卵巢癌胃转移1例及文献复习

目的探讨卵巢癌胃转移病例的临床表现、病理特征及治疗。方法2016年9月沧州市中西医结合医院发现1例卵巢癌胃转移,分析其病史、影像及病理学特征。结果病史、影像及CA125能为诊断卵巢癌胃转移提供线索,确诊则需要病理及免疫组化,治疗可以参照卵巢癌相关指南。结论对罕见肿瘤一定要结合临床特征、肿瘤标志物、明确相应病灶病理,才能不漏诊,提高诊疗精准性。

凋亡抑制蛋白Survivin在胃源性卵巢转移癌中的表达和意义

目的:探讨Survivin在胃源性卵巢转移癌中的表达与其发生、发展的关系及临床意义。方法:采用免疫组化SP法和流式细胞学技术检测Survivin蛋白在胃源性卵巢转移癌、相应胃癌原发灶、卵巢良性上皮肿瘤和正常卵巢组织中的表达情况。结果:卵巢上皮癌中Survivin胞核、胞浆阳性表达率分别为100.0%、90.3%;胃癌原发病灶中Survivin胞核、胞浆阳性表达率分别为100.0%、50.0%;两种组织中Survivin蛋白表达FI值分别为(1.10±0.09)和(1.10±0.09),较良性肿瘤和正常卵巢组织均显著升高(P<0.05)。卵巢转移癌组织中Survivin胞浆表达率与相应胃癌原发病灶相比明显升高(P<0.05)。在胃源性卵巢转移癌中,肿瘤直径≥5cm组Survivin胞浆阳性表达率(100.0%)明显高于肿瘤直径<5cm组〔66.7%,FI=(1.04±0.05)〕(P<0.05);而Survivin胞浆表达率与卵巢转移癌患者的年龄、组织学分级及有无腹水无关(P>0.05)。结论:Survivin表达增强,特别是胞浆中Survivin表达增强可能是促进胃癌卵巢转移形成的重要因素之一,检测胞浆中Survivin表达可能是监测胃癌卵巢转移的重要生物学指标。

Gastric signet-ring adenocarcinoma presenting with breast metastasis

Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen （ER） and progesterone receptors （PR） and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a highgrade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases （Krukenberg＇s tumor）. A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.