Hogg Russell, Scurry James, Kim Soo-Nyung, Friedlander Michael, Hacker Neville
Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, Australia.
Gynecol Oncol. 2007 Jul;106(1):44-51. doi: 10.1016/j.ygyno.2007.01.054. Epub 2007 Apr 27.
Ovarian serous borderline tumor (SBT) and grade 1 (low grade) serous carcinoma are closely related, but, unlike SBT which has been well studied, there have been few studies looking primarily at grade 1 serous carcinoma. The objective of this study was to better understand the relationship between serous borderline tumors and grade 1 serous carcinomas.
We performed a clinicopathologic review of 46 women with SBT and 16 with grade 1 serous carcinoma.
Thirteen of forty-six (28%) SBTs had a micropapillary pattern, 12/46 (26%) had evidence of microinvasion and 19/46 (41%) had extraovarian implants, of which 1/19 (5%) was invasive. Three of forty-six (7%) of SBTs recurred, all of which were originally advanced stage. No patient with a microinvasive SBT recurred. The 16 grade 1 serous carcinomas divided into those with evidence of coexisting SBTs (5 cases) and those without (11 cases). Nine of sixteen (56%) carcinomas recurred, comprising 5/5 with SBT and 4/11 without. All patients had advanced stage at diagnosis. Microinvasion, invasive implants and recurrences all showed qualitative histologic resemblance to carcinoma. There were no micropapillary areas in any of the carcinomas, although cribriform pattern was seen in these tumors.
Advanced stage at diagnosis was the most important prognostic marker in patients with SBT. Although a micropapillary pattern was common, it did not adversely affect prognosis per se, but was associated with a higher stage. A micropapillary pattern was not seen adjacent to microinvasion or in association with grade 1 serous carcinoma. Microinvasion was common but, in our series, did not appear to worsen the prognosis. Grade 1 serous carcinoma was less common than SBT and had a more unfavorable prognosis. The qualitative histologic similarity between microinvasion, invasive implants, recurrences and grade 1 serous carcinoma suggests that microinvasion represents early invasion and is not just another histologic pattern of SBT. We speculate that some invasive implants and recurrences may be peritoneal grade 1 serous carcinoma.
卵巢浆液性交界性肿瘤（SBT）与1级（低级别）浆液性癌密切相关，但与已得到充分研究的SBT不同，主要针对1级浆液性癌的研究较少。本研究的目的是更好地了解浆液性交界性肿瘤与1级浆液性癌之间的关系。
我们对46例患有SBT的女性和16例患有1级浆液性癌的女性进行了临床病理回顾。
46例SBT中有13例（28%）具有微乳头模式，12/46（26%）有微浸润证据，19/46（41%）有卵巢外种植，其中1/19（5%）为浸润性。46例SBT中有3例（7%）复发，均为晚期。微浸润性SBT患者均未复发。16例1级浆液性癌分为有并存SBT证据的（5例）和无并存SBT证据的（11例）。16例中有9例（56%）癌复发，包括5/5有SBT的和4/11无SBT的。所有患者诊断时均为晚期。微浸润、浸润性种植和复发在组织学上均与癌有定性相似性。所有癌中均无微乳头区域，尽管这些肿瘤可见筛状模式。
诊断时为晚期是SBT患者最重要的预后标志物。虽然微乳头模式常见，但本身并不对预后产生不利影响，而是与更高分期相关。微浸润或与1级浆液性癌相关处未见微乳头模式。微浸润常见，但在我们的系列研究中似乎并未使预后恶化。1级浆液性癌比SBT少见，预后更差。微浸润、浸润性种植、复发与1级浆液性癌在组织学定性上的相似性表明，微浸润代表早期浸润，而不仅仅是SBT的另一种组织学模式。我们推测一些浸润性种植和复发可能是腹膜1级浆液性癌。
