卵巢外腹膜原发性浆液性腺癌临床及病理分析

Clinicopathological studies of extraovarian peritoneal serous papillary carcinoma

目的 :分析卵巢外腹膜原发性浆液性乳头状腺癌的临床及病理学特点。 方法 :回顾性分析 6例卵巢外腹膜原发性浆液性乳头状腺癌临床特征 ,并运用组织病理学、免疫组化及电镜技术观察卵巢外腹膜原发性浆液性腺癌。 结果 :患者平均发病年龄 43.7岁 ,双侧卵巢及输卵管基本正常。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、CA 12 5、CEA、p5 3、AE1、AE3均阳性。 结论 :女性腹膜原发性浆液性乳头状腺癌是来源于第二米勒系统的恶性肿瘤 ,组织病理形态与卵巢浆液性乳头状腺癌相似 ,诊断其为原发性腹膜浆液性腺癌时必须双侧卵巢、输卵管无同类型肿瘤。组化及免疫组化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。

Objectives:To study the clinicopathological features of extraovarian peritoneal serous papillary carcinoma. Methods: The clinical pictures and pathological characteristics of 6 cases extraovarian peritoneal serous papillary carcinoma admitted to our hospital from 1992 to 1999 were studies retrospectively. H & E staining, histochemical staining and immunohistochemical staining were used. Results: The ages of the 6 patients were between 32~62(43.7) years old. The bilateral ovaries and fallopian tubes were almost normal. Tumors were examined histomorphologically by microscope and electron microscope, periodic acid Schiff (PAS) stain was used in the histochemical study and carcinoembryonic antigen (CEA), CA125, p53, AE1 and AE3 monoclonal antibody assays were detected immunohistochemically. The results revealed no difference between extraovarian peritoneal serous papillary carcinoma and ovarian serous papillary carcinoma. Conclusions:Extraovarian peritoneal serous papillary carcinoma is considered arising from the secondary Müllerian system. Histologically, extraovarian peritoneal serous papillary carcinoma was identical to that of the similar epithelial carcinomas arising from the ovaries. The diagnosis was 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 poor.