Acs Geza
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadephia, PA 19104, USA.
Am J Clin Pathol. 2005 Jun;123 Suppl:S13-57. doi: 10.1309/J6PXXK1HQJAEBVPM.
The prognosis for stage I serous borderline ovarian tumors (SBOTs) is thought to be excellent, despite rare, late recurrences. The behavior of advanced-stage SBOTs primarily depends on the invasiveness vs noninvasiveness of associated extraovarian implants. Pelvic and abdominal lymph node involvement and foci of microinvasion do not seem to adversely affect prognosis. Serous tumors with a micropapillary and/or cribriform growth pattern seem to be more frequently bilateral and exophytic and manifest at an advanced stage with a higher incidence of invasive implants than typical SBOTs. Molecular data suggest that such tumors may represent an intermediate stage in the typical SBOT-invasive low-grade serous carcinoma progression. Limited experience with endocervical (müllerian)-type mucinous borderline tumors shows a possible relation to SBOTs in clinicopathologic features and biologic behavior Intestinal-type mucinous borderline ovarian tumors (I-MBOTs) and well-differentiated mucinous carcinomas manifest at stage I in most cases; the prognosis is excellent. Mucinous tumors associated with pseudomyxoma peritonei are almost always secondary to similar tumors of the appendix or other gastrointestinal sites and should not be diagnosed as high-stage I-MBOTs. Rare primary ovarian mucinous tumors associated with pseudomyxoma peritonei are those arising in mature cystic teratomas. Advanced-stage ovarian mucinous carcinomas typically show frank, infiltrative-type invasion; the prognosis is poor.
尽管I期浆液性交界性卵巢肿瘤(SBOT)有罕见的晚期复发情况,但一般认为其预后良好。晚期SBOT的行为主要取决于相关卵巢外种植灶的侵袭性与非侵袭性。盆腔和腹部淋巴结受累以及微浸润灶似乎对预后没有不利影响。具有微乳头和/或筛状生长模式的浆液性肿瘤似乎更常为双侧性且外生性生长,与典型SBOT相比,在晚期出现侵袭性种植灶的发生率更高。分子数据表明,此类肿瘤可能代表典型SBOT向侵袭性低级别浆液性癌进展的中间阶段。宫颈内膜(苗勒氏管)型黏液性交界性肿瘤的经验有限,其在临床病理特征和生物学行为方面可能与SBOT有关。肠型黏液性交界性卵巢肿瘤(I-MBOT)和高分化黏液性癌在大多数情况下表现为I期,预后良好。与腹膜假黏液瘤相关的黏液性肿瘤几乎总是继发于阑尾或其他胃肠道部位的类似肿瘤,不应诊断为高级别I-MBOT。与腹膜假黏液瘤相关的罕见原发性卵巢黏液性肿瘤是那些起源于成熟囊性畸胎瘤的肿瘤。晚期卵巢黏液性癌通常表现为明显的浸润性生长,预后较差。