目的探讨女性生殖道同期发生的黏液性上皮化生和肿瘤(synchronous mucinous metaplasia and neoplasia of the female genital tract,SMMN-FGT)的临床表现、病理特征、诊治方法及预后。方法回顾性分析2014年10月至2020年4月复旦大学附...目的探讨女性生殖道同期发生的黏液性上皮化生和肿瘤(synchronous mucinous metaplasia and neoplasia of the female genital tract,SMMN-FGT)的临床表现、病理特征、诊治方法及预后。方法回顾性分析2014年10月至2020年4月复旦大学附属妇产科医院诊断的14例SMMN-FGT患者的临床资料和随访记录。结果发病中位年龄为46岁(33~70岁),初发症状主要为阴道排液(8/14)及卵巢囊肿(4/14)。所有行HPV检查的患者(13/14)结果均为阴性。所有患者均接受手术治疗,其中7例行全子宫+双附件切除术,4例行广泛全子宫+双附件切除术+盆腔淋巴结清扫术,3例行全子宫+双侧输卵管切除术,保留卵巢。术后病理提示14例病变累及子宫内膜,13例累及宫颈,9例累及输卵管,9例累及卵巢,7例同时累及宫颈、子宫内膜,输卵管及卵巢。8例患者进展为恶性肿瘤,术后接受辅助治疗。随访14~80个月,1例因复发死亡,13例继续随访中。结论SMMN-FGT是一组同时累及女性生殖道多个部位的黏液性病变,阴道排液多为其首发症状,其宫颈病变与HPV感染无关。治疗以手术为主,合并恶性病变患者须行辅助治疗,预后有待进一步随访。展开更多
AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the pr...AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the presence of mutations in APC and p53, and the microsatellite instability （MSI） status in 48 gastric adenomas and 171 differentiated-type carcinomas, The tumor differentiation phenotype was determined by examining the expression of human gastric mucin （HGM）, NUC6, MUC2 and CD10, The tumors were then classified into gastric- （G-）, gastric and intestinal mixed （GI-）, or intestinal- （I-） phenotypes, according to the immunopositivity of the above markers, The presence of mutations in APC and p53 and the MSI status were also investigated in all the tumors, RESULTS： Gastric adenomas were significantly associated with CDIO expression, I-phenotype tumors and the presence of APC mutations, compared with carcinomas （66.7% vs 25.1%, P 〈 0.0001; 56.3% vs 14.6%, P 〈 0.0001; 39.6% vs 14.0%, P 〈 0.0001, respectively） and inversely associated with expressions of HGM and MUC6 and the presence of p53 mutations （10.4% vs 62.6%, P 〈 0.0001; 39.6% vs 64.3%, P = 0.003; 2.0% vs 26.3%, P = 0.001, respectively）. The frequency of APC mutations was significantly higher in HGM-negative tumors, MUC6-negative tumors, CD10-positive tumors and I-phenotype tumors than in HGM-positive tumors, MUC6- positive tumors, CD10-negative tumors and G-phenotype tumors （32.7% vs 7.1%, P 〈 0.0001; 27.8% vs 14.0%, P = 0.0182; 37.3% vs 10.4%, P 〈 0.0001; and 38.5% vs 9.5%, P = 0.0017, respectively）. The frequency of MSI was significantly higher in MUC6-positive tumors, CD10- negative tumors and G-phenotype tumors than in MUC6- negative tumors, CD10-positive tumors and I-phenotype tumors （24.8% vs 6.7%, P = 0.0009; 22.2% vs 8.0%, P = 0.0143; and 28.6% vs 9.6%, P = 0.0353, respectively）. CONCLUSION： The tumor differentiation phenotype is closely related to tumor invasion and genetic alterations in gastric differentiated-type tumors.展开更多
文摘目的探讨女性生殖道同期发生的黏液性上皮化生和肿瘤(synchronous mucinous metaplasia and neoplasia of the female genital tract,SMMN-FGT)的临床表现、病理特征、诊治方法及预后。方法回顾性分析2014年10月至2020年4月复旦大学附属妇产科医院诊断的14例SMMN-FGT患者的临床资料和随访记录。结果发病中位年龄为46岁(33~70岁),初发症状主要为阴道排液(8/14)及卵巢囊肿(4/14)。所有行HPV检查的患者(13/14)结果均为阴性。所有患者均接受手术治疗,其中7例行全子宫+双附件切除术,4例行广泛全子宫+双附件切除术+盆腔淋巴结清扫术,3例行全子宫+双侧输卵管切除术,保留卵巢。术后病理提示14例病变累及子宫内膜,13例累及宫颈,9例累及输卵管,9例累及卵巢,7例同时累及宫颈、子宫内膜,输卵管及卵巢。8例患者进展为恶性肿瘤,术后接受辅助治疗。随访14~80个月,1例因复发死亡,13例继续随访中。结论SMMN-FGT是一组同时累及女性生殖道多个部位的黏液性病变,阴道排液多为其首发症状,其宫颈病变与HPV感染无关。治疗以手术为主,合并恶性病变患者须行辅助治疗,预后有待进一步随访。
基金Supported by Grant-in-Aid for Scientific Research, Japan Society for the Promotion of Science, No. 17790928
文摘AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the presence of mutations in APC and p53, and the microsatellite instability （MSI） status in 48 gastric adenomas and 171 differentiated-type carcinomas, The tumor differentiation phenotype was determined by examining the expression of human gastric mucin （HGM）, NUC6, MUC2 and CD10, The tumors were then classified into gastric- （G-）, gastric and intestinal mixed （GI-）, or intestinal- （I-） phenotypes, according to the immunopositivity of the above markers, The presence of mutations in APC and p53 and the MSI status were also investigated in all the tumors, RESULTS： Gastric adenomas were significantly associated with CDIO expression, I-phenotype tumors and the presence of APC mutations, compared with carcinomas （66.7% vs 25.1%, P 〈 0.0001; 56.3% vs 14.6%, P 〈 0.0001; 39.6% vs 14.0%, P 〈 0.0001, respectively） and inversely associated with expressions of HGM and MUC6 and the presence of p53 mutations （10.4% vs 62.6%, P 〈 0.0001; 39.6% vs 64.3%, P = 0.003; 2.0% vs 26.3%, P = 0.001, respectively）. The frequency of APC mutations was significantly higher in HGM-negative tumors, MUC6-negative tumors, CD10-positive tumors and I-phenotype tumors than in HGM-positive tumors, MUC6- positive tumors, CD10-negative tumors and G-phenotype tumors （32.7% vs 7.1%, P 〈 0.0001; 27.8% vs 14.0%, P = 0.0182; 37.3% vs 10.4%, P 〈 0.0001; and 38.5% vs 9.5%, P = 0.0017, respectively）. The frequency of MSI was significantly higher in MUC6-positive tumors, CD10- negative tumors and G-phenotype tumors than in MUC6- negative tumors, CD10-positive tumors and I-phenotype tumors （24.8% vs 6.7%, P = 0.0009; 22.2% vs 8.0%, P = 0.0143; and 28.6% vs 9.6%, P = 0.0353, respectively）. CONCLUSION： The tumor differentiation phenotype is closely related to tumor invasion and genetic alterations in gastric differentiated-type tumors.
