摘要
目的探讨卵巢原发性类癌的临床病理特征、诊断要点及预后。方法收集北京协和医院2002至2017年诊断为卵巢原发性类癌的17例患者临床资料，进行组织形态学观察、免疫组织化学染色及随访，结合相关文献分析其临床病理特征及预后。结果患者年龄24～64岁（平均42岁）。3例表现为下腹部疼痛，14例无明显症状，体检时发现附件包块。10例肿瘤位于左侧卵巢，7例位于右侧卵巢。肿瘤最大径2～14cm，其中7例为囊实性、6例为囊性、4例为实性。镜下观察，6例为甲状腺肿性类癌，4例为岛状型类癌，4例为梁状型类癌，2例为岛状及梁状？昆合型类癌，1例为黏液性类癌。17例均未见坏死，核分裂象均≤1／10HPF。11例伴卵巢其他肿瘤成分，其中10例伴卵巢畸胎瘤，1例伴卵巢黏液性囊腺瘤。免疫表型上，17例神经元特异性烯醇化酶和突触素均阳性，10例嗜铬素粒A阳性，Ki-67阳性指数均≤2％。此外，甲状腺转录因子1在甲状腺肿性类癌的甲状腺肿区域均阳性，类癌区域均阴性。16例随访13～188个月，均未发现复发，1例失访。结论卵巢原发性类癌极少见．临床症状不明显，多在体检时发现。一般发生在单侧卵巢，常与畸胎瘤混合存在，偶尔可合并黏液性囊腺瘤等，该类肿瘤预后良好。
Objective To study the clinicopathologic feature, diagnostic strategy and prognostic significance of primary carcinoid of the ovary （ PCOTO ）. Methods A series of 17 patients previously diagnosed as PCOTO at Department of Pathology, Peking Union Medical College Hospital during the period from 2002 to 2017 were evaluated with clinical data analysis, histopathology and immunohistochemistry, and the patients were followed up and the relevant literatures were reviewed.Results The age of patients ranged from 24 to 64 years （mean, 42 years）. Fourteen patients were found a pelvic mass for a health check-up, and only 3 patients presented with pain in the lower abdomen. The left ovary was involved initially in ten patients, and the right in seven. The major axis of the tumor ranged from 2 to 14 cm. The surface of these tumors was smooth. Seven of the tumors were solid-cystic, 6 were cystic and 4 were solid. Under light microscope, 6 cases were diagnosed as strumal carcinoid, 4 cases were insular carcinoid, 4 cases were trabecular carcinoid, 3 cases were insular and trabecular mixed type carcinoid and 1 case was mucinous careinoid. The mitotic figures were no more than 1/10 HPF. There were 11 cases complicated with other ovarian tumors, including 10 cases with teratoma, and 1 case with mucinous cystic adenoma. The paraffin- embedded tissues of all cases showed immunoreactivity for NSE and Syn, and the positive propotion of CgA was 10/17. TrF1 was positive in thyroid follicles and negative in strumal carcinoid. The positive index of Ki-67 was no more than 2%. Follow-up of 13 to 188 months showed 16 patients without recurrence and 1 patients were loss to follow-up. Conclusions PCOTO is very rare. Most of the patients are found with a mass during health check-up in unilateral ovary and without obvious clinical symptoms. Histologically, the tumor always exists with other ovarian tumors, including teratoma and mucinous cystic adenoma, with relatively good prognosis.
作者
朱燃
薛晓伟
罗玉凤
吴焕文
霍真
Zhu Ran;Xue Xiaowei;Luo Yufeng;Wu Huanwen;Huo Zhen(Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences ＆ Peking Union Medical College, Beijing 100730, China)
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2018年第5期339-343,共5页
Chinese Journal of Pathology
关键词
卵巢疾病
类癌瘤
免疫组织化学
诊断
鉴别
Ovary disease
Carcinoid tumor
Immunohistochemistry
Diagnosis, differential
