1Department of Histopathology (J.W., M.A.E.-B.), Imperial College London, Hammersmith Hospital, London, United Kingdom 2Department of Pathology (M.A.E.-B.), Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Int J Gynecol Pathol. 2014 Mar;33(2):166-75. doi: 10.1097/PGP.0b013e318288b384.
Ovarian mucinous tumors (OMTs) of the intestinal type share morphologic features with primary tumors of other sites, and it can often be difficult to distinguish primary ovarian from metastatic mucinous tumors. MUC1, MUC2, MUC5AC, and MUC6 expressions were studied by immunohistochemistry in 36 OMTs of intestinal type (17 malignant, 19 borderline), 18 pancreatic, 12 biliary, 15 esophageal, 9 gastric, and 7 colorectal/appendiceal adenocarcinomas. All samples were from primary sites, except for colorectal tumors which were from ovarian metastases. Borderline and malignant OMTs show similar mucin immunoprofile, being strongly and uniformly positive for MUC5AC (97.2% of cases), whereas only focally positive for MUC1 (19.4%), MUC2 (38.9%), and MUC6 (22.2%). The positive frequencies of pancreatic adenocarcinomas for MUC1, MUC2, MUC5AC, and MUC6, respectively, were 100%, 16.7%, 94.4%, and 61.1%; for biliary (cholangiocarcinomas) were 91.7%, 0%, 16.7%, and 8.3%; for esophageal carcinomas were 73.3%, 33.3%, 53.3%, and 26.7%; for gastric carcinomas were 44.4%, 44.4%, 44.4%, and 0% and for lower gastrointestinal tract cancers were 28.6%, 85.7%, 42.9%, and 0%. Our study shows that OMTs are usually MUC5AC+/MUC1-, which is different from pancreatic, biliary, esophageal, gastric, and colorectal/appendiceal carcinomas. We recommend that these mucin stains be added to the panel of immunostains to differentiate metastatic tumors to the ovary from primary OMTs.
肠型卵巢黏液性肿瘤（OMT）与其他部位的原发性肿瘤具有相似的形态学特征，因此常常难以区分卵巢原发和转移性黏液性肿瘤。本研究通过免疫组化方法检测了 36 例肠型 OMT（17 例恶性，19 例交界性）、18 例胰腺、12 例胆道、15 例食管、9 例胃和 7 例结直肠/阑尾腺癌中 MUC1、MUC2、MUC5AC 和 MUC6 的表达。除了结直肠肿瘤来自卵巢转移外，所有标本均来自原发性肿瘤。交界性和恶性 OMT 具有相似的黏液免疫表型，均强烈且均匀地表达 MUC5AC（97.2%的病例），而仅局灶性表达 MUC1（19.4%）、MUC2（38.9%）和 MUC6（22.2%）。胰腺腺癌中 MUC1、MUC2、MUC5AC 和 MUC6 的阳性率分别为 100%、16.7%、94.4%和 61.1%；胆道（胆管癌）为 91.7%、0%、16.7%和 8.3%；食管腺癌为 73.3%、33.3%、53.3%和 26.7%；胃腺癌为 44.4%、44.4%、44.4%和 0%；结直肠/阑尾腺癌为 28.6%、85.7%、42.9%和 0%。我们的研究表明，OMT 通常为 MUC5AC+/MUC1-，与胰腺、胆道、食管、胃和结直肠/阑尾腺癌不同。我们建议在免疫组化检测中加入这些黏蛋白染色，以区分卵巢转移瘤和原发性 OMT。
