Fukunaga M, Ushigome S
Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.
Mod Pathol. 1998 Aug;11(8):784-8.
Little is known concerning epithelial metaplastic changes (metaplasia) in ovarian endometriosis. Three hundred fifteen consecutive cases of ovarian endometriosis between 1987 and 1995 were retrieved from hospital files and clinicopathologically analyzed. Two hundred fifty-seven cases were not associated with malignant ovarian epithelial tumor or atypia Four cases were atypical endometriosis. The remaining 54 cases were associated with malignant ovarian epithelial tumor, including borderline tumor. Metaplasias in ovarian endometriosis were observed in 162 (63%) cases not associated with malignant epithelial tumor or atypia. Ciliated cell and eosinophilic metaplasias were the most common (44%, respectively), followed by hobnail (13%) and mucinous (4%) types. Metaplasias in endometriosis were observed in all of the four atypical endometriosis cases and all of the 54 cases with malignant ovarian epithelial tumor. Among these cases, ciliated cell and eosinophilic metaplasia were also the most common. There was no correlation between types of carcinoma and types of metaplasia in endometriosis, but in all of the four Müllerian mucinous borderline tumors, ovarian endometriosis with mucinous metaplasia and hyperplasia was contiguous or intimately associated with the tumor. Metaplasia was often observed in ovarian endometriosis and most frequently was associated with malignant ovarian epithelial tumor or atypia. Metaplastic changes in ovarian endometriosis should not be interpreted as neoplastic features. Mucinous metaplasia and hyperplasia in ovarian endometriosis might be closely associated with the development of Müllerian mucinous borderline tumors.
关于卵巢子宫内膜异位症中的上皮化生改变（化生），人们了解甚少。从医院档案中检索出1987年至1995年间连续的315例卵巢子宫内膜异位症病例，并进行临床病理分析。257例与恶性卵巢上皮肿瘤或异型性无关。4例为非典型子宫内膜异位症。其余54例与恶性卵巢上皮肿瘤相关，包括交界性肿瘤。在162例（63%）与恶性上皮肿瘤或异型性无关的卵巢子宫内膜异位症病例中观察到化生。纤毛细胞化生和嗜酸性化生最为常见（分别为44%），其次是鞋钉样化生（13%）和黏液性化生（4%）。在所有4例非典型子宫内膜异位症病例和所有54例伴有恶性卵巢上皮肿瘤的病例中均观察到子宫内膜异位症中的化生。在这些病例中，纤毛细胞化生和嗜酸性化生也最为常见。子宫内膜异位症中的癌类型与化生类型之间无相关性，但在所有4例苗勒管黏液性交界性肿瘤中，伴有黏液性化生和增生的卵巢子宫内膜异位症与肿瘤相邻或密切相关。化生在卵巢子宫内膜异位症中常可见，且最常与恶性卵巢上皮肿瘤或异型性相关。卵巢子宫内膜异位症中的化生改变不应被解释为肿瘤特征。卵巢子宫内膜异位症中的黏液性化生和增生可能与苗勒管黏液性交界性肿瘤的发生密切相关。
