Recurrent ovarian granulosa cell tumors: clinical and imaging features

Background Granulosa cell tumor of the ovary differs from epithelial ovarian tumors in histologic appearance, clinical course and imaging findings. The purpose of this study was to evaluate clinical and imaging features of recurrent ovarian granulosa cell tumors. Methods We performed retrospective evaluation of the medical, surgicopathologic records and CT or MR images of 11 patients with pathologically proven recurrent ovarian granulosa cell tumor. Results The first recurrence of granulosa cell tumor was diagnosed at between 4 months and 18 years after the initial surgical resection of tumor (mean; 9.7 years). Six patients relapsed after 10 years after initial diagnosis. The recurrent tumors were located in the pelvic cavity alone in three patients, extrapelvic peritoneal cavity alone in two, both pelvic and extrapelvic peritoneal cavity in three, and paraaortic retroperitoneal space in three. The imaging appearances of recurrent masses were variable ranging from solid masses to completely cystic masses. Conclusion Recurrent granulosa cell tumor is characterized by late tumor recurrence manifested as a relatively small number of discrete peritoneal or retroperitoneal masses with variable imaging appearances from solid to cystic masses.     

Virilizing tumors of the ovary: imaging features.

AIM: Virilizing tumors of the ovary are an uncommon cause of a common clinical problem. The reported imaging features of these tumors are based on case reports. The purpose of this study was to determine the spectrum of imaging characteristics of these tumors based on a larger referral population. PATIENTS AND METHODS: Case records from the Armed Forces Institute of Pathology were searched for clinical evidence of virilization as a presentation of an excised sex cord-stromal and steroid cell ovarian tumor. Records and imaging studies on 14 patients with virilizing tumors were found. All available imaging studies (ultrasound studies of the pelvis (11 patients), CT scans of the pelvis (five patients), MRI examinations of the pelvis (two patients), and plain films of the pelvis (four patients) were reviewed by three radiologists independently for ascites, calcification, percent solid portion, echogenicity and attenuation. RESULTS: On CT and/or ultrasound most (69%) of the tumors appeared to be solid or mostly solid. The amount of solid tissue varied with the tumor type, granulosa cell tumors were predominantly cystic. The masses were isoechoic (82%) or hypoechoic (18%). Ascites was an infrequent (23%) finding. Only a minority of these tumors (14%) were calcified on imaging studies. Six tumors were 5.0 cm or less in mean size, and two less than 3.0 cm in size. All cases were stage I tumors at presentation. CONCLUSION: The majority of virilizing tumors of the ovary are typically solid, noncalcified, confined to the ovary at presentation, and not associated with ascites. Variability in appearance depends in part on tumor type. Many are small and may be difficult to recognize as a mass morphologically.     

Fetal juvenile granulosa cell tumor with hermaphroditism verus - prenatal diagnosis, management and outcome

Fetal ovarian cysts are common during pregnancy and after delivery. Most of these cysts are simple cysts that involute during pregnancy or in the first months of life. However, complicated cyst with a heterogeneous structure and also possible and can result in various complications: rupture, hemorrhage, ascites, edema of the labia, compression of other viscera, and ovarian torsion. In this case report we describe rare diagnosis of a complicated fetal ovarian cyst with edema of the labia and moderate ascites. The neonate had ambiguous genitalia with clitoromegaly. The newborn underwent surgery with oophorectomy. During the operation a uterus with fallopian tubes was found. The pathological findings showed a juvenile granulosa cell tumor FIGO Ia. Karyotyping revealed a mosaic of 45, X/ 46, X mar (Y) in the peripheral blood as well as in the granulosa cell tumor. Because of a right side inguinal hernia, the child underwent a second surgery. Specimen taken from the abdominal gonad and the inguinal region showed testicular and dysplastic ovarian tissue. There were elevated levels of androgens in the child's peripheral blood due to the granulosa cell tumor. In summary, this case report describes a fetus with true hermaphroditism and a juvenile granulosa cell tumor diagnosed as a complicated ovarian cyst in the 32 (nd )week of pregnancy.     

4项凝血指标联合CA125检测对良恶性卵巢肿瘤辅助诊断的价值分析

目的探讨4项凝血指标凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)联合糖类抗原(CA)125检测对良恶性卵巢肿瘤辅助诊断的价值。方法比较62例卵巢癌患者(卵巢癌组)与62例良性肿瘤患者(良性肿瘤组),以及不同国际妇产科协会(FIGO)分期卵巢癌患者,不同病理类型卵巢癌患者中CA125、4项凝血指标水平;采用受试者工作特征(ROC)曲线分析联合检测对良恶性卵巢肿瘤辅助诊断的价值。结果卵巢癌组CA125、TT、FIB、D-D、PLT水平均明显高于良性肿瘤组,差异有统计学意义(P<0.05);卵巢癌早期(FIGO分期Ⅰ~Ⅱ期)患者CA125、FIB水平低于卵巢癌晚期(FIGO分期Ⅲ~Ⅳ期)患者,差异有统计学意义(P<0.05),而TT、D-D、PLT水平比较,差异无统计学意义(P>0.05)。不同病理类型患者之间CA125、D-D水平比较,差异有统计学意义(P<0.05);CA125、TT、FIB、D-D、PLT单项指标对于良恶性卵巢肿瘤具有辅助诊断价值,5项指标联合检测对卵巢癌诊断的ROC曲线下面积为0.982,特异度为100.00%,诊断价值更高。结论CA125及4项凝血指标联合检测比单项指标检测对良恶性卵巢肿瘤具有更高的辅助诊断价值。     

Ovarian dysgerminoma: a retrospective analysis of results of treatment, sites of treatment failure, and radiosensitivity

Thirty-five patients with a diagnosis of pure ovarian dysgerminoma underwent assessment at our institution between 1950 and 1984. The median age of these patients was 21 years (range, 8 to 41 years). The surgical pathologic stages of the tumors were as follows: stage IA1 in 18 patients, stage IA2 in 2, stage IB1 in 2, stage IC in 1, stage IIB in 2, stage III in 9, and stage IV in 1. The overall survival at 5, 10, and 20 years was 94.3%, 82.9%, and 82.9%, respectively, for all 35 patients and 100%, 83.9%, and 83.9%, respectively, for the 18 patients with stage IA1 lesions. The maximum interval from diagnosis to relapse was 3.7 years. All patients were under surveillance for a minimum of 2 years (median follow-up, 15.9 years). Of the 18 patients with stage IA1 disease, 16 did not receive prophylactic radiation therapy to the para-aortic lymph nodes, and in 6 of the 16 (38%) recurrent disease developed in this region. Five of these patients were salvaged with radiation therapy and one with radiation therapy and subsequent chemotherapy. No definite correlation was noted between the size or mass of the resected unilateral encapsulated tumor and the risk of development of recurrent disease. For patients with stage IA1 dysgerminoma who have undergone unilateral oophorectomy, two treatment options seem reasonable: (1) observation, with radiation therapy reserved for subsequent recurrence, or (2) prophylactic radiation therapy (2,000 cGy) to para-aortic and ipsilateral common iliac lymph nodes, which would preserve fertility.     

Data from small cell neuroendocrine carcinoma of the cervix: FIGO 2018 staging is more accurate than FIGO 2009

ObjectiveTo compare the prognostic value of International Federation of Gynecology and Obstetrics (FIGO) 2009 and 2018 staging systems in surgical patients with small cell neuroendocrine carcinoma of the cervix (SCNEC).MethodsWe re-staged 64 surgical IB–IIA (FIGO 2009) SCNEC patients according to the FIGO 2018 system and refined stage IIIC of FIGO 2018 based on tumor local invasion. The prognostic factors were analyzed, and the advantages of FIGO 2018 were compared with 2009.ResultsThe 5-year overall survival rate (OS) was 78.5% for stage I and 22.2% for stage II (FIGO 2009). In FIGO 2018, there was no difference between stage I and II, and the 5-year OS was 74.1%, 60.2%, and 0% for stage I/II, IIIC1, and IIIC2. After combining stage IIIC with the local invasion stage (T1 was limited to the cervix and vagina; T2 involved the parametrium; T3 involved the pelvic or abdominal cavity), the 5-year OS for stage IIICT1, IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively.ConclusionsFor stage II SCNEC patients, FIGO 2009 underestimated the prognosis, while FIGO 2018 was more accurate. For stage IIIC, FIGO 2018 might be more individualized and accurate after combining stage IIIC with tumor local invasion.     

The ultrastructure of selected gynecologic neoplasms

Several articles have been published recently that discuss the role of electron microscopy in the diagnosis and study of gynecologic neoplasms. It becomes apparent from those works and the review just presented that, although an ultrastructural study is not necessary for reaching a diagnosis of many of these tumors, it may be necessary or supportive in identifying the more poorly differentiated ones. Furthermore, electron microscopy is valuable in providing evidence for the histogenesis of some of these neoplasms. Unfortunately for the pathologist, a certain level of morphologic differentiation (and an absence of metaplasia) in a cell is usually necessary for these goals to be achieved. For example, an adenomatoid tumor (see the article by Dr. Srigley, Mr. Toth, and Mr. Edwards in this issue) of the fallopian tube can readily be accepted as being composed of mesothelial cells, because both the neoplastic cells and normal mesothelial cells have the same highly differentiated features of long, slender microvilli, prominent intercellular junctions, and many microfilaments. On the other hand, there is very little resemblance between the granulosa cells of a granulosa-cell tumor and mature mesothelial cells. Thus, if one of the theories of histogenesis of granulosa cells were correct--namely, that they are derived ultimately from mesothelial lining--the ultrastructural evidence would rest on recognizing a similarity between the two types of cells at an earlier stage of differentiation. The neoplastic granulosa cell has differentiated along a separate, specialized line in which the ultrastructural resemblance to the parent cell is partly, if not completely, lost. Another example of the type of information that electron microscopy can provide is in relation to the common epithelial tumors. There is good evidence that the serous tumors in this group arise from mesothelium, although ultrastructurally their differentiation has veered from a mesothelial direction to one in which the cells have a complement of organelles related to secretory activity. Paradoxically, the mucinous cystic tumors, which have been classified traditionally as tumors of surface epithelial origin, are now thought to be of germ-cell origin in some cases, as examples of monophyletic teratomas. The ultrastructural evidence for this conclusion rests on the presence of anchoring filaments in the microvilli of the neoplastic cells, similar to those of normal intestinal epithelium, and on an admixture of various types of gastrointestinal cells, including those that contain dense-core granules (argentaffin cells).(ABSTRACT TRUNCATED AT 400 WORDS)     

Tumor angiogenesis assessed by three-dimensional power Doppler ultrasound in early, advanced and metastatic ovarian cancer: A preliminary study.

OBJECTIVE: To evaluate tumor vascularity by three-dimensional power Doppler ultrasound (3D-PDU) in early and advanced stage primary ovarian cancers and in metastatic tumors to the ovary. PATIENTS AND METHODS: This was a retrospective analysis of clinical and sonographic data from 49 women with primary ovarian cancers or metastatic tumors to the ovary. All women underwent 3D-PDU prior to surgery. Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) from solid portions or papillary projections in the tumors were calculated using the Virtual Organ Computer-aided AnaLysis (VOCAL(trade mark)) program. Definitive histological diagnosis was obtained in each case. RESULTS: Among the 49 women, 10 had stage I primary cancers (five low-malignant potential tumors and five invasive tumors), 26 had advanced stage primary ovarian cancers and 13 had metastatic tumors to the ovary. Mean VI and VFI were significantly higher in advanced stage tumors and metastatic tumors as compared with early stage tumors. No differences in 3D-PDU indices were found between advanced stage and metastatic cancers. CONCLUSIONS: Vascular indices derived from 3D-PDU tend to be higher in advanced stage and metastatic ovarian cancers as compared with early stage ovarian tumors.     

卵巢非侵袭性低级别浆液性癌保留生育功能手术五例及文献复习

  目的  分析卵巢非侵袭性低级别浆液性癌(low-grade serous carcinoma, LGSC)患者保留生育功能手术的特点。  方法  回顾性收集2015年1月至2015年6月北京协和医院病理诊断为卵巢非侵袭性LGSC且进行保留生育功能手术的患者, 对其临床病理特点、手术过程和随访情况进行总结。  结果  共有5例非侵袭性LGSC且保留生育功能患者, 中位年龄29岁(24~34岁); 1例行开腹手术, 4例行腹腔镜手术; 4例手术行卵巢囊肿剔除, 1例患者因为卵巢急性扭转坏死行受累附件切除。1例国际妇产科联盟(International Federation of Gynecology and Obstetrics, FIGO)分期为IB期, 4例为IA期。所有患者术后均未接受进一步治疗。中位随访7个月(6~12个月), 所有患者均未复发, 1例患者自然受孕且母胎情况良好。  结论  对于非侵袭性LGSC患者, 能否保留生育功能、保留生育功能手术术后的生育情况、复发率及随诊方案, 仍是目前临床处理的棘手问题。本研究为年轻的非侵袭性LGSC患者提供了保留卵巢的选择, 但患者的长期预后(包括生育和生存)尚有待进一步随访。     

Clinicopathological features of gastric cancer cases and aberrantly expressed recoverin

Cancer-associated retinopathy (CAR) is an ocular manifestation of a paraneoplastic syndrome whereby immunological reactions toward recoverin, a retina-specific calcium binding protein, and other retinal antigens aberrantly expressed in tumor cells lead to the degeneration of retinal photoreceptor cells. Recently we reported that aberrant expression of recoverin was identified in more than 50% of tumor cells and their cell lines from several kinds of cancers, including gastric cancer, lung carcinoma, and other cancers. To elucidate the clinicopathological significance of aberrantly expressed recoverin in cancer cells, we performed immunocytochemical analysis using a monoclonal antibody against human recoverin. Within 18 patients with different clinical stages (I-IV) of gastric cancer, the aberrant expression of recoverin in tumor cells was recognized in 6 out of 18 patients (2 out of 2 stage IA, 1 out of 1 stage IB, 2 out of 3 stage II, 0 out of 7 stage IIIA, 0 out of 1 stage IIIB, and 1 out 4 stage IV). The present data are consistent in part with the previous observations that recoverin-expressing cancer cells induced tumor immunity and provide a favorable prognosis for primary cancer in CAR patients.     

An activating Pik3ca mutation coupled with Pten loss is sufficient to initiate ovarian tumorigenesis in mice

Mutations in the gene encoding the p110α subunit of PI3K (PIK3CA) that result in enhanced PI3K activity are frequently observed in human cancers. To better understand the role of mutant PIK3CA in the initiation or progression of tumorigenesis, we generated mice in which a PIK3CA mutation commonly detected in human cancers (the H1047R mutation) could be conditionally knocked into the endogenous Pik3ca locus. Activation of this mutation in the mouse ovary revealed that alone, Pik3caH1047R induced premalignant hyperplasia of the ovarian surface epithelium but no tumors. Concomitantly, we analyzed several human ovarian cancers and found PIK3CA mutations coexistent with KRAS and/or PTEN mutations, raising the possibility that a secondary defect in a co-regulator of PI3K activity may be required for mutant PIK3CA to promote transformation. Consistent with this notion, we found that Pik3caH1047R mutation plus Pten deletion in the mouse ovary led to the development of ovarian serous adenocarcinomas and granulosa cell tumors. Both mutational events were required for early, robust Akt activation. Pharmacological inhibition of PI3K/mTOR in these mice delayed tumor growth and prolonged survival. These results demonstrate that the Pik3caH1047R mutation with loss of Pten is enough to promote ovarian cell transformation and that we have developed a model system for studying possible therapies.     

腹腔镜治疗卵巢小肿物139例

目的：评价腹腔镜治疗卵巢小肿物的临床效果。方法：应用腹腔镜对139例5cm以下的卵巢小肿物进行诊断和治疗。结果：139例患者手术全过程在电视腹腔镜下完成。术后病理证实，卵巢赘生性肿物占71．2％（99／139）；非赘生性肿物占28．8％（40／139）。术后随访2～8年，32例有生育要求的患者，22例已足月分娩，3例在妊娠中，4例仍未妊娠，3例失访。42例巧克力囊肿患者，随访至今仅3例复发。结论：对卵巢赘生性肿物早期治疗可减少肿瘤组织对卵巢组织的破坏，这样可尽量多地保留正常卵巢组织。     

5种肿瘤标志物检测在卵巢肿瘤的临床意义

目的探讨血清CA125、CA724、CA199、CEA、AFP多种肿瘤标志物在卵巢肿瘤的临床意义与诊断价值。方法采用电化学发光方法检测45例卵巢上皮性癌患者2、1例卵巢恶性生殖细胞肿瘤患者,对照组为15例交界性卵巢上皮类肿瘤患者、56例卵巢良性肿瘤患者(上皮性及生殖性)、76例卵巢巧克力囊肿患者、23例附件脓肿患者血清CA125、CA724、CA199、CEA、AFP水平并进行比较。结果①卵巢癌患者五种肿瘤标志物均高于卵巢良性肿瘤(P0.01),CA125良性肿瘤与交界性肿瘤比较有统计学意义(P0.05),其余四种肿瘤标志物良性肿瘤与交界性肿瘤比较无统计学意义(P0.05)。②仅采用CA724与CA125相比时,则CA724在诊断卵巢癌的特异性高,而CA125灵敏性较高;在恶性卵巢上皮性肿瘤中,CA125在腹水阳性时升高明显,与腹水阴性有统计学意义(P0.05)。③CA199在上皮性粘液性腺癌明显升高,与浆液性腺癌有显著性差异(P0.05);AFP在恶性生殖类肿瘤异常升高,与上皮性恶性肿瘤有显著性差异(P0.05)。结论上述五种肿瘤标志物在诊断卵巢癌都有一定的临床意义。     

宫颈绒毛腺管状腺癌的临床病理

  目的  探讨宫颈绒毛腺管状腺癌的临床病理特征、诊断标准及预后。  方法  分析北京协和医院10例宫颈绒毛腺管状腺癌的临床病理表现, 临床资料包括年龄、症状、术前检查、国际妇产科联盟(International Federation of Gynecology Obstetrics, FIGO)分期、治疗方式及随访结果, 病理表现包括大体表现、颈管浸润程度、有无淋巴结转移及淋巴脉管内瘤栓、组织学分型、核异型性、核分裂及伴随病变。  结果  10例患者平均发病年龄为39岁; 8例FIGO分期Ib1, 1例IIa, 1例Ia1;手术方式为全子宫切除+盆腔淋巴结清扫术+双附件切除术/卵巢活检术; 术后平均随访29个月, 8例健康生存, 1例复发, 1例失访。大体观察, 5例呈息肉样或菜花状外生性肿物, 直径5~25 mm; 4例呈乳头状或细绒毛样粗糙区, 面积25 mm×14 mm至35 mm×20 mm; 1例术后转移病例表现为溃疡型肿物, 直径25 mm。镜下肿瘤浸润深度2~12 mm, 浸润宽度5~26 mm, 1例累及阴道后穹窿; 9例有轻-中度核异型性, 术后转移1例病例呈中-重度核异型性; 核分裂平均48个/10高倍视野(HPF); 9例伴有宫颈上皮内瘤变Ⅲ级(cervical intraepithelial neoplasia Ⅲ, CIN Ⅲ)和/或原位腺癌(adenocarcinoma in situ, ACIS), 2例同时伴有高分化黏液腺癌; 1例观察到宫颈壁内个别淋巴脉管内瘤栓。10例均未发现子宫体受累、盆腔淋巴结或卵巢转移。  结论  宫颈绒毛腺管状腺癌的预后整体较好。提示预后不良的病理指标除了宫颈管壁深层浸润、累及宫体、血管浸润、淋巴结转移外, 还包括肿瘤细胞重度异型性和/或合并其他恶性程度更高的肿瘤成分。     

卵巢粘液性肿瘤细胞基质MMP-9的表达及其临床意义

目的：研究卵巢粘液性肿瘤组织中细胞外基质金属蛋白酶-9(MMP-9)的表达及其与临床病理因素的关系。方法：通过免疫组织化学方法检测43例卵巢粘液性囊腺瘤MMP-9的表达情况。结果：MMP-9在粘液性囊腺瘤中无表达，在交界性粘液性囊腺瘤及粘液性囊腺癌中的阳性率分别为22．2％、55．2％；MMP-9的表达与粘液性囊腺癌的组织学分级、FIGO分期及术后复发和死亡有密切关系。2例交界性粘液囊腺瘤MMP-9阳性，同时这2例出现复发。结论：MMP-9表达与卵巢粘液性囊腺瘤的恶性程度有关，可望作为交界性粘液性囊腺瘤及粘液性囊腺癌的诊断和分级的客观指标，并协助临床估计预后。     

Sclerosing stromal tumor of the ovary: color Doppler findings.

The sclerosing stromal tumor (SST) of the ovary is a distinct benign neoplasm that differs from fibromas, thecomas, luteinized tumors and lipoid cell tumors. It accounts for 6% of ovarian stromal tumors and tends to occur at an earlier age. On gray-scale ultrasound examination, SSTs of the ovary are solid or cystic and multilocular. We describe here, we believe for the first time, the findings on color Doppler imaging of an SST of the ovary. A 29-year-old woman presented with an organic ovarian mass. She underwent a transvaginal ultrasound examination that revealed an echogenic cyst with acoustic shadowing. Color Doppler demonstrated marked peripheral vascularization. Findings on computed tomography and magnetic resonance imaging strongly suggested the preoperative diagnosis of SST of the ovary, which was confirmed at pathology. Association of an echogenic ovarian mass with acoustic shadowing and a high degree of peripheral vascularization may strongly suggest the diagnosis of SST of the ovary.     

儿童卵巢幼年颗粒细胞瘤超声表现及病理对照研究

目的探讨儿童卵巢幼年颗粒细胞瘤（JGCTs）超声表现及病理特征。 方法回顾性分析2005年1月至2020年12月经重庆医科大学附属儿童医院手术病理证实为JGCTs的14例患儿的临床资料。依据国际卵巢肿瘤分析组织（IOTA）标准对瘤体超声图像进行模式分型,并与术后组织病理结果进行对照分析。 结果14例患儿肿瘤最大径线范围37~286 mm,最大径线平均值（105±56）mm。超声声像图表现为：实性6例（42.9%）、多房囊实性4例（28.6%）、单房囊实性1例（14.3%）、多房囊性2例（14.3%）以及单房囊性1例（7.1%）。病理结果显示,实性包块由大量颗粒细胞弥漫增生形成,其间伴有散在大小不等滤泡、坏死出血及纤维条索组织。多房囊实性、单房囊实性、多房囊性及单房囊性肿瘤内均可见数量不一的大滤泡,滤泡内大多数为颗粒细胞分泌的嗜碱性、嗜酸性液体。临床表现为乳房增大5例（35.7%）,阴道出血及分泌物5例（35.7%）;超声提示子宫增大10例（71.4%）。所有患儿术前血清雌二醇水平均升高,均值（534.0±839.5）pmol/L。 结论JGCTs超声表现多样,实性和多房囊实混合性更常见,其病理特征为大量颗粒细胞弥漫增生伴散在大小不等滤泡,超声表现结合内分泌临床表现及血清雌二醇的升高有助于临床诊断。     

卵巢组织中 M1/M2 巨噬细胞特征分子标志基因表达与组织分化程度的相关关系简

目的 探讨卵巢癌组织中M1/M2巨噬细胞特征分子诱生型一氧化氮合成酶（iNOS）、白介素12（IL-12）和Arg-1、CD206基因表达与肿瘤临床分级和组织分化程度之间的关系.方法 运用实时荧光定量逆转录PCR法检测114例卵巢癌患者组织中M1型巨噬细胞标志IL-12、iNOS以及M2型巨噬细胞标志Arg-1、CD206的基因转录情况,并分析其与临床分期和组织学分级之间的关系.结果①在高分化卵巢癌患者肿瘤组织中M1型巨噬细胞分子标志IL-12（68.4%）、iNOS（84.2%）基因的表达率高于中低分化卵巢癌（38.9%,42.1%,P＜0.001）;②在 FIGOⅠ＋Ⅱ期患者肿瘤组织中M2型巨噬细胞的标志Arg-1（41.5%）、CD163（46.3%）的表达率低于Ⅲ＋Ⅳ期患者（64.4%,76.7%,P＜0.001）.③高分化程度与高iNOS（r=0.609,P＜0.01）,IL-12（r=0.578,P＜0.01）基因表达率有关;高FIGO分期与高Arg-1（r=0.692,P＜0.01）和CD206（r =0.607,P＜0.01）基因表达率有关.结论 卵巢癌患者肿瘤组织中同时有M1型和M2型巨噬细胞特征基因的表达,M1型特征基因表达与高组织分化程度相关,M2型特征基因表达与高FIGO分期相关.