Prat Jaime
Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
Best Pract Res Clin Obstet Gynaecol. 2017 May;41:15-30. doi: 10.1016/j.bpobgyn.2016.08.007. Epub 2016 Oct 3.
Epithelial ovarian tumors are heterogeneous neoplasms primarily classified according to cell type. They are further subdivided into benign, borderline, and malignant (carcinomas), and this subdivision is very important as it correlates with behavior. Borderline ovarian tumors show epithelial proliferation higher than that seen in their benign counterparts and variable nuclear atypia; however, in contrast to carcinomas, there is no destructive stromal invasion, and their prognosis is much better. Ovarian carcinomas are the most common ovarian cancers and the most lethal gynecological malignancies. On the basis of histopathology and molecular genetics, they are divided into five types (high-grade serous (70%), endometrioid (10%), clear cell (10%), mucinous (3%), and low-grade serous carcinomas (<5%)), which are morphologically diverse and account for over 95% of cases. These tumors are essentially distinct diseases, as indicated by differences in epidemiological and genetic risk factors, precursor lesions, patterns of spread, molecular alterations, response to chemotherapy, and prognosis. For a successful specific treatment, reproducible histopathological diagnosis of the tumor cell type is critical.
上皮性卵巢肿瘤是异质性肿瘤，主要根据细胞类型进行分类。它们进一步细分为良性、交界性和恶性（癌），这种细分非常重要，因为它与肿瘤行为相关。交界性卵巢肿瘤的上皮增殖高于其良性对应物，且有不同程度的核异型性；然而，与癌不同的是，没有破坏性的间质浸润，其预后要好得多。卵巢癌是最常见的卵巢癌，也是最致命的妇科恶性肿瘤。根据组织病理学和分子遗传学，它们分为五种类型（高级别浆液性癌（70%）、子宫内膜样癌（10%）、透明细胞癌（10%）、黏液性癌（3%）和低级别浆液性癌（<5%）），这些类型形态各异，占病例总数的95%以上。这些肿瘤本质上是不同的疾病，这体现在流行病学和遗传危险因素、前驱病变、扩散模式、分子改变、对化疗的反应以及预后等方面的差异。为了成功进行特异性治疗，对肿瘤细胞类型进行可重复的组织病理学诊断至关重要。
