原发性卵巢透明细胞癌临床病理分析及Napsin A对其诊断价值研究

Clinical pathological analysis and diangosis value of Napsin A in primary ovarian clear cell carcinoma

目的探讨原发性卵巢透明细胞癌(OCCC)的临床病理特点及Napsin A对OCCC的诊断价值。方法对2000年1月至2017年9月首都医科大学附属北京安贞医院收治的21例原发性OCCC进行光镜观察及应用免疫组织化学方法检测Napsin A的表达情况,并与15例卵巢高级别浆液性癌、18例卵巢子宫内膜样腺癌比较。结果 OCCC光镜下可见3种肿瘤细胞:透明细胞、鞋钉样细胞和嗜酸性细胞,3种细胞可以单独存在,也可以两种或3种混合存在,形成乳头状、囊管状及实性片状。Napsin A在OCCC和卵巢子宫内膜样腺癌中的阳性率分别为95.2%(20/21)、5.6%(1/18),在卵巢高级别浆液性癌中不表达(0/15)。Napsin A在OCCC中的阳性率明显高于卵巢高级别浆液性癌和卵巢子宫内膜样腺癌,差异有统计学意义(P<0.01)。结论 OCCC有特异的镜下特点,且Napsin A是OCCC比较特异的标志物,有助于OCCC的诊断和鉴别诊断。

Objective To analyze the clinicopathological features of ovarian clear cell carcinomas and to study the diag- nostic value of Napsin A for it.Methods A total of 21 cases of ovarian clear cell carcinomas received microscopic ob- servation, and immunohistochemical method was used to detect the expression of Napsin A in the 21 cases of ovarian clear cell carcinoma, and compared with 15 cases of high-grade serous carcinomas and 18 cases of endometrioid adeno- carcinomas.Results Three common tumor cells （clear cells, hobnail cells and eosinophilic cells）were found under mi- crosope.The 3 cells existed separately or mixed in 2 or 3 cells.The tumor cells took on cystic, cord or papillary shapes and being sheet-like.The positive rate of Napsin A in the ovarian clear carcinoma was 95.2% （20/21）, higher than those in high-grade serous carcinomas （0/15）and endometrioid adenocarcinomas5.6% （1/18）.The difference was statistically significant （P〈0.01）.Conclusion The diagnosis of ovarian clear cell carcinomas mainly depends on the observation of the microscope and Napsin A is a more specific marker for the diagnosis of ovarian clear cell carcinoma, which may be helpful for the diagnosis and differential diagnosis.