Dvoretsky P M, Richards K A, Angel C, Rabinowitz L, Stoler M H, Beecham J B, Bonfiglio T A
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York 14642.
Hum Pathol. 1988 Jan;19(1):57-63. doi: 10.1016/s0046-8177(88)80316-2.
Clinical and morphologic factors that affected the distribution of disease are described in 100 cases of ovarian cancer at autopsy. In addition to the expected pattern of pelvic and abdominal peritoneal spread, extensive visceral parenchymal metastases were seen: liver parenchyma (45%), lung parenchyma (39%), small and large intestinal wall (52% and 55%), lymph nodes (70%), pancreas (21%), ureter (24%), bone (11%), and brain (6%). Liver parenchymal metastases replaced more than one third of the liver in 25% of cases, whereas lung metastases always involved less than one third of the lungs. When intestinal wall invasion was seen, bowel obstruction was present more often (71%) than when only intestinal serosa was involved (30%). Lymphatic invasion was predictive of lymph node, small intestinal wall, pancreatic, and liver as well as lung parenchymal metastases. Blood vessel invasion was predictive of pancreatic and ureteral metastases. Clinical stage I at diagnosis was associated with high incidences of liver parenchymal (56%), lymph node (56%), lung parenchymal (44%), large intestinal wall (33%), and bone (33%) metastases. Thus, ovarian cancer has parenchymal metastases similar to other carcinomas in addition to its peritoneal spread. Lymphatic and blood vessel invasion is predictive of such involvement. Intestinal wall invasion predicts bowel obstruction.
在100例卵巢癌尸检病例中描述了影响疾病分布的临床和形态学因素。除了盆腔和腹腔腹膜扩散的预期模式外，还发现了广泛的内脏实质转移：肝实质（45%）、肺实质（39%）、小肠和大肠壁（52%和55%）、淋巴结（70%）、胰腺（21%）、输尿管（24%）、骨（11%）和脑（6%）。25%的病例中肝实质转移取代了超过三分之一的肝脏，而肺转移总是累及不到三分之一的肺。当观察到肠壁侵犯时，肠梗阻的发生率（71%）比仅累及肠浆膜时（30%）更高。淋巴管侵犯可预测淋巴结、小肠壁、胰腺、肝脏以及肺实质转移。血管侵犯可预测胰腺和输尿管转移。诊断时的临床I期与肝实质（56%）、淋巴结（56%）、肺实质（44%）、大肠壁（33%）和骨（33%）转移的高发生率相关。因此，卵巢癌除了腹膜扩散外，还具有与其他癌相似的实质转移。淋巴管和血管侵犯可预测这种受累情况。肠壁侵犯可预测肠梗阻。
