子宫内膜和卵巢双原发癌(synchronous endometrial and ovarian carcinoma,SEOC)的概念在上世纪八十年代被Ulbright等[1]提出,病因及发病机制不明确。SEOC诊断困难,主要是因为病理诊断标准复杂,难以与子宫内膜癌卵巢转移(endometrial ca...子宫内膜和卵巢双原发癌(synchronous endometrial and ovarian carcinoma,SEOC)的概念在上世纪八十年代被Ulbright等[1]提出,病因及发病机制不明确。SEOC诊断困难,主要是因为病理诊断标准复杂,难以与子宫内膜癌卵巢转移(endometrial carcinoma with ovarian metastasis,ECO)鉴别。虽然SEOC中子宫内膜及卵巢原发肿瘤多为早期,且大多患者预后好,但治疗缺乏统一标准,突出的问题是将SEOC按照ECO进行术后辅助治疗,存在治疗过度。本文将对SEOC的流行病学、病因、诊断、治疗及预后进行文献综述。展开更多
OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis （AEM）, and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs. The...OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis （AEM）, and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs. The changes in the glandular epithelium, stroma, and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4% （163/3,724） of the endometriosis （EM） cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa. Of the cases of ovarian EM, 6.8% were AEM. All of the 27 cases （15.7%） of the AEMs associated with a tumor were found in the ovaries, of which 15 were malignant, 9 borderline, and 3 benign. Of the ovary AEMs, 14.9% were associated with a borderline or malignant tumor. The AEM epithelia were mainly arranged in the form of surface epithelia, with only a few glands. Present were characteristic features of moderate to marked pleomorphism, epithelial tufting, bud or firework-like structures on microscopy. Epithelial metaplastic changes were observed in 86 cases （50%） of the 172 AEM foci. Epithelium, endometrioid stroma, and fibrotic-collagen formed a three-layer structure in the wall of the AEM cysts. The endometrioid stroma were usually thin compared to the fibro-collagen tissue. The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM. AEMs have a relative higher potential for tumorigenesis and canceration, especially for ovarian cancer. The process of damage, repair, and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.展开更多
文摘子宫内膜和卵巢双原发癌(synchronous endometrial and ovarian carcinoma,SEOC)的概念在上世纪八十年代被Ulbright等[1]提出,病因及发病机制不明确。SEOC诊断困难,主要是因为病理诊断标准复杂,难以与子宫内膜癌卵巢转移(endometrial carcinoma with ovarian metastasis,ECO)鉴别。虽然SEOC中子宫内膜及卵巢原发肿瘤多为早期,且大多患者预后好,但治疗缺乏统一标准,突出的问题是将SEOC按照ECO进行术后辅助治疗,存在治疗过度。本文将对SEOC的流行病学、病因、诊断、治疗及预后进行文献综述。
文摘OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis （AEM）, and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs. The changes in the glandular epithelium, stroma, and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4% （163/3,724） of the endometriosis （EM） cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa. Of the cases of ovarian EM, 6.8% were AEM. All of the 27 cases （15.7%） of the AEMs associated with a tumor were found in the ovaries, of which 15 were malignant, 9 borderline, and 3 benign. Of the ovary AEMs, 14.9% were associated with a borderline or malignant tumor. The AEM epithelia were mainly arranged in the form of surface epithelia, with only a few glands. Present were characteristic features of moderate to marked pleomorphism, epithelial tufting, bud or firework-like structures on microscopy. Epithelial metaplastic changes were observed in 86 cases （50%） of the 172 AEM foci. Epithelium, endometrioid stroma, and fibrotic-collagen formed a three-layer structure in the wall of the AEM cysts. The endometrioid stroma were usually thin compared to the fibro-collagen tissue. The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM. AEMs have a relative higher potential for tumorigenesis and canceration, especially for ovarian cancer. The process of damage, repair, and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.
