卵巢外腹膜浆液性乳头状癌5例临床及病理学分析

Extraovarian peritoneal serous papillary carcinoma: A clinicopathological studies of 5 cases .

目的探讨卵巢外腹膜浆液性乳头状癌(EPSPC)的临床及病理学特点. 方法对1990年1月～2004年12月经我院治疗的5例卵巢外腹膜浆液性乳头状癌的临床资料进行回顾性分析,运用组织病理学、免疫组化染色进行观察.结果患者平均发病年龄60.4岁,1例双侧卵巢及输卵管基本正常,4例卵巢间质无肿瘤恶性浸润或仅累及卵巢表面上皮.5例均有腹膜的广泛病变.肿瘤组织病理形态与卵巢浆液性乳头状腺癌相似.组化及免疫组化染色PAS、CA125、CEA均阳性.结论卵巢外腹膜浆液性乳头状癌是来源于第二苗勒系统的恶性肿瘤,组织病理形态与卵巢浆液性乳头状腺癌相似,诊断卵巢外腹膜浆液性乳头状癌时必须双侧卵巢、输卵管无同类型肿瘤.组化及免疫组化检测有助于与腹膜恶性间皮瘤的鉴别.预后较卵巢浆液性乳头状腺癌差.对患者行肿瘤细胞减灭术及PAC化疗方案可改善预后.

Objective To study the clinicopathological features of extraovarian peritoneal serous papillary carcinoma（EPSPC）. Methods The clinical pictures and pathological characteristics of 5 cases EPSPC collected in our hospital from 1990 to 2004 were studied retrospectively. Histochemical staining and immunohistochemical staining were used. Results The ages of the 5 patients were between 48 - 67 （ mean 60.4 ） years old. The bilateral ovaries and fallopian tubes were almost normal. Tumors were examined histomorphologically by microscope, periodic acid - Schiff（PAS） stain was used in the histochemical study and carcinoembryonic antigen （CEA） , CA125 monoclonal antibody assays were detected immunohistochemically. No difference between EPSPC and ovarian serous papillary carcinoma was found. Conclusion EPSPC is considered arising from the secondary Müllerian system. Histologically, EPSPC is identical to that of the similar epithelial carcinomas arising from the ovaries. The diagnosis is made only when the ovaries were not involved and without any evidence of similar epithelial carcinoma obtained in the ovaries. Histochemical staining and immunohistochemical staining are helpful as accessory criteria for the differential diagnosis between primary carcinoma of the peritoneum and malignant mesothelioma. The prognosis is pooro The prognosis may be improved by cytoreductive surgery and adjuvant chemotherapy.