卵巢浆黏液性肿瘤7例临床病理分析及分子特征  

Ovarian seromucinous tumours: a clinicopathological analysis and molecular characteristics of seven cases

作　　者：刘晔[1] 任雷 王雯雯 顾慧[1] 李丽[1] 鲍书友 秦妍婷[2] 李葵芳[1] LIU Ye;REN Lei;WANG Wen-wen;GU Hui;LI Li;BAO Shu-you;QIN Yan-ting;LI Kui-fang(Department of Pathology,Jiangyin Traditional Chinese Medicine Hospital,Jiangyin 214400,China;Department of Gynaecology,Jiangyin Traditional Chinese Medicine Hospital,Jiangyin 214400,China)

机构地区：[1]江苏省江阴市中医院病理科,江苏江阴214400 [2]江苏省江阴市中医院妇科,江苏江阴214400

出　　处：《诊断病理学杂志》2024年第2期123-127,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨卵巢浆黏液性肿瘤的临床病理特征、免疫表型、鉴别诊断及分子特征。方法收集7例卵巢浆黏液性肿瘤的临床病理资料,进行病理形态观察、免疫组织化学及分子检测,并复习文献。结果7例患者年龄25~56岁,中位年龄42岁,肿瘤最大径2.8~13.0 cm,1例双侧,6例单侧。7例均由颈管内膜型黏液上皮及苗勒管上皮组成,形成乳头状、筛状及微乳头状结构,伴大量中性粒细胞浸润,毁损性浸润及细胞异型显著提示恶变。免疫组化:7例表达雌激素受体、孕激素受体、细胞角蛋白7;5例表达PAX-8;3例表达PAX-2;7例PTEN缺失;Ki-67增殖指数为5%~40%;2例BRAF、PIK3CA、PIK3R1、PTEN基因突变,ARID1A、Tp53、BRCA1、BRCA2未见异常。7例均微卫星稳定。结论卵巢浆黏液性肿瘤有独特的病理形态学特征。免疫表型及分子特征提示其与子宫内膜样肿瘤重叠,预后较好。Objective To elucidate the clinicopathologic characteristics, immunophenotype, differential diagnosis and molecular characteristics of ovarian seromucinous tumours. Methods Clinicopathological characteristics of 7 cases of ovarian seromucinous tumours were analyzed. Immunohistochemical and molecular detection were performed, and relevant literatures were reviewed. Results The age of the 7 patients ranged from 25 to 56 years. The median age of patients was 42 years. The maximum dimension of these tumours ranged from 2. 8 to 13. 0 cm. One case were bilateral ovarian lesion and six cases of unilateral. All 7 tumors contained endocervical-like mucinous cells and Mullerian epithelium cells. The tumors exhibited papillary architectures, cribriform and micropapillary architectures. Massive neutrophilic infiltration could be seen in the stroma. Destructive infiltration and significant cellular heterogeneity suggested malignancy.Immunohistochemically, ER, PR and CK7 were positive in 7/7 cases. PAX-8 was positive in 5/7 cases and PAX-2 was positive in 3/7 cases. 7 cases had PTEN deletion;Ki-67 positivity index was 5%-40%;2 cases suggest that BRAF,PIK3CA, PIK3R1 and PTEN gene mutations, and no abnormalities were seen in ARID1A, Tp53, BRCA1, and BRCA2. All cases were microsatellite stability. Conclusion Ovarian seromucinous tumours possesses distinctive pathomorphological features. Immunophenotypical and molecular characteristics overlap with endometrioid tumors. It has relatively better prognosis.

关 键 词：卵巢浆黏液性肿瘤 子宫内膜样癌 免疫组织化学 临床病理 二代测序 

分 类 号：R737.31[医药卫生—肿瘤]