Kriplani Divya, Patel Mandakini M
Department of Pathology, Government Medical College, Surat, Gujarat, India.
South Asian J Cancer. 2013 Oct;2(4):254-8. doi: 10.4103/2278-330X.119888.
Among cancers of the female genital tract, the incidence of ovarian cancer ranks below only carcinoma of the cervix and the endometrium. Recent years have witnessed significant development in the use of immunohistochemistry in diagnostic ovarian pathology.
We received 95 specimens and biopsies of primary ovarian neoplasms and neoplasms metastatic to the ovary in a period of 2 years. Of these 30 cases were of the primary surface epithelial neoplasms and seven of metastatic tumors.
The most common tumors metastasizing to the ovary originate from the gastrointestinal tract followed by the endometrium. We used a panel of six markers including cytokeratin-7 (CK7), CK20, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), estrogen receptor (ER) and Wilms' tumor 1 (WT1) to help classify various surface epithelial tumors as well as to differentiate them from tumors metastatic to the ovary.
CK7 is the most helpful marker to differentiate primary ovarian carcinoma from metastatic colorectal carcinoma of the ovary. Nearly, 96% of ovarian adenocarcinomas were positive for CK7 in contrast to metastatic colorectal, which showed only 25% positivity. We also found that CK7, CK20 and CEA are useful markers to differentiate primary serous tumors from primary mucinous tumors; however, these are less helpful in differentiating ovarian mucinous adenocarcinomas from colorectal adenocarcinomas metastasizing to the ovaries. WT1 helps in typing primary surface epithelial tumors of the ovary and is also significant in determining whether a serous carcinoma within the ovary is primary or metastatic.
在女性生殖道癌症中，卵巢癌的发病率仅次于子宫颈癌和子宫内膜癌。近年来，免疫组织化学在卵巢病理诊断中的应用有了显著发展。
在两年时间里，我们接收了95份原发性卵巢肿瘤及卵巢转移瘤的标本和活检组织。其中30例为原发性表面上皮肿瘤，7例为转移瘤。
最常转移至卵巢的肿瘤起源于胃肠道，其次是子宫内膜。我们使用了一组六种标志物，包括细胞角蛋白-7（CK7）、CK20、癌胚抗原（CEA）、癌抗原125（CA125）、雌激素受体（ER）和威尔姆斯瘤1（WT1），以帮助对各种表面上皮肿瘤进行分类，并将它们与转移至卵巢的肿瘤区分开来。
CK7是区分原发性卵巢癌与卵巢转移性结直肠癌最有用的标志物。近96%的卵巢腺癌CK7呈阳性，而转移性结直肠癌仅25%呈阳性。我们还发现，CK7、CK20和CEA是区分原发性浆液性肿瘤与原发性黏液性肿瘤的有用标志物；然而，在区分卵巢黏液性腺癌与转移至卵巢的结直肠腺癌方面，这些标志物的作用较小。WT1有助于对卵巢原发性表面上皮肿瘤进行分型，在确定卵巢内的浆液性癌是原发性还是转移性方面也具有重要意义。
