卵巢交界性子宫内膜样肿瘤4例临床病理观察  

Clinicopathological observation of 4 cases of ovarian borderline endometrioid tumor

作　　者：黄勇杰 曾思红 黄彩燕 周艳 罗枫 HUANG Yongjie;ZENG Sihong;HUANG Caiyan;ZHOU Yan;LUO Feng(Department of Pathology,Qingyuan People's Hospital,Qingyuan,Guangdong 511500,China;Hemodialysis Center,Qingyuan People's Hospital,Qingyuan,Guangdong 511500,China;Department of Traditional Chinese Medicine,QingYuan Maternal and Child Health Hospital,QingYuan,Guangdong 511500,China)

机构地区：[1]清远市人民医院病理科,广东清远511500 [2]清远市人民医院血液透析中心,广东清远511500 [3]清远市妇幼保健院中医科,广东清远511500

出　　处：《安徽医药》2022年第4期801-804,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 深入了解卵巢交界性子宫内膜样肿瘤(EBT)的临床病理特点、鉴别诊断、治疗和预后。方法 对清远市人民医院病理科2012年1月至2019年9月诊断的4例卵巢EBT的临床资料、组织学形态、免疫组化特点及预后进行分析总结,并复习相关文献。结果 4例因不规则阴道出血、下腹胀痛或发现盆腔占位入院,均行子宫及双附件切除术,其中3例行盆腔淋巴结清扫。镜下见排列紊乱、拥挤的子宫内膜样腺体,上皮细胞具有轻度或中度不典型性,部分区域上皮呈复层,腺体间见丰富的纤维间质;1例伴有子宫内膜样囊肿,腺体伴桑葚样鳞状化生;1例见上皮内癌及间质微浸润,且对侧卵巢及宫腔均见低级别子宫内膜样癌,术后多次化疗。肿瘤细胞角蛋白(CK)、角蛋白7(CK7)、糖类抗原(CA125)、雌激素受体(ER)及孕激素受体(PR)均(+),波形蛋白(Vimentin)部分(+),蛋白质53(P53)约5%~10%(+),增殖指数(Ki-67)约5%~25%(+),Wilms肿瘤蛋白1(WT-1)(-)。随访至今(7个月至7.5年),4个病例均处于无瘤生存状态,暂无复发转移迹象。结论 卵巢交界性子宫内膜样肿瘤少见,可与子宫内膜异位症或子宫内膜样癌并存,以手术治疗为主,预后良好。Objective To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of ovarian endometrioid borderline tumor (EBT).Methods The clinical data,histological morphology,immunohistochemical characteristics and prognosis of 4 cases of ovarian EBT diagnosed in the Department of Pathology,Qingyuan People’s Hospital from January 2012 to September2019 were analyzed and summarized,and the relevant literature was reviewed.Results 4 cases were admitted to hospital because of irregular vaginal bleeding,abdominal distention or pelvic space occupying.All patients underwent hysterectomy and bilateral adnexectomy,3 cases of them underwent pelvic lymph node dissection.Microscopically,there were disordered and crowded endometrioid glands.The epithelial cells were mildly or moderately atypical.The epithelium of some areas was stratified,and there was abundant fibrous stroma between the glands.One case was accompanied by endometrioid cyst,and the glands with mulberry-like squamous metaplasia;one case was seen with intraepithelial carcinoma and interstitial microinvasion,and the other side of ovary and uterine cavity were seen with low-grade endometrial carcinoma,and after operation,multiple chemotherapy was performed.Tumor cells were positive for Cytokeratin (CK),Cytokeratin 7 (CK7),Carbohydrate antigen 125 (CA125),estrogen receptor (ER) and progesterone receptor (PR),partially positive for Vimentin,protein 53 (P53,about 5%~10%),and negative for Wilms tumor 1 (WT-1).Ki-67 index was about 5%~25%.Follow-up up to date (ranging from 7 months to 7.5 years),all the 4 cases were in tumor-free survival state,with no signs of recurrence or metastasis.Conclusion Ovarian endometrioid borderline tumors are rare and can coexist with endometriosis or endomet-rioid carcinoma.Surgery is the main treatment and the prognosis is good.

关 键 词：卵巢肿瘤 角蛋白9 抗原 肿瘤相关 碳水化合物 受体 雌激素 肿瘤蛋白质类 交界性子宫内膜样肿瘤 预后 

分 类 号：R737.31[医药卫生—肿瘤]