女性盆腔浆液性癌20例临床病理分析

Pelvic serous carcinoma of female: a clinicopathogical analysis of 20 cases

目的 探讨女性盆腔浆液性癌（pelvic serous carcinoma,PSC）的临床病理学特征、免疫表型、发病机制及鉴别诊断。方法 回顾性分析20例PSC的临床病理资料、组织学形态及免疫表型,并复习相关文献。结果 20例PSC,年龄23～87岁,平均58.9岁。PSC可发生于输卵管、卵巢和腹膜,常因腹胀、腹痛或盆腔占位就诊,发现时常广泛累及盆腔多个脏器,不易明确原发部位。输卵管浆液性癌原发灶小,易种植,卵巢和腹膜浆液性癌常伴有浆液性输卵管上皮内癌（serous tubal intraepithelial carcinoma,STIC）。结论 输卵管黏膜上皮细胞可能是PSC的主要来源。诊断PSC时需仔细检查输卵管以明确其原发部位,病变广泛累及腹膜时需与腹膜间皮瘤和盆腔外腺癌腹膜转移相鉴别。

Purpose To study the clinicopathological and immunohistochemical features, carcinogenesis and differential diagnosis of female pelvic serous carcinoma. Methods The clinical data, macroscopic and microscopic features and immunostaining results of 20 patients with pelvie serous carcinoma were studied, and some associated literatures were reviewed. Results 20 cases of PSC aged from 23 to 87, with the mean age being 58.9. PSC may occur in fallopian tube, ovary and peritoneum, while they were referred to hospital because of abdominal distention, abdominal pain or pelvic mass. The tumor often invasive pelvic organs diffusely when they were diag- nosed, so, the primary site were difficultly determined. Usually, the primary focus of serous carcinoma of fallopian tube is small and easily planted in pelvic. The patients with ovarian serous carcinoma or peritoneal serous carcinoma had serous tubal intraepithelial car- cinoma at the mean time. Conclusions The tubal epithelial cells may be the major source of PSC. About the specimen of PSC, we need check the fallopian tube carefully to determine the primary site, and make differential diagnosis with peritoneal malignant mesothe- lioma and metastatic carcinoma from other sites than pelvic when it diffusely invasive peritoneum.