Khalifeh Ibrahim, Munkarah Adnan R, Lonardo Fulvio, Malone John M, Morris Robert, Lawrence W Dwayne, Ali-Fehmi Rouba
Departments of Pathology and Gynecology Oncology, Harper University Hospital and Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Int J Gynecol Pathol. 2004 Apr;23(2):162-9. doi: 10.1097/00004347-200404000-00011.
The objective of this study was to compare the immunohistochemical profile and clinical course of primary peritoneal serous carcinoma (PPC) and primary ovarian serous carcinoma (OSC). These entities are virtually indistinguishable morphologically, but their differential molecular and clinical features are incompletely characterized. Twenty-nine cases of high-grade, high-stage PPC and 96 cases of stage matched OSCs were compared. PPC was identified based on the criteria proposed by the Gynecologic Oncology Group. The tumors were staged according to International Federation of Gynecology and Obstetrics criteria for ovarian cancer and graded according to World Health Organization criteria. Expression of Cox-2, CD-34, bcl-2, and p53 was compared in the two tumors and correlated with clinical data including stage, age, race, and overall survival. Although the median survival, using Kaplan-Meier test, of patients with OSC (1060 days, 35.3 months) was longer than those with PPC (708 days, 23.6 months) the difference was not statistically significant. However, Cox-2 expression was correlated with microvessel density in PPC (p=0.026) and OSC cases (p=0.005), and high expression of Cox-2 correlated with lower survival rate in OSC cases (p=0.045) but not in PPC cases (p=0.12). These findings, coupled with the morphologic overlap existing between OSC and PPC, support the view that they represent related pathologic entities.
本研究的目的是比较原发性腹膜浆液性癌（PPC）和原发性卵巢浆液性癌（OSC）的免疫组化特征及临床病程。这些实体在形态学上几乎无法区分，但其分子和临床特征的差异尚未完全明确。对29例高级别、高分期的PPC病例和96例分期匹配的OSC病例进行了比较。PPC是根据妇科肿瘤学组提出的标准确定的。肿瘤根据国际妇产科联盟卵巢癌标准进行分期，并根据世界卫生组织标准进行分级。比较了两种肿瘤中Cox-2、CD-34、bcl-2和p53的表达，并与包括分期、年龄、种族和总生存期在内的临床数据进行关联分析。尽管使用Kaplan-Meier检验，OSC患者的中位生存期（1060天，35.3个月）长于PPC患者（708天，23.6个月），但差异无统计学意义。然而，Cox-2表达与PPC（p=0.026）和OSC病例（p=0.005）中的微血管密度相关，Cox-2高表达与OSC病例较低的生存率相关（p=0.045），但与PPC病例无关（p=0.12）。这些发现，再加上OSC和PPC之间存在的形态学重叠，支持了它们代表相关病理实体的观点。
