Ferreira C R, Carvalho J P, Soares F A, Siqueira S A C, Carvalho F M
Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Int J Gynecol Cancer. 2008 Jan-Feb;18(1):59-65. doi: 10.1111/j.1525-1438.2007.00988.x. Epub 2007 May 19.
Pseudomyxoma peritonei (PMP) is a clinical condition initially thought to be related to ovarian mucinous tumors; however, immunohistochemistry and molecular biology techniques have convincingly made the link to appendiceal mucinous neoplasms, resulting in changes in histologic and clinical approaches. The objective of this study was to compare the immunohistochemical profile of ovarian tumors associated with PMP and intestinal mucinous ovarian neoplasms without PMP. The study was retrospective and included 28 intestinal ovarian mucinous tumors selected from the files of the Division of Surgical Pathology of the University of Sao Paulo Medical School, from 1996 to 2005. Seven cases were associated with PMP of disseminated peritoneal adenomucinosis-type and all presented borderline histology. Immunohistochemical staining for mucin genes products (MUC1, MUC2, MUC5AC, and MUC6), CK7, CK20, CA19.9, and CA125 were performed in tissue microarrays. Of note, we detected differences in the expression of MUC2 and CK20 between cases with and without PMP. Comparisons of borderline histology with that of benign/malignant tumors also revealed differences in MUC2 and CK20. Our results confirm that there is a distinct profile of intestinal ovarian tumors associated with pseudomyxoma, particularly with respect to the expression of the gel-forming mucin MUC2. The profile of borderline tumors, even in cases without PMP, was distinct from that of other primary mucinous tumors of the intestinal type, suggesting that borderline histology may represent a secondary tumor or a less aggressive variant of PMP. An appendiceal origin seems the most probable for this group of neoplasias.
腹膜假黏液瘤（PMP）是一种临床病症，最初被认为与卵巢黏液性肿瘤有关；然而，免疫组织化学和分子生物学技术有力地证明了其与阑尾黏液性肿瘤的关联，从而导致组织学和临床治疗方法的改变。本研究的目的是比较与PMP相关的卵巢肿瘤和无PMP的肠道黏液性卵巢肿瘤的免疫组织化学特征。该研究为回顾性研究，纳入了1996年至2005年从圣保罗大学医学院外科病理科档案中选取的28例肠道卵巢黏液性肿瘤。7例与播散性腹膜腺黏液瘤型PMP相关，均表现为交界性组织学特征。在组织微阵列中对黏蛋白基因产物（MUC1、MUC2、MUC5AC和MUC6）、CK7、CK20、CA19.9和CA125进行免疫组织化学染色。值得注意的是，我们检测到有PMP和无PMP病例之间MUC2和CK20表达存在差异。交界性组织学与良性/恶性肿瘤的比较也显示出MUC2和CK20存在差异。我们的结果证实，与假黏液瘤相关的肠道卵巢肿瘤具有独特的特征，特别是在凝胶形成黏蛋白MUC2的表达方面。即使在无PMP的病例中，交界性肿瘤的特征也与其他原发性肠道型黏液性肿瘤不同，这表明交界性组织学可能代表继发性肿瘤或PMP的侵袭性较低的变体。对于这组肿瘤，阑尾起源似乎是最有可能的。
