Guerrieri C, Högberg T, Wingren S, Fristedt S, Simonsen E, Boeryd B
Department of Pathology, University Hospital of Linköping, Sweden.
Cancer. 1994 Oct 15;74(8):2329-40. doi: 10.1002/1097-0142(19941015)74:8<2329::aid-cncr2820740818>3.0.co;2-g.
The morphologic spectrum of ovarian mucinous tumors is well known, but the features that predict aggressive behavior are still controversial.
Ninety-two cases of primary ovarian mucinous tumors with atypical epithelial proliferation and/or stromal invasion were analyzed histologically and by DNA flow cytometry, and the results were correlated with clinical findings.
The authors reviewed 57 intestinal mucinous borderline tumors (IMBT), 3 endocervical-like mucinous borderline tumors (EMBT), 21 noninvasive mucinous carcinomas (NIMC), and 11 invasive mucinous carcinomas (IMC). The 5-year survival rate for Stage I tumors was: IMBT 100%, EMBT 100%, NIMC 94% and IMC 60%. The 5-year survival of Stage II-IV tumors was: IMBT 50%, NIMC 33% and IMC 0%. Forty-four IMBTs were diploid, and 4 were aneuploid. All six high stage IMBTs were diploid. Two EMBTs were diploid, and one was aneuploid. There were seven diploid, four polyploid, and six aneuploid NIMCs. Two of the three lethal NIMCs were aneuploid. Four IMCs were diploid, and four were aneuploid. Of these, only the diploid Stage I IMCs were nonlethal. All NIMCs that recurred or presented with metastases had been sampled inadequately. High stage tumors with pseudomyxoma peritonei (PP)-type lesions often were associated with pseudomyxoma ovarii of the cellular type.
Mucinous tumors with stromal invasion or presenting with PP had a definite malignant behavior. All other atypical mucinous tumors, when confined to the ovary and optimally sampled, had an excellent prognosis. DNA ploidy analysis may prove useful in determining the risk of progression, especially in Stage I IMCs.
卵巢黏液性肿瘤的形态学谱已为人熟知，但预测侵袭性行为的特征仍存在争议。
对92例具有非典型上皮增生和/或间质浸润的原发性卵巢黏液性肿瘤进行组织学分析和DNA流式细胞术检测，并将结果与临床发现相关联。
作者回顾了57例肠型黏液性交界性肿瘤（IMBT）、3例宫颈内膜样黏液性交界性肿瘤（EMBT）、21例非侵袭性黏液癌（NIMC）和11例侵袭性黏液癌（IMC）。Ⅰ期肿瘤的5年生存率为：IMBT 100%，EMBT 100%，NIMC 94%，IMC 60%。Ⅱ - Ⅳ期肿瘤的5年生存率为：IMBT 50%，NIMC 33%，IMC 0%。44例IMBT为二倍体，4例为非整倍体。所有6例高分期IMBT均为二倍体。2例EMBT为二倍体，1例为非整倍体。有7例二倍体、4例多倍体和6例非整倍体NIMC。3例致死性NIMC中有2例为非整倍体。4例IMC为二倍体，4例为非整倍体。其中，仅Ⅰ期二倍体IMC无致死性。所有复发或出现转移的NIMC取材均不充分。伴有腹膜假黏液瘤（PP）样病变的高分期肿瘤常与细胞型卵巢假黏液瘤相关。
伴有间质浸润或出现PP的黏液性肿瘤具有明确的恶性行为。所有其他非典型黏液性肿瘤，当局限于卵巢且取材理想时，预后良好。DNA倍体分析可能有助于确定进展风险，尤其是在Ⅰ期IMC中。
