卵巢子宫内膜样腺癌:组织学起源分析和性激素受体状态检测

Endometrioid adenocarcinoma of the ovary:an analysis of its histologic origin and sex steroid receptor status

目的 :探讨子宫内膜异位症 (异位症 )与卵巢上皮性癌 (卵巢癌 )的关系 ,以及雌、孕激素受体、雌激素调节蛋白pS2在卵巢宫内膜样癌组织中的表达及相关性。方法 :对 6 3例卵巢宫内膜样腺癌组织中合并内膜异位症的情况在光镜下进行回顾性观察分析 ,并用免疫组化对 6 3例病变组织作ER、PR和pS2标记。结果 :6 3例卵巢子宫内膜样癌合并异位症者 8例 ,有 1例可直接观察到良性异位灶由非典型增生逐渐向宫内膜样腺癌过渡的形态。宫内膜腺癌合并有粘液腺癌者 3例 ,浆液腺癌者2例。瘤组织中ER、PR和 pS2阳性表达率分别为 38.1% (2 4 / 6 3)、4 6 .2 % (2 6 / 6 3)和 2 5 .4 % (16 / 6 3)。ER和 pS2蛋白阳性表达呈正相关 (P <0 .0 1)。结论 :卵巢宫内膜样癌主要来自卵巢生发上皮向子宫内膜方向分化 ,少数病例来自于异位症病灶恶变。激素与部分肿瘤的发生、发展有关。对肿瘤组织行ER、PR、pS2检测 ,有助于指导对该肿瘤的激素治疗。

Objective:To analyse the relationship between endometriosis and endometrioid adenocarcinoma of the ovary,and investigate the expression of ER,PR and pS2 proteins in endometrioid adenocarcinoma tissue. Methods: 63 cases of endometrioid adenocarcinoma of the ovary were observed retrospectively under the light microscope,and immunohistochemical staining for ER,PR and pS2 were performd in the tumor tissues. Results: Among the 63 cases,there were 8(12.7%)accompanied with endometriosis ,of which 1 was observed having transitional lesions ranging from the benign endometriosis to malignant endometrioid carcinoma.Of the 63 cases,Admixtures of endometrioid carcinoma with mucinous were present in 3 cases,and with serous carcinoma in 2.Positive expression rates for ER,PR and pS2 protein in endometrioid carcinoma were 38.1%(24/63),46.2%(26/63) and 25.4% (16/63),respectively.There was an apparent correlation between the expressions of ER and pS2 protein ( P <0.01).Conclusion: Endometrioid carcinoma of the ovary originates mainly from the coelomic epithelium of the ovary ,and few cases arise from the malignant transformation of endometriosis.The hormones must have some role in the development and growth of the carcinomas.The detection of ER,PR,and pS2 may be helpful in instructing hormone manipulation therapy to endometrioid carcinoma.