Pavlidis Nicholas, Fizazi Karim
School of Medicine, Department of Medical Oncology, University of Ioannina, P.O. Box 1186, 451 10 Ioannina, Greece.
Crit Rev Oncol Hematol. 2009 Mar;69(3):271-8. doi: 10.1016/j.critrevonc.2008.09.005. Epub 2008 Nov 1.
Carcinoma of unknown primary (CUP) is one of the 10 most frequent cancers worldwide. It constitutes 3-5% of all human malignancies. Patients with CUP present with metastases without an established primary site. CUP manifests as an heterogeneous group of mainly epithelial cancers recognised by distinct clinicopathological entities. The diagnostic work-up includes extensive histopathology investigations and modern imaging technology. Nevertheless, the primary tumour remains undetected most of the time. Molecular diagnosis with DNA microarrays demonstrates high sensitivity, but its prognostic contribution is still uncertain. Certain clinicopathological CUP entities are considered as favourable sub-sets responding to systemic platinum-based chemotherapy or managed by locoregional treatment. These sub-sets are: the poorly differentiated carcinomas involving the mediastinal-retroperitoneal nodes, peritoneal papillary serous adenocarcinomatosis in females, poorly differentiated neuroendocrine carcinomas, isolated axillary node adenocarcinomas in females or cervical nodal involvement by a squamous cell carcinoma. Patients who belong to the non-favourable sub-sets have a worse prognosis.
原发灶不明癌（CUP）是全球十大常见癌症之一。它占所有人类恶性肿瘤的3 - 5%。CUP患者出现转移但原发部位未明确。CUP表现为一组异质性的主要上皮性癌症，由不同的临床病理实体所识别。诊断检查包括广泛的组织病理学研究和现代成像技术。然而，大多数情况下原发肿瘤仍未被发现。DNA微阵列分子诊断显示出高敏感性，但其对预后的贡献仍不确定。某些临床病理CUP实体被认为是对基于铂的全身化疗有反应或可通过局部区域治疗处理的有利亚组。这些亚组包括：累及纵隔 - 腹膜后淋巴结的低分化癌、女性腹膜乳头状浆液性腺癌、低分化神经内分泌癌、女性孤立性腋窝淋巴结腺癌或鳞状细胞癌累及宫颈淋巴结。属于非有利亚组的患者预后较差。
