Department of Obstetrics and Gynecology, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.
Pathol Oncol Res. 2011 Sep;17(3):605-11. doi: 10.1007/s12253-010-9356-5. Epub 2011 Jan 28.
In the early stages of epithelial ovarian cancer, histopathological grading is important. However, the grading of ovarian clear cell carcinoma (OCCC) remains controversial. We aimed to identify irregular giant nuclear cells (IGNCs) by a simple method in clinical practice, and to evaluate the prognostic value of IGNCs in pT1 OCCC. Eighty-seven pT1 OCCC patients who underwent initial surgery at Jikei University Kashiwa Hospital, Chiba, Japan, were retrospectively assessed. Paraffin-embedded tissue sections (PTSs) stained with hematoxylin and eosin were reviewed. Giant nuclear cells (GNCs) were defined as cells with a nuclear length of more than twice the median nuclear length. GNCs with irregular nuclear circumferences were defined as IGNCs. Cases where one or more GNCs existed and where IGNCs accounted for >10% of the GNCs were classified as IGNC-positive. We also attempted to identify IGNCs on touch imprint cytology smears (TICSs). Among the 87 cases, 68 were IGNC-negative and 19 were IGNC-positive. The 5-year disease-free and overall survival rates were 88.9% and 90.3% in the total patients, 98.3% and 100% in the IGNC-negative group, and 59.7% and 62.0% in the IGNC-positive group, respectively. These survival rates were significantly lower in the IGNC-positive group than in the IGNC-negative group (adjusted hazard ratio = 14, 95% confidence interval = 2.7-124 and adjusted hazard ratio = 25, 95% confidence interval = 2.9-768, respectively). Prognostic differences were not identified for other factors. IGNC identification on 28 available TICSs predicted IGNC identification on PTSs (sensitivity = 50.0%, specificity = 100%, P = 0.007). The presence of IGNCs has clinical and prognostic value for pT1 OCCC.
在卵巢上皮性癌的早期阶段，组织病理学分级很重要。然而，卵巢透明细胞癌（OCCC）的分级仍存在争议。我们旨在通过一种简单的方法在临床实践中识别不规则巨核细胞（IGNC），并评估 pT1 OCCC 中 IGNC 的预后价值。我们回顾性评估了在日本千叶市筑波大学济科医院接受初次手术的 87 例 pT1 OCCC 患者。对苏木精和伊红染色的石蜡包埋组织切片（PTS）进行了回顾。巨核细胞（GNC）定义为细胞核长度超过中位数细胞核长度两倍的细胞。具有不规则核轮廓的 GNC 被定义为 IGNC。存在一个或多个 GNC 且 IGNC 占 GNC 总数的>10%的病例被归类为 IGNC 阳性。我们还试图在触印细胞学涂片（TICS）上识别 IGNC。在 87 例病例中，68 例为 IGNC 阴性，19 例为 IGNC 阳性。总患者的 5 年无病生存率和总生存率分别为 88.9%和 90.3%，IGNC 阴性组为 98.3%和 100%，IGNC 阳性组为 59.7%和 62.0%。IGNC 阳性组的这些生存率明显低于 IGNC 阴性组（调整后的危险比=14，95%置信区间=2.7-124 和调整后的危险比=25，95%置信区间=2.9-768）。其他因素未发现预后差异。28 例可获得的 TICS 上的 IGNC 识别预测了 PTS 上的 IGNC 识别（敏感性=50.0%，特异性=100%，P=0.007）。存在 IGNC 对 pT1 OCCC 具有临床和预后价值。
