Wittekind C, Horn L-C
Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Pathologe. 2009 Mar;30(2):125-30. doi: 10.1007/s00292-008-1117-9.
Patients with cancers of unknown primary (CUP syndrome) represent a relatively large group of cancer patients (5-10%) in whom the histomorphological diagnosis is made from tissue from the metastasis, and the site of the primary tumour remains unclear. The incidence is variable, depending on the definition used and the intensity of the search for a primary tumour. From a biological and prognostic point of view, it is helpful to distinguish eight clinical entities of the CUP syndrome; four of these entities can be subdivided histologically. Histopathologic diagnosis should be performed using a diagnostic algorithm based on the HE morphology and supplemented by immunohistochemistry. With the use of a broad spectrum of immunohistochemical markers, many tumour entities can be diagnosed, so in most cases molecular genetic investigations are not necessary.
原发灶不明癌（CUP综合征）患者占癌症患者总数的比例相对较大（5%-10%），这类患者的组织形态学诊断是基于转移灶组织做出的，而原发肿瘤的部位仍不清楚。其发病率因所采用的定义以及对原发肿瘤的排查力度不同而有所差异。从生物学和预后的角度来看，区分CUP综合征的八个临床实体是有帮助的；其中四个实体在组织学上还可进一步细分。组织病理学诊断应采用基于苏木精-伊红（HE）形态学并辅以免疫组织化学的诊断算法。通过使用广泛的免疫组织化学标志物，许多肿瘤实体都可以得到诊断，因此在大多数情况下无需进行分子遗传学研究。
