卵巢转移性黏液性肿瘤27例临床病理分析

Clinicopathological study of metastatic ovarian mucinous neoplasms

目的 探讨卵巢转移性黏液性肿瘤（metastatic mucinous neoplasms,MMN）的临床病理学特征。方法 对27例卵巢MMN标本行HE、免疫组化SP法染色及临床病理资料分析。结果 27例卵巢MMN肿瘤直径2~28cm,平均12.5cm;发生于双侧者12例,单侧者15例（右侧13例）;来源于阑尾19例、结肠5例、子宫颈2例、胰腺1例;大体呈囊性或囊实性者16例,实性11例;光镜下来源于阑尾及胰腺者可见类似良性的囊腺瘤样区域,实性区域可见毁损性的间质浸润,来源于结肠及子宫颈者可见弥漫性间质浸润及黏液渗出;免疫组化标记CK20多数阳性,CK7少数阳性,MUC-2的阳性率高于MUC-1,CDX-2及villin绝大多数阳性。结论 卵巢MMN的诊断需紧密联系临床,免疫组化标记仅有一定的辅助作用。

Purpose To evaluate the clinicopathological features of ovarian metastatic mucinous neoplasms （MMNs）. Methods 27 cases of ovarian MMN were collected to analyze clinicopathological data. The methods of HE and immunohistoehemical staining were used. Results The diameters of 27 ovarian MMN were between 2 to 28 cm and the average value was 12.5 cm. 12 cases occurred in bilateral and 15 cases were in unilateral ovary （ 13 cases in the fight ovary）. Among 27 cases of ovarian MMN, 19 cases were derived from the appendix, 5 cases were from colon, 2 cases were from cervical and 1 case was from pancreas. Grossly, 16 cases were cysts or cyst and solid areas. 11 cases were solid. Under light microscope, the epithelium of metastatic neoplasms from the appendix and pan- creas mimicked benign cystadenoma, and the destructive stromal invasive pattern could be seen in the solid area. MMN from colon and cervical had diffused interstitial infiltrates and mucus effusion. Immunohistochemically, most of the cases showed CDX-2 and villin positive, the majority were CK20-positive, but CKT-positive rate was low, and the positive rate of MUC-2 was higher than that of MUC-1. Conclusion For the diagnosis of ovarian metastatic mucinous neoplasms, pathological results should be closely combined with clinical features, and immunohistochemistry staining may only play an assistant role.