Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center Seoul.
Histopathology. 2010 Oct;57(4):587-96. doi: 10.1111/j.1365-2559.2010.03673.x.
Clinicopathological aspects of the endocervical-like mucinous borderline tumour of the ovary (EMBT), including higher frequencies of bilaterality, endometriosis and hormone receptor reactivity, and often admixtures of various Müllerian-type epithelia, closely resembles endometrioid tumour more than mucinous borderline tumour of the intestinal type (IMBT). Thus, the aims of this study were to determine whether EMBT is really a subtype of mucinous borderline tumours, as shown in the current classification system, and to determine the best classification for EMBT.
The clinicopathological and immunohistochemical features of 17 EMBTs were analysed, including oestrogen receptor (ER), progesterone receptor (PR), PTEN, cytokeratins (CK) 7 and 20, and β-catenin. Additionally, mutational analyses of the KRAS (exon 1) and PTEN genes (all nine exons) were performed in all cases, and the results were compared with literature findings for IMBT and endometrioid tumours. Twelve patients (71%) were confirmed histologically to have endometriosis in one or both ovaries. In seven cases, gradual transitions from endometriotic foci to the EMBT were identified. Immunohistochemically, all cases were reactive for ER and PR, with no nuclear expression of β-catenin. CK7 positivity was strong in all patients, whereas there was no reactivity for CK20. PTEN reactivity was diffuse in the nuclei of epithelial and underlying stromal cells. Sixty-nine per cent showed KRAS mutations in exon 1 and codon 12, but no PTEN mutation was identified in any of the nine exons.
Our study suggests that EMBT has features of both mucinous and endometrioid tumours and is an additional tumour type arising in endometriosis. While clinicopathological features of EMBTs are closer to endometrioid tumours, they still have molecular characteristics closer to IMBTs.
卵巢内似宫颈的黏液性交界性肿瘤（EMBT）的临床病理特征，包括更高的双侧性、子宫内膜异位症和激素受体反应性，以及常常混合各种 Müllerian 型上皮，与肠型黏液性交界性肿瘤（IMBT）相比，更类似于子宫内膜样肿瘤。因此，本研究旨在确定 EMBT 是否真的如当前分类系统所示，是黏液性交界性肿瘤的一个亚型，并确定 EMBT 的最佳分类。
分析了 17 例 EMBT 的临床病理和免疫组织化学特征，包括雌激素受体（ER）、孕激素受体（PR）、PTEN、细胞角蛋白（CK）7 和 20 以及β-连环蛋白。此外，对所有病例进行了 KRAS（外显子 1）和 PTEN 基因（所有九个外显子）的突变分析，并将结果与 IMBT 和子宫内膜样肿瘤的文献发现进行了比较。12 例患者（71%）在一个或两个卵巢中经组织学证实存在子宫内膜异位症。在 7 例中，从子宫内膜异位症病灶到 EMBT 逐渐过渡。免疫组织化学上，所有病例均对 ER 和 PR 反应，核内无β-连环蛋白表达。CK7 阳性在所有患者中均较强，而 CK20 无反应。PTEN 反应在上皮和下方基质细胞的核内弥漫。69%的病例在外显子 1 和密码子 12 中显示 KRAS 突变，但在任何一个外显子中均未发现 PTEN 突变。
我们的研究表明，EMBT 具有黏液性和子宫内膜样肿瘤的特征，是子宫内膜异位症中发生的另一种肿瘤类型。虽然 EMBT 的临床病理特征更接近子宫内膜样肿瘤，但它们仍具有更接近 IMBT 的分子特征。
