Ordóñez N G, Sahin A A
University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Hum Pathol. 1998 Mar;29(3):294-9. doi: 10.1016/s0046-8177(98)90050-8.
Serum assays for CA 125 are often used in the diagnosis and follow-up of patients with gynecologic neoplasms. A case of a 34-year-old woman with desmoplastic small round cell tumor (DSRCT) having an unusual morphology, including the presence of a signet ring cell component, and high serum CA 125 levels that was initially diagnosed as poorly differentiated carcinoma of the ovary is herein reported. Ultrastructurally, the signet ring appearance was shown to be the result of either the presence of intracytoplasmic vacuoles or dilatation of the intercellular space. Immunoperoxidase staining showed strong reactivity for desmin, keratin, vimentin, and CA 125. Immunohistochemical studies were performed on six additional DSRCTs but only two showed focal staining for CA 125. Because the patient's CA 125 serum level decreased after she received chemotherapy and her tumor was removed, and it became elevated again when the disease recurred, it is possible that CA 125 could be used as a marker of persistent and recurrent disease in those uncommon cases of DSRCT in which there are elevated serum levels of this marker at the onset of treatment.
血清CA 125检测常用于妇科肿瘤患者的诊断和随访。本文报告了一例34岁患有促纤维增生性小圆细胞瘤（DSRCT）的女性病例，该肿瘤具有不寻常的形态，包括印戒细胞成分，且血清CA 125水平较高，最初被诊断为卵巢低分化癌。超微结构显示，印戒样外观是由于胞质内空泡的存在或细胞间隙扩张所致。免疫过氧化物酶染色显示对结蛋白、角蛋白、波形蛋白和CA 125有强烈反应。对另外6例DSRCT进行了免疫组织化学研究，但只有2例显示CA 125局灶性染色。由于患者接受化疗并切除肿瘤后血清CA 125水平下降，而疾病复发时该水平再次升高，因此在那些治疗开始时血清该标志物水平升高的罕见DSRCT病例中，CA 125有可能用作持续性和复发性疾病的标志物。
