卵巢粘液性肿瘤凝集素受体组织化学研究

应用ＡＢＣ亲和组化技术研究了卵巢粘液性瘤的１１种凝集素受体分布。肿瘤和ＰＮＡ（花生），ＳＪＡ（槐）和ＤＢＡ（双花）结合后，粘液性囊腺瘤仅部分瘤细胞顶部的细胞膜和胞浆均匀着色，而交界性囊腺和腺癌细胞浆内分别可见阳性染色颗粒，肠化型粘液腺瘤的阳性反应率高于颈管型粘液腺瘤（Ｐ＝０．０５）。     

卵巢浆液性肿瘤中MCM4与Ki-67的表达及意义

目的 探讨微小染色体维持蛋白4(minichromosome maintenance proteins 4,MCM4)、Ki-67在卵巢浆液性肿瘤中的表达及意义.方法 采用免疫组化EliVision两步法检测MCM4、Ki-67蛋白在10例正常卵巢上皮组织(对照组)、19例卵巢良性浆液性嚢腺瘤、16例交界性浆液性肿瘤和43例浆液性腺癌中的表达.结果 MCM4在对照组、卵巢良性浆液性囊腺瘤、交界性浆液性肿瘤、浆液性腺癌的阳性表达率分别为10.00%、21.05%、43.75%、79.07%,Ki-67在对照组、卵巢浆液性乳头状腺瘤、交界性嚢腺瘤、浆液性腺癌的阳性表达率分别为10.00%、15.79%、25.00%、53.49%,其随着卵巢肿瘤病变的升级呈增高的趋势.MCM4在卵巢浆液性腺癌和交界性浆液性肿瘤中的表达与正常对照组相比差异具有统计学意义(P<0.05).Ki-67在卵巢浆液性癌和交界性浆液性肿瘤中的表达与正常对照组相比差异具有统计学意义(P<0.05).MCM4在卵巢浆液性癌中的表达与临床分期、病理分级及转移[淋巴结转移和(或)器官转移]有明显相关(P<0.05).Ki-67蛋白在卵巢浆液性癌中的表达与病理分级及淋巴结转移有明显相关(P<0.05),MCM4和Ki-67呈正相关.结论 MCM4、Ki-67为卵巢浆液性肿瘤的增殖指标,用于卵巢良、恶性肿瘤的鉴别和诊断,并可初步评估肿瘤预后,指导临床治疗.     

前列腺癌的神经内分泌分化

一、良性前列腺中的神经内分泌细胞 正常前列腺主要由分泌细胞和基底细胞组成,可在HE染色下由普通显微镜分辨。另外还有散在微量的神经内分泌细胞（neuroendocfine cell,NE细胞）,该细胞仅能由电镜分辨,或者通过免疫组织化学方法用特异性标记物如嗜铬粒素A（CgA）、突触素（Syn）、神经元特异性烯醇化酶（NSE）等识别。前列腺的NE细胞具有上皮性、神经性和内分泌性特征,散在分布于前列腺,但在移行区和外周区比在中心区更多见。NE细胞的这种分布,可能与前列腺增生和前列腺癌有关。     

卵巢上皮性肿瘤肠粘液抗原的癌胚抗原的免疫组织化学研究

应用两种肠粘液抗原和ＣＥＡ对７８例卵巢上皮性肿瘤石蜡标本进行免疫组分染色。三种抗原在良性和交界性肿瘤以腔缘分布为主，可见恶性肿瘤腔缘，胞浆弥漫分布并随组织学级的增高趋向于胞浆分布；三种抗原的阳笥率在浆液性癌和粘液性癌中的判别不显著，但ＣＥＡ在浆性癌中表达强度低于粘液性癌；在子宫内膜样癌中三抗原之阳性率和表达强度均较低，故可以辅助鉴别浆液性癌，粘液性癌和宫内膜样癌。     

卵巢粘液性肿瘤组化和免疫组化研究

对50例卵巢粘液性肿瘤进行组化和免疫组化研究。良性、交界性和恶性3组肿瘤酸性粘蛋白的含量和粘蛋白的分布范围形成鲜明对比;在甲苯胺蓝异染性方面有明显差异。这对鉴别卵巢粘液性肿瘤良、恶性有参考价值。3组肿瘤免疫组化阳性反应的程度无明显差异,腺癌分化的程度与CEA细胞阳性率不呈正相关。表明CEA染色不能判断卵巢粘液性肿瘤的恶性程度。正常卵巢组织CEA阴性,如果良性肿瘤内CEA含量较多,从生物化学上已暗示可能己越出良性范畴,但在组织学上尚未表现出来。应注意随访。     

卵巢Brenner肿瘤的临床病理分析

目的:探讨卵巢Brenner肿瘤的临床病理特征、免疫表型、诊断及鉴别诊断.方法:回顾性分析21例卵巢Brenner肿瘤的临床资料、组织学形态、免疫表型,并复习相关文献.结果:21例卵巢Brenner肿瘤患者均为成年女性,年龄为28～76(平均52)岁,其中13例(61.9％)已绝经,8例(38.1％)未绝经.囊实性肿物...     

卵巢上皮性肿瘤神经内分泌细胞增殖与凋亡研究

目的： 观察卵巢上皮性肿瘤组织中神经内分泌细胞（NECs）的形态特点及增殖与凋亡状况，以探讨其生物学及临床意义。 方法： 手术切除的卵巢上皮性肿瘤标本79例，其中良性20例，交界性18例，恶性41例，正常卵巢组织22例作对照，采用嗜铬素A（CgA）免疫组化染色显示NECs，并进行CgA/Ki67及TUNEL/CgA双重染色，观察NECs的增殖与凋亡状况。 结果： 卵巢上皮性肿瘤组织NECs的阳性率、分布范围及染色强度均高于正常卵巢组织。卵巢上皮性肿瘤中NECs形态多样，具有神经元样突起，延伸到毗邻细胞或基底膜，NECs之间亦有突起相互接触。双重免疫组化染色显示NECs均呈TUNEL染色阴性，部分细胞Ki67染色阳性。 结论： 卵巢上皮性肿瘤组织中NECs与肿瘤细胞一样可增殖，但不发生凋亡，其分泌产物可促进周围非NECs的增殖，抑制其凋亡。     

卵巢Brenner肿瘤24例临床病理分析

目的 探讨卵巢Brenner肿瘤(Brenner tumor,BT)的临床病理学特征、治疗及预后.方法 回顾性分析2013年3月 ～2020年3月南京医科大学附属无锡妇幼保健院收治的24例卵巢BT患者的临床资料、病理学特征及免疫表型,并复习相关文献.结果 24例BT中16例(66.7％)为良性BT,7例(29.2％)为...     

Intestinal differentiation in ovarian mucinous tumours

Summary Fifty-five ovarian mucinous tumours, 22 benign, 16 borderline and 17 malignant, were examined for intestinal differentiation (ID). This was defined by the presence of one or more of endocrine, absorptive, goblet or Paneth cells, and identified by routine haematoxylin and eosin as well as histochemical and immunoperoxidase techniques. Twenty benign (91%), 14 borderline (88%) and all malignant tumours contained foci of ID. The frequency of ID was not significantly different between the mucinous tumour types (chi-squared test for independence). Follow-up was available on all patients with borderline tumours: 14 were stage Ia, including both cases without ID, and 2 were stage Ic at presentation. All are alive and free of disease at 9–39 months (median 15.5 months). We conclude that the presence of ID in borderline mucinous tumours is unlikely to be of prognostic significance, and that a subdivision of these tumours into müllerian and intestinal types is unnecessary.Preliminary results were presented at the second meeting of the International Gynaecologic Cancer Society, October 1989     

卵巢浆液性和粘液性交界瘤的临床病理分析

目的：观察卵巢交界瘤的临床病理学特点,探索肿瘤不同组织学改变的意义。方法：对45例卵巢浆液性和粘液性交界瘤进行回顾性分析,肿瘤分期按国际妇产科联合会（FIGO）标准,Ⅰ期34例,Ⅱ期4例,Ⅲ期7例。结果：45例卵巢浆液性和粘液性交界瘤占同期卵巢上皮恶性肿瘤的25．4％,浆液性同粘液性交界瘤的比为1：1．3,11例生长于卵巢表面的浆液性交界瘤中,9例出现腹膜种植,2例为浸润性种植,7例为非浸润性种植。2例浆液性交界瘤和1例粘液性交界瘤分别于术后5、4和1年复发。33例交界瘤经2－9年随访,按Kaplan-Meier法5年生存率为100％。结论：卵巢浆液性交界瘤预后较好,卵巢表面生长的浆液性交界瘤常伴有腹膜种植。     

卵巢粘液性肿瘤组织发生的初步探讨

目的：初步探讨卵巢粘液性肿瘤（ＯＭＴ）的组织发生。方法：用组织化学染色方法观察９１例ＯＭＴ上皮的粘液分泌。按粘液性质将上皮分为３型：胃型、肠型和中间型。并将肿瘤分为简单型及混合型。结果：良性５６例中,４５例为混合型,其中２２例由３种上皮成份组成,２３例含２种上皮,另有１１例为简单型。中间型、胃型及肠型３种上皮在良性肿瘤中的出现频率分别是４０／５６、３５／５６、２９／５６。２１例交界性、１４例恶性Ｏ     

The role of intratumoral lymphovascular density in distinguishing primary from secondary mucinous ovarian tumors

OBJECTIVE:

Ovarian mucinous metastases commonly present as the first sign of the disease and are capable of simulating primary tumors. Our aim was to investigate the role of intratumoral lymphatic vascular density together with other surgical-pathological features in distinguishing primary from secondary mucinous ovarian tumors.

METHODS:

A total of 124 cases of mucinous tumors in the ovary (63 primary and 61 metastatic) were compared according to their clinicopathological features and immunohistochemical profiles. The intratumoral lymphatic vascular density was quantified by counting the number of vessels stained by the D2-40 antibody.

RESULTS:

Metastases occurred in older patients and were associated with a higher proportion of tumors smaller than 10.0 cm; bilaterality; extensive necrosis; extraovarian extension; increased expression of cytokeratin 20, CDX2, CA19.9 and MUC2; and decreased expression of cytokeratin 7, CA125 and MUC5AC. The lymphatic vascular density was increased among primary tumors. However, after multivariate analysis, the best predictors of a secondary tumor were a size of 10.0 cm or less, bilaterality and cytokeratin 7 negativity. Lack of MUC2 expression was an important factor excluding metastasis.

CONCLUSIONS:

The higher intratumoral lymphatic vascular density in primary tumors when compared with secondary lesions suggests differences in the microenvironment. However, considering the differential diagnosis, the best discriminator of a secondary tumor is the combination of tumor size, laterality and the pattern of expression of cytokeratin 7 and MUC2.     

卵巢浆液性交界及恶性肿瘤K-ras基因突变分析

目的探讨K-ras基因在卵巢浆液性交界及恶性肿瘤发生发展过程中的作用。方法收集51例卵巢浆液性肿瘤标本,包括经典型交界性浆液性肿瘤18例,微乳头型交界性浆液性肿瘤11例,浸润性微乳头型浆液性癌12例,经典型浆液性癌10例。采用显微切割技术获取肿瘤细胞后,提取基因组DNA、PCR技术扩增K—ras基因第一外显子,通过直接测序的方法鉴定K—ras基因第12、13密码子的突变情况。结果1例经典型交界性浆液性肿瘤K—ras基因第12密码子发生突变,突变类型为GGT→GTT即甘氨酸→缬氨酸,余50例标本未见突变;所有标本K—ras基因第13密码子均为野生型。结论K—ras基因第12、13密码子在被检患者中卵巢浆液性交界及恶性肿瘤中的突变频率很低,其在该肿瘤发生发展过程中可能不起主要作用。     

叶酸受体α在卵巢上皮性肿瘤中的表达

目的 探讨卵巢上皮性肿瘤中叶酸受体(FR)α的表达及其临床病理学意义.方法 制备包括86例卵巢癌及29例卵巢交界性肿瘤的组织芯片,采用免疫组织化学EnVision法检测上述肿瘤组织中FRα的表达情况,同时采用即时PCR检测40例新鲜冷冻卵巢癌组织以及14例卵巢交界性肿瘤组织中FRα mRNA的表达情况.分析卵巢上皮性肿瘤中FRα表达水平与肿瘤的组织类型、不同发病模式以及临床分期的关系.结果 免疫组织化学染色结果显示,86例卵巢癌中有40例(46.5%)对FRα呈明确阳性反应,其中浆液性癌阳性表达率最高,为62.7%(32/51),高于其他组织类型的癌(P=0.000).按照卵巢癌发病模式区分,Ⅱ型卵巢癌FRα的表达明显高于Ⅰ型卵巢癌,差异具有统计学意义(P=0.001).卵巢癌组FRα表达阳性率高于交界性肿瘤(46.5%∶27.6%),但差异无统计学意义(P=0.074).卵巢癌组FRα的表达与临床分期无相关性(P=0.498).相似的结果也见于采用即时PCR检测FRα mRNA的表达情况:卵巢癌组FRα mRNA表达值高于交界性肿瘤组(P=0.000),在交界性肿瘤中,浆液型mRNA表达值高于黏液型,差异具有统计学意义(P=0.007).结论 卵巢上皮性肿瘤中FRα呈高表达,特别是在恶性肿瘤和浆液性肿瘤中.     

卵巢上皮性肿瘤肠粘液抗原和癌胚抗原的免疫组织化学研究

应用两种肠粘液抗原（ＬａｒｇｅＩｎｔｅｓｔｉｎａｌＭｕｃｉｎｏｕｓＡｎｔｉｇｅｎ，ＬＩＭＡ，ＳｍａｌｌＩｎｔｅｓｄｔｉｎａｌＡｎｔｉ－ｇｅｎ，ＳＩＭＡ）和ＣＥＡ对７８例卵巢上皮性肿瘤石蜡标本进行免疫组化染色。三种抗原在良性和交界性肿瘤中以腔缘型分布为主，可见恶性肿瘤腔缘、胞浆弥漫分布并随组织学分级的增高趋向于胞浆分布；三种抗原的阳性率在浆液性癌和粘液性癌中的差别不显著，但ＣＥＡ在浆液性癌中表达强度低于粘液性癌（Ｐ＜０．０５）；在子宫内膜样癌中三抗原之阳性率和表达强度均较低，故可以辅助鉴别浆液性癌、粘液性癌和官内膜样癌。ＣＥＡ和ＬＩＭＡ大量出现于癌细胞内的肿瘤更具侵袭性，易致肿瘤扩散转移，预后较差。     

Morphology of borderline mucinous ovarian tumors

The examination of structures of the tumor tissues taken from 47 patients with borderline mucinous tumours of the ovary showed that the tumors belonging to this group, like their serous analogues, were an indistinctly limited nosological entity that characterizes a particular stage in the malignant transformation of the epithelium as evidenced by a wide range of structures that are interchangable from mucinous adenofibroma to mucinous carcinoma. Death may result from pseudomyxoma or dissemination that follows the pattern seen in cancer. The latter generally stems from small-sized areas of occult cancer which are detectable from a retrospective analysis of the material available. Intraoperative laceration of the tumor makes no contribution to the occurrence of peritoneal pseudomyxoma. The results of the histochemical study into the mucosa indicated that the tumor cells were heterogeneous in mucosaccharides. The cells which were completely free from acid fractions in the presence of neutral mucins were identified. Disregarding the features indicated, one can reasonably reject the fact that the neoplasm is of mucinous character as judged from alcian blue-stained specimens.     

卵巢癌血管生成的多样性

新血管生成在个体发育、创伤愈合等过程中起着至关重要的作用,也是肿瘤生存、转移、复发的组织基础[1].研究表明,少数极恶性肿瘤存在血管生成(angiogenesis)、血管形成(vasculogenesis)和血管生成拟态(vasculogenic mimicry)等方式,多种血管新生方式与肿瘤的转移、复发等恶性生物行为密切相关.卵巢癌的死亡率在女性生殖道癌瘤中居首位,患者5年生存率长期徘徊在30%左右,最新研究证实,卵巢恶性肿瘤血管生成具有多样性,本文将就卵巢癌不同血管生成方式的研究进展及其与卵巢恶性生物学行为的关系进行综述.