Höhn A K, Einenkel J, Wittekind C, Horn L-C
Abteilung Mamma-, Gynäko- & Perinatalpathologie, Institut für Pathologie, Department für Diagnostik, Universitätsklinikum Leipzig AöR, Liebigstr. 24, 04103, Leipzig, Deutschland,
Pathologe. 2014 Jul;35(4):322-6. doi: 10.1007/s00292-014-1908-0.
During recent years paramount changes have occurred in the pathogenesis of ovarian cancer and recent clinical studies identified new prognostic factors. Consequently, the FIGO has established a new staging system collectively covering carcinomas derived from the ovaries, the fallopian tubes and primary peritoneal cancers as well as malignant ovarian germ cell and sex-cord stromal tumors. The new staging system started on 01 January 2014. Major changes occurred in the FIGO IC/T1c stage with surgical spill (FIGO IC1/T1c1) versus capsule ruptured before surgery or tumor on ovarian or fallopian tube surface (FIGO IC2/T1c2) versus malignant cells in the ascites or peritoneal washings (FIGO IC3/T1c3). The regional lymph node metastases were subcategorised using a cut-off value of 10 mm as the largest dimension of the metastatic deposits. Distant metastases (excluding peritoneal metastases) were substaged as FIGO IVA/M1a in cases of cytologically or histologically proven pleural involvement and as FIGO IVB/M1b in cases of parenchymal metastases and metastases in extra-abdominal organs (including lymph nodes outside the peritoneal cavity and the inguinal lymph nodes).
近年来,卵巢癌的发病机制发生了重大变化,近期的临床研究发现了新的预后因素。因此,国际妇产科联盟(FIGO)建立了一个新的分期系统,该系统共同涵盖源自卵巢、输卵管和原发性腹膜癌的癌症,以及恶性卵巢生殖细胞和性索间质肿瘤。新的分期系统于2014年1月1日开始实施。FIGO IC/T1c期发生了重大变化,包括手术时肿瘤溢出(FIGO IC1/T1c1)与术前包膜破裂或卵巢或输卵管表面有肿瘤(FIGO IC2/T1c2)与腹水或腹腔冲洗液中有恶性细胞(FIGO IC3/T1c3)。区域淋巴结转移根据转移灶最大径为10 mm的临界值进行亚分类。远处转移(不包括腹膜转移)在细胞学或组织学证实有胸膜受累的情况下分为FIGO IVA/M1a,在有实质转移和腹外器官转移(包括腹膜腔外淋巴结和腹股沟淋巴结)的情况下分为FIGO IVB/M1b。