[腹膜黏液性肿瘤的临床病理特征及组织发生]

[Clinicopathologic characteristics and histogenesis of mucinous tumor of peritoneum].

作者信息

Zhang Heping, Sun Yu, Huang Xiaozheng, Jia Ling, Bai Yanhua, Cao Dengfeng

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education); Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China.

E-mail:

出版信息

Zhonghua Bing Li Xue Za Zhi. 2014 Mar;43(3):163-8.

PMID:24842014

Abstract

OBJECTIVE

To investigate the clinicopathologic characteristics, prognosis and histologic origin of the mucinous tumor of the peritoneum.

METHODS

According to 2010 WHO classification of tumours of the digestive system, 34 cases diagnosed as "pseudomyxoma peritonei (PMP) " were reevaluated and divided into low grade and high grade. Immunohistochemistry was applied to investigate the expression of SATB2 and the histologic origin of the mucinous tumor of the peritoneum, using antibodies against SATB2, CK7, CK20 and CDX-2. The relationship between clinicopathologic characteristics and prognosis of the low grade and high grade tumors were analyzed.

RESULTS

Twenty five patients had low grade mucinous tumors (two of them were no cell type), nine patients had high grade mucinous tumors. There was no significant difference between low grade and high grade mucinous tumors in age, sex, recurrence and organs involvement (P>0.05). Thirty patients were followed up, the overall survival rates of patients with low grade and high grade mucinous tumors were 13/21 (61.9%) and 3/9, respectively. The median survival time was 74 and 24 months in low and high grade patients, and the difference was statistically significant (P=0.002).Immunohistochemistry showed the expression rates of CDX-2, CK20, and CK7 in totally 32 cases (excluding 2 cases of no cell type) were 30/32(93.8%), 31/32 (96.9%), and 3/16, respectively; the expression rates of CDX-2, CK20, and CK7 in 16 cases with distinct primary site were 15, 16, and 1, respectively; fifteen of 16 cases of tumors of unknown primary site were positive for CDX-2 and CK20, two of the them were positive for CK7. There was no difference in the expression of CDX-2, CK20 and CK7 between tumors with distinct primary site and tumors with unknown primary site (P>0.05). The expression rate of SATB2 in the cases was 56.3% (18/32), excluding 2 cases of no cell type. There was no significant difference between low grade and high grade tumors in the expression of SATB2 [15/23(65.2%) vs 3/9, P=0.102], also SATB2 was not related to the prognosis of the tumor (P=0.786).

CONCLUSION

The prognosis of the mucinous tumor of the peritoneum was significantly different between low grade and high grade according to WHO 2010 classification, and most mucinous tumor of the peritoneum originated from the appendix.

摘要

目的

探讨腹膜黏液性肿瘤的临床病理特征、预后及组织学起源。

方法

根据2010年世界卫生组织消化系统肿瘤分类，对34例诊断为“腹膜假黏液瘤（PMP）”的病例进行重新评估，并分为低级别和高级别。应用免疫组织化学方法，使用抗SATB2、CK7、CK20和CDX-2抗体，研究SATB2的表达及腹膜黏液性肿瘤的组织学起源。分析低级别和高级别肿瘤的临床病理特征与预后之间的关系。

结果

25例患者为低级别黏液性肿瘤（其中2例为无细胞型），9例患者为高级别黏液性肿瘤。低级别和高级别黏液性肿瘤在年龄、性别、复发及器官受累方面无显著差异（P>0.05）。30例患者进行了随访，低级别和高级别黏液性肿瘤患者的总生存率分别为13/21（61.9%）和3/9。低级别和高级别患者的中位生存时间分别为74个月和24个月，差异具有统计学意义（P=0.002）。免疫组织化学显示，32例（不包括2例无细胞型）病例中CDX-2、CK20和CK7的表达率分别为30/32（93.8%）、31/32（96.9%）和3/16；16例有明确原发部位的病例中CDX-2、CK20和CK7的表达率分别为15、16和1；16例原发部位不明的肿瘤中有15例CDX-2和CK20阳性，其中2例CK7阳性。有明确原发部位的肿瘤与原发部位不明的肿瘤在CDX-2、CK20和CK7的表达上无差异（P>0.05）。排除2例无细胞型病例后，SATB2在病例中的表达率为56.3%（18/32）。低级别和高级别肿瘤在SATB2表达上无显著差异[15/23（65.2%）对3/9，P=0.102]，且SATB2与肿瘤预后无关（P=0.786）。