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卵巢和子宫内膜中的钙化及其肿瘤

Calcifications in ovary and endometrium and their neoplasms.

作者信息

Silva Elvio G, Deavers Michael T, Parlow A F, Gershenson David M, Malpica Anais

机构信息

Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

出版信息

Mod Pathol. 2003 Mar;16(3):219-22. doi: 10.1097/01.MP.0000057236.96797.07.

Abstract

In this study, we investigated the role of hormones in the pathogenesis of calcifications in ovary and in endometrium and their neoplasms of the gynecologic tract and assessed the anatomic location and incidence of these calcifications. The study consists of three parts designed to investigate the pathogenesis, the location, and the incidence of calcifications in ovary and endometrium and their neoplasms. In the first part, 79 female guinea pigs were divided into 10 groups, and different hormones, given weekly for 12 months, were administered to the guinea pigs by group. A control group of 7 guinea pigs received sterile water. Calcifications developed in 5 of 7 guinea pigs treated with prolactin, 10 of 20 treated with human chorionic gonadotropin, 5 of 11 treated with estradiol, 3 of 7 treated with estrone, 1 of 6 treated with growth hormone, and 1 of 10 treated with testosterone; in 20 of the guinea pigs, the calcifications developed in the stroma of the endometrium, and in 5 guinea pigs, they developed in the ovary. The second part of the study consisted of an evaluation of the specific location of calcifications in 43 consecutive human surgical ovaries and endometria. Calcifications were seen only in the stroma in 100% of the ovarian serous adenofibroma specimens; in ovarian serous borderline neoplasms, the stroma contained 70 to 100% of the calcifications, and the epithelium had 0 to 30% of the calcifications. In ovarian serous carcinoma specimens, the calcifications were seen in the stroma in 50 to 60% of the cases, in the epithelium in 40% of the cases, and in areas of necrosis in 10% of the cases. The third part of the study was directed to determine the frequency of calcifications in ovarian lesions. We found that all cases of endosalpingiosis and ovarian low-grade serous carcinoma had calcifications, whereas 80% of the cases of serous borderline tumor had calcifications, and only 50% of the cases of ovarian high-grade serous carcinoma contained calcifications. The results of this study indicate that the majority of the calcifications in the ovary and the endometrium and their neoplasms are present in the stroma. This is most probably secondary to metabolic changes, which could be related to hormones and not caused by degenerative changes in epithelial cells.

摘要

在本研究中,我们调查了激素在卵巢及子宫内膜钙化及其妇科肿瘤发病机制中的作用,并评估了这些钙化的解剖位置和发生率。该研究包括三个部分,旨在调查卵巢和子宫内膜及其肿瘤中钙化的发病机制、位置和发生率。在第一部分中,79只雌性豚鼠被分为10组,每组豚鼠每周接受不同激素治疗,持续12个月。7只豚鼠的对照组接受无菌水。接受催乳素治疗的7只豚鼠中有5只出现钙化,接受人绒毛膜促性腺激素治疗的20只中有10只出现钙化,接受雌二醇治疗的11只中有5只出现钙化,接受雌酮治疗的7只中有3只出现钙化,接受生长激素治疗的6只中有1只出现钙化,接受睾酮治疗的10只中有1只出现钙化;在20只豚鼠中,钙化出现在子宫内膜间质中,5只豚鼠的钙化出现在卵巢中。研究的第二部分包括对43例连续的人类手术切除的卵巢和子宫内膜中钙化的具体位置进行评估。在100%的卵巢浆液性腺纤维瘤标本中,钙化仅见于间质;在卵巢浆液性交界性肿瘤中,70%至100%的钙化位于间质,0%至30%的钙化位于上皮。在卵巢浆液性癌标本中,50%至60%的病例钙化见于间质,40%的病例钙化见于上皮,10%的病例钙化见于坏死区域。研究的第三部分旨在确定卵巢病变中钙化的频率。我们发现,所有输卵管内膜异位症和卵巢低级别浆液性癌病例均有钙化,而80%的浆液性交界性肿瘤病例有钙化,只有50%的卵巢高级别浆液性癌病例有钙化。本研究结果表明,卵巢、子宫内膜及其肿瘤中的大多数钙化存在于间质中。这很可能是代谢变化的继发结果,可能与激素有关,而非上皮细胞的退行性变化所致。

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