Int J Gynecol Cancer. 2018 Mar;28(3):486-492. doi: 10.1097/IGC.0000000000001185.
Although calcification in the gynecologic tumor microenvironments is a common phenomenon, doctors and researchers still disregard or ignore the issue. In fact, this change in the gynecologic tumor microenvironments is clinically significant and a number of studies have reported an association between calcification and gynecological tumor progression. In ovarian cancer, calcification is predominantly psammomatous and largely occurs in serous papillary ovarian tumors. In addition, calcification in ovarian cancer correlated with lower histologic grade and may indicate a poorer survival rate. In uterine fibroids, calcification occurs as a degenerative change and is predictive of a good prognosis. As for endometrial cancer and cervical cancer, calcification rarely occurs in these cancers. The mechanism of calcification in the gynecologic tumor microenvironments is not currently clear. One theory is that calcification occurs due to degeneration of the tumor cells; another theory is that calcification occurs in response to secretions from cells in the tumor microenvironment. Although previous studies have revealed a direct association between calcifications and gynecological tumors, this association has not been fully clarified. To better clarify the significance of calcification in terms of diagnosing and treating gynecological tumors, the associations between calcification and the different histologic stages and prognosis in gynecological tumors should be further studied. In particular, more attention should be paid to the morphological characteristics, chemical nature, and mechanism of calcifications in the gynecological tumor microenvironments.
尽管妇科肿瘤微环境中的钙化是一种常见现象,但医生和研究人员仍然忽视或忽略这个问题。事实上,这种妇科肿瘤微环境的变化具有重要的临床意义,许多研究已经报道了钙化与妇科肿瘤进展之间的关联。在卵巢癌中,钙化主要为砂粒体状,主要发生在浆液性乳头状卵巢肿瘤中。此外,卵巢癌中的钙化与较低的组织学分级相关,可能预示着生存率较低。在子宫肌瘤中,钙化发生为退行性变化,预示着预后良好。至于子宫内膜癌和宫颈癌,这些癌症中很少发生钙化。妇科肿瘤微环境中钙化的机制目前尚不清楚。一种理论认为钙化是由于肿瘤细胞的退化引起的;另一种理论认为钙化是对肿瘤微环境中细胞分泌的反应。尽管之前的研究已经揭示了钙化与妇科肿瘤之间的直接关联,但这种关联尚未得到充分阐明。为了更好地阐明钙化在诊断和治疗妇科肿瘤方面的意义,应该进一步研究钙化与妇科肿瘤不同组织学阶段和预后之间的关系。特别是,应该更加关注妇科肿瘤微环境中钙化的形态特征、化学性质和机制。