,记录大体标本所见 ,调出全部蜡块重新切片 ,并行PAS染色及细胞角蛋白 (CK) 7、CK2 0、ER、PR、牛血清清蛋白 1 0 0 (S 1 0 0 )、卵巢癌抗原 (CA) 1 2 5、癌胚抗原 (CEA)、CD1 5免疫组化染色。 结果 :1 2例患者年龄在 32～ 6 7(平均 4 8.75 )岁 ,1 0 / 1 1例患者血CA1 2 5明显增高。组化及免疫组化染色示阳性者 :PAS为 7/ 1 1 ,CK7为 1 0 / 1 1 ,CK2 0为1 0 / 1 1 ,CD1 5为 1 1 / 1 1 ,S 1 0 0为 8/ 1 1 ,CA1 2 5为 6 / 1 1 ,CEA为 6 / 1 1 ,ER为 4 / 1 1 ,PR为 2 / 1 1。黏液性腹膜癌预后极差 ,其余类型与卵巢原发性上皮癌相似。 结论 :女性FPCP被认为起源于中肾旁管 (M櫣ｌｌｅｒ管 ) ,组织学上与同类型的卵巢癌一致 ,在排除卵巢原发癌的基础上可作出诊断 ,免疫组化有助于区分女性FPCP、腹膜间皮瘤和卵巢原发癌。

Objective:To study the clinicopathologic and immunohistochemical features of 12 female patients with primary carcinoma of the peritoneum(FPCP)——ten patients with papillary serous carcinoma of the peritoneum (PSCP), one patient with primary mucinous carcinoma of the peritoneum (PMCP), one patient with primary endometrioid carcinoma of the peritoneum (PECP). Methods:All data were obtained in our hospital from 1992 to 2002. The clinical data and slides, follow up information, and the gross specimens were reviewed. All fixed specimens were sectioned for periodic acid Schiff diastase and immunohistochemical staining with cytokeratin7, cytokeratin20, CEA, estrogen receptor, progesterone receptor, S 100 protein, and CA125, CD15 done. Results:The 12 patients' age ranged 32-67 years (average, 48.75 years). Serum CA125 values were significant by elevated in ten. Immunohistochemical staining showed positive in periodic acid Schiff diastase (7/11), CD15 (11/11), cytokeratin7 (10/11), cytokeratin20 (10/11), S 100 protein (8/11), CEA (6/11), CA125 (6/11), estrogen receptor (4/11), progesterone receptor (2/11). The prognosis of the patient with PMCP was very poor same to primary ovarian carcinoma. Conclusion:Female primary carcinoma of the peritoneum is arise from the second Müllerian system, which is identical to the same type of ovarian carcinoma histologically. The diagnosis is careful differentiation with the ovarian carcinoma. Immunohistochemical staining is helpful as supportive feature for the differential diagnosis among the primary carcinoma of the peritoneum, peritoneal malignant mesothelioma and primary ovarian carcinoma in female.