Zhou J, Iwasa Y, Konishi I, Kan N, Kannagi R, Kobashi Y, Kim Y C, Yamabe H
Department of Gynecology and Obstetrics, Kyoto University Hospital, Japan.
Cancer. 1995 Aug 1;76(3):429-36. doi: 10.1002/1097-0142(19950801)76:3<429::aid-cncr2820760313>3.0.co;2-8.
Papillary serous carcinoma of the peritoneum (PSCP) is a primary peritoneal tumor in women that histologically resembles papillary serous carcinoma of the ovary (PSCO). Recognition of PSCP as an entity is controversial, as is the histogenesis, histopathologic differential diagnosis, and treatment.
Ten cases of PSCP retrieved from the pathology files of 4 hospitals in Kyoto and Nara, Japan, were studied clinicopathologically and immunohistochemically.
Patient ages at presentation ranged from 40 to 74 years (median, 56 years). All patients were Asian (Japanese). None of the patients had a history of asbestos exposure. Most of the patients had abdominal swelling, ascites with positive cytology, and elevated serum CA125. At surgery, omental tumors with dissemination to the abdominal and pelvic peritoneum were found in all patients. The histology was similar to that of Grade 2 to 3 PSCO. Immunohistochemical studies using a panel of monoclonal antibodies against carbohydrates showed that Lewis Y is a good marker, in addition to S-100, placental alkaline phosphatase, CA125, and CD15 for separating PSCP from malignant mesothelioma (MM). With cytoreductive surgery and cisplatin-based combination chemotherapy and in some cases adoptive immunotherapy and radiation, a median survival of 27 months and a 5-year survival rate of 27% were attained. One patient with Grade 3 tumor has survived for more than 6 years after surgery.
(1) Papillary serous carcinoma of the peritoneum is a definite clinicopathologic entity; (2) immunohistochemistry is a useful tool for distinguishing PSCP from MM; (3) cytoreductive surgery and cisplatin-based combination chemotherapy with other adjunct therapies such as immunotherapy and radiation may improve patient survival in PSCP.
腹膜乳头状浆液性癌（PSCP）是一种女性原发性腹膜肿瘤，其组织学表现类似于卵巢乳头状浆液性癌（PSCO）。PSCP作为一个独立的疾病实体的认知存在争议，其组织发生、组织病理学鉴别诊断及治疗均存在争议。
对从日本京都和奈良4家医院病理档案中检索出的10例PSCP病例进行临床病理及免疫组化研究。
患者就诊时年龄为40至74岁（中位数为56岁）。所有患者均为亚洲人（日本人）。无一例患者有石棉暴露史。大多数患者有腹部肿胀、腹水且细胞学检查阳性以及血清CA125升高。手术时，所有患者均发现大网膜肿瘤并已播散至腹盆腔腹膜。组织学表现与2至3级PSCO相似。使用一组针对碳水化合物的单克隆抗体进行的免疫组化研究表明，除了S-100、胎盘碱性磷酸酶、CA125和CD15外，Lewis Y是将PSCP与恶性间皮瘤（MM）区分开来的良好标志物。通过细胞减灭术和顺铂为基础的联合化疗，以及在某些情况下的过继性免疫治疗和放疗，中位生存期达到27个月，5年生存率为27%。1例3级肿瘤患者术后存活超过6年。
（1）腹膜乳头状浆液性癌是一个明确的临床病理实体；（2）免疫组化是区分PSCP与MM的有用工具；（3）细胞减灭术和顺铂为基础的联合化疗以及免疫治疗和放疗等其他辅助治疗可能改善PSCP患者的生存。
