浆液性和黏液性卵巢交界性肿瘤：临床表现、高危组织病理学特征及致死性复发率的差异
Serous and mucinous borderline ovarian tumours: differences in clinical presentation, high-risk histopathological features, and lethal recurrence rates.
作者信息
Vasconcelos I, Darb-Esfahani S, Sehouli J
机构信息
Department of Gynaecology, Charité Medical University of Berlin, Campus Virchow Klinikum, Berlin, Germany.
Department of Pathology, Charité Medical University of Berlin, Campus Virchow Klinikum, Berlin, Germany.
出版信息
BJOG. 2016 Mar;123(4):498-508. doi: 10.1111/1471-0528.13840. Epub 2015 Dec 25.
BACKGROUND
Mucinous and serous borderline ovarian tumours (mBOTs and sBOTs) are controversial diseases.
OBJECTIVES
With this systematic review we aim to evaluate the different high-risk histopathological features and recurrence rates.
SEARCH STRATEGY
The PubMed database was searched using two terms: {serous AND [(borderline) OR (low malignant potential)] AND ovarian AND tumour} and {mucinous AND [(borderline) OR (low malignant potential)] AND ovarian AND tumour}.
SELECTION CRITERIA
Cohorts of either sBOT or mBOT, peer-reviewed, retrospective, or prospective.
DATA COLLECTION AND ANALYSIS
Lethal recurrence data for micropapillary patterns (MPs), microinvasion, non-invasive and invasive implants, and intraepithelial carcinoma (IECA). The primary measure of effect was the odds ratio of lethal recurrence reduction.
RESULTS
Data from patients in 42 studies including 4414 sBOTs and 12 studies including 894 mBOTs were pooled. Of these, 53.3% presented early-stage typical sBOTs, 24.4% presented with MPs, 22.3% presented with microinvasion, 34.4% presented with non-invasive implants, and 7.3% presented with invasive implants. The pooled lethal recurrence rates were, respectively: 18.3, 16.8, 10.7, 16.2, and 33.8%. Patients with MPs were more likely to suffer lethal recurrence when compared with high-stage sBOTs (odds ratio, OR 0.501; P = 0.003), whereas the trend in microinvasive sBOTs did not reach statistical significance. Regarding mBOTs, 61.6% presented with early-stage typical mBOTs, 19.6% presented with microinvasion, 34.8% presented with IECA, and six patients presented with non-invasive implants; none presented with invasive implants. The lethal recurrence rates were, respectively: 3.6, 0, 3.7, and 0%.
CONCLUSION
Micropapillary patterns (MPs) showed a higher risk for lethal recurrence when compared with high-stage sBOTs. Regarding mBOTs, IECA and microinvasion do not play a role in the lethal recurrence rate.
TWEETABLE ABSTRACT
Micropapillary pattern confirmed as high-risk in BOT. IECA and microinvasion don't play a role in mucinous BOT.
背景
黏液性和浆液性卵巢交界性肿瘤（mBOTs和sBOTs）是存在争议的疾病。
目的
通过本系统评价，我们旨在评估不同的高风险组织病理学特征和复发率。
检索策略
使用两个检索词在PubMed数据库中进行检索：{浆液性 AND [(交界性) OR (低恶性潜能)] AND 卵巢 AND 肿瘤}和{黏液性 AND [(交界性) OR (低恶性潜能)] AND 卵巢 AND 肿瘤}。
入选标准
sBOT或mBOT队列研究，经过同行评审，回顾性或前瞻性研究。
数据收集与分析
微乳头模式（MPs）、微浸润、非侵袭性和侵袭性种植以及上皮内癌（IECA）的致死性复发数据。主要疗效指标是致死性复发降低的比值比。
结果
汇总了42项研究中4414例sBOT患者的数据以及12项研究中894例mBOT患者的数据。其中，53.3%为早期典型sBOT，24.4%有MPs，22.3%有微浸润，34.4%有非侵袭性种植，7.3%有侵袭性种植。汇总的致死性复发率分别为：18.3%、16.8%、10.7%、16.2%和33.8%。与高分期sBOT相比，有MPs的患者更易发生致死性复发（比值比，OR 0.501；P = 0.003），而微浸润性sBOT的这一趋势未达到统计学意义。对于mBOT，61.6%为早期典型mBOT，19.6%有微浸润，34.8%有IECA，6例有非侵袭性种植；无侵袭性种植病例。致死性复发率分别为：3.6%、0%、3.7%和0%。
结论
与高分期sBOT相比，微乳头模式（MPs）显示出更高的致死性复发风险。对于mBOT，IECA和微浸润在致死性复发率方面不起作用。
可发推文摘要
微乳头模式在BOT中被确认为高风险。IECA和微浸润在黏液性BOT中不起作用。
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