卵巢恶性Brenner氏瘤与移行细胞癌临床病理研究

Clinico-pathological Study of Ovarian Malignant Brenner Tumors

卵巢恶性Brenner氏瘤(MBT)和移行细胞癌(TCC)是两类少见的卵巢原发癌.组织形态类似泌尿道的移行上皮,两者以TCC不含典型的Brenner瘤成分来划分,支持这一观点的理由是TCC中找不见Brenner瘤中所常见的间质钙化,TCC较MBT更具浸润性.本文通过对3例MBT与9例TCC临床及病理资料比较,结合文献复习对TCC进一步探讨,认为MBT应视为由良性Brenner瘤发展而来.而TCC应视为体腔上皮直接化生发展而来.将TCC进一步分为纯型,占优势型,灶性型及对TCC成分划分为乳头状型和MBT样型.进一步研究发现,乳头状型较MBT样型临床分期高,但不管是纯型,占优势型,乳头状型还是MBT样型,化疗反应都有效,灶性型预后可能与其中占优势的其他非TCC成分有关.

Ovarian malignant Brenner Tumors (MBT) and transitional cell carcinoma (TCC) are rare primary ovarian carcinomas. Histologic features of these tumors are closely mimic to carcinoma of urothelium. They were grouped under Brenner Tumor in the past. However,the TCC has no benign Brenner Component and is rather aggressive in behavior. In this report the clinical and pathologic features of 3 MBTS along with 9 TCC are reported . It is considered that MBT could arise from a benign Brenner tumor, whereas TCC most likely originate directly from the celomic epithelium. Celomic inclusion cysts can undergo urothelial metaplasia to transitional epithelium. The 9 TCC are divided into pure, predominant and focal types and the TCC components are further divided into papillary type and 'malignant Brenner-like type'. The findings suggest that,TCC is more aggressive and often present with advanced disease.Irrespective of either pure , predominant , papillary or Brenner-like type they all appear to respond well to chemotherapy.