Diebold J
Pathologisches Institut, Luzerner Kantonsspital, Spitalstraße, 6000, Luzern, Schweiz,
Pathologe. 2014 Jul;35(4):314-21. doi: 10.1007/s00292-014-1906-2.
Because of different patterns of molecular changes, a dualistic model of serous tumors is now assumed with serous borderline tumors (SBT) and low-grade serous carcinomas (LGSC) on one side and high-grade serous carcinomas (HGSC) on the other. The clinical course and the type of treatment of SBT and LGSC depend crucially on whether they are associated with extraovarian manifestations. So-called invasive implants of SBT correspond morphologically to LGSC. The MD Anderson grading system has become established for the distinction between LGSC and HGSC, HGSC shows a wide range of growth patterns, including a transitional epithelial-like type. Carcinosarcomas can be interpreted as HGSC variants. Considering the new theory that all serous neoplasms of the ovary, peritoneum and fallopian tubes are derived from the tubal fimbria, the term "ovarian carcinoma" seems no longer appropriate.
由于分子变化模式不同,目前假定浆液性肿瘤存在二元模型,一侧为浆液性交界性肿瘤(SBT)和低级别浆液性癌(LGSC),另一侧为高级别浆液性癌(HGSC)。SBT和LGSC的临床病程及治疗类型关键取决于它们是否伴有卵巢外表现。SBT所谓的浸润性种植在形态上与LGSC相符。MD安德森分级系统已被确立用于区分LGSC和HGSC,HGSC呈现多种生长模式,包括移行上皮样类型。癌肉瘤可被解释为HGSC变体。考虑到所有卵巢、腹膜和输卵管浆液性肿瘤均起源于输卵管伞端这一新理论,“卵巢癌”这一术语似乎不再合适。