卵巢原发与转移性粘液腺癌的鉴别──HID－AB、GOS、ConA粘液染色法

 卵巢原发与转移性粘液腺癌的鉴别，目前尚无较客观的标准。为寻找出较客观的鉴别标准，以分析其各自粘液性状为目的。本文采用粘液组织化学方法、分别对卵巢原发粘液性腺癌与大肠原发腺癌进行了对照观察。结果发现卵巢原发粘液性腺癌的粘液所见为：1.粘液量丰富，Sialo粘液优势。2.具有胃腺窝上皮型和幽门腺型特定型粘液。以上结果发现HID-AB,GoS,ConA粘液染色法可以作为比较客观的，准确的鉴别手段应用于临床病理诊断中。     

卵巢原发与转移性粘液腺癌的鉴别

卵巢原发与转移性粘液腺癌的鉴别ｇｉ卵巢原发粘液性腺癌．粘液量丰富，淡染的为Ｓｉａｌｏｍｕｃｉｎ，浓染的为ｓｕｌｆｏｍｕｃｉｎ．（ＨＩＤ—ＡＢ染色，Ｘ１００）；９２大肠原发腺癌．粘液量少，浓染的为ｓｕｌｆｏｍｕｃｉｎ．（ＨＩＤ—ＡＢ染色，Ｘ１００）；８...     

血清CA125、CA199、CA153在卵巢浆、粘液性囊腺癌诊断和动态观察中的价值

目的：探讨血清中ＣＡ１２５、ＣＡ１９９、ＣＡ１５３对卵巢癌浆、粘液性囊腺癌的诊断和动态观察中的价值。方法：采用微粒子酶免疫测定法，于术前对４５例卵巢浆、粘液性囊腺癌和２３例附件良性疾病患者血清中的ＣＡ１２５、ＣＡ１９９、ＣＡ１５３水平进行测定，以观察其在诊断上的敏感性和特异性。对１８例卵巢浆液囊腺癌和１５例粘液囊腺癌行上述三种抗原作治疗中的动态观察，以探讨其价值。结果：此三项指标对浆、粘液卵巢癌诊断的敏感性和特异性，ＣＡ１２５分别为７３．３％和５０．０％；ＣＡ１９９为４２．２％和７７．３％；ＣＡ１５３为１５．６％和９０．９％。卵巢癌液囊腺癌ＣＡ１２５阳性率为１００％，明显高于粘液腺癌（Ｐ＜０．０１）；而卵巢粘液囊腺癌ＣＡ１９９阳性率为７８．３％明显高于浆液腺癌（Ｐ＜０．０１）；ＣＡ１５３在两癌中的阳性率分别为１３．６％及１７．４％，两者无差异性（Ｐ＞０．０５）。治疗中动态观察显示，ＣＡ１２５与ＣＡ１９９对卵巢浆、粘腺癌经满意手术和术后１～２疗程有效化疗后的患者，可降至正常；对术中有较大残留灶者两抗原值虽有下降，但常未能达正常；对复发患者，其值亦升高。结论：ＣＡ１２５和ＣＡ１９９均是卵巢浆、粘液囊腺癌诊断和监     

MG系列单克隆抗体在卵巢癌早期诊断中的意义

 应用ABC免疫组化方法和MG系列胃肠道单克隆抗体对99例卵巢肿瘤组织进行了免疫组化染色。结果表明:29例粘液性囊腺癌MG抗原阳性率为89.6%，26例卵巢转移癌(16例胃腺癌转移卵巢，8例直肠粘液癌术后转移卵巢，2例子宫内膜癌转移卵巢)MG抗原阳性率为95.1%，20例粘液性腺瘤MG抗原阳性率为15%；24例浆液性腺癌则MG抗原均为阴性；10例正常卵巢对照片MG均为阴性，统计学处理表明，粘液性囊腺癌和转移癌与其余各组比较，MG有显著差别(P<0.01)，因而，以上这些提示:由于卵巢粘液性囊腺癌与胃肠道粘液癌的粘液成份相似，加之MG的阳性染色，更进一步证实了消化道粘液癌与卵巢粘液癌之间肿瘤相关抗原的存在，且我们可用MG单克隆抗体鉴别原发性卵巢粘液性囊腺癌和浆液性囊腺癌。又由于MG在粘液性腺瘤中阳性率是15%，在正常卵巢组织中MG均为阴性，提示我们MG单克隆抗体对卵巢癌的早期诊断有一定的临床意义。     

MG系列单克隆抗体在卵巢癌早期诊断中的意义

应用ABC免疫组化方法和MG系列胃肠道单克隆抗体对99例卵巢肿瘤组织进行了免疫组化染色。结果表明:29例粘液性囊腺癌MG抗原阳性率为89.6％,26例卵巢转移癌(16例胃腺癌转移卵巢,8例直肠粘液癌术后转移卵巢,2例子宫内膜癌转移卵巢)MG抗原阳性率为95.1％,20例粘液性腺瘤MG抗原阳性率为15％;24例浆液性腺癌则MG抗原均为阴性;10例正常卵巢对照片MG均为阴性,统计学处理表明,粘液性囊腺癌和转移癌与其余各组比较,MG有显著差别(P<0.01),因而,以上这些提示:由于卵巢粘液性囊腺癌与胃肠道粘液癌的粘液成份相似,加之MG的阳性染色,更进一步证实了消化道粘液癌与卵巢粘液癌之间肿瘤相关抗原的存在,且我们可用MG单克隆抗体鉴别原发性卵巢粘液性囊腺癌和浆液性囊腺癌。又由于MG在粘液性腺瘤中阳性率是15％,在正常卵巢组织中MG均为阴性,提示我们MG单克隆抗体对卵巢癌的早期诊断有一定的临床意义。     

原发性肺腺癌的粘液组织化学研究

目的：研究原发性肺腺癌产生粘液物质的类型、性质及分布。方法：收集２２例原发性肺腺癌进行五种粘液组化染色，ＡＢｐＨ２．５，ＡＢｐＨ１．０，ＨＩＤ－ＡＢｐＨ２．５，ＡＢｐＨ２．５－ＰＡＳ，ＰＡＳ－Ｄ。结果：２２例均见粘液细胞型粘液，２１例邮被膜型粘液（两者主要为唾液酸粘液），１０例见到腺腔型粘液（硫酸粘液为主）。不同类型不同性质粘液可共存于同一肺腺癌中。结论：被膜型粘肺腺癌一种独立类型粘液，与粘液细胞     

血清CA125,CA199,CA153在卵巢浆,粘液性囊腺癌诊断和动态观察中的价值

目的：探讨血清ＣＡ１２５、ＣＡ１９９、ＣＡ１５３对卵巢癌浆、粘液性囊腺癌的诊断和动态观察中的价值。方法：采用微粒子酶免疫测定法，于术前对４５例卵巢浆、粘液性囊腺癌和２３例附件良性疾病患者血清中的ＣＡ１２５、ＣＡ１９９、ＣＡ１５３水平进行测定，以观察其在诊断上的敏感性和特异性。对１８例卵巢浆液囊腺癌和１５例粘液囊腺癌行上述三种抗原作治疗中的动态观察，以探讨其价值。结果：此三项指标对浆、粘液卵巢癌诊断     

改良的抑制素放射免疫测定及其对卵巢肿瘤的监测作用

目的研究并应用一种改良的抑制素（Ｉｎｈｉｂｉｎ，ＩＮＨ）放射免疫测定（ＲＩＡ）。方法对卵巢颗粒细胞瘤、卵泡膜细胞瘤及卵巢上皮性肿瘤等多种卵巢肿瘤进行监测。结果１．卵巢颗粒细胞瘤、卵泡膜细胞瘤和卵巢粘液性囊腺癌及恶性畸胎瘤患者血浆ＩＮＨ浓度均值高于其他肿瘤患者，差异非常显著，Ｐ＜０．０１。２．卵巢颗粒细胞瘤、卵泡膜细胞瘤和粘液性囊腺癌及内膜样癌患者血浆ＩＮＨ值术前异常升高，术后一周降至正常范围，并可动态监测病情变化。结论１．改良的ＩＮＨＲＩＡ方法方便、省时、定量、敏感性高。２．ＩＮＨ可作为卵巢肿瘤的良好监测指标，与ＣＡ┐１２５联合应用，将有助于卵巢癌的早期诊断、治疗及随访     

C－erbB＿2、p53、p21在卵巢粘液性癌表达及其临床意义的研究

本实验对５０例卵巢粘液性囊腺癌中Ｃ－ｅｒｂＢ２（ｎｅｕ）癌基因，ｐ５３抗癌基因、ｐ２１蛋白（ｒａｓ基因产物）的表达进行研究，观察其在卵巢癌、交界性瘤、良性瘤的表达率，并采用半定量的ＡＢＣ免疫组化染色方法，研究不同强度表达与病理分化、临床分期、预后关系，得到初步结果。Ｃ－ｅｒｂＢ２在卵巢粘液癌中表达４８％，其限性表达率及表达强度与预后和病理分化有关。ｐ５３在卵巢粘液癌中表达４Ｏ％，但其表达率、表达强度与预后、手术分期和病理分化无明显相关性。ｐ２１在粘液癌中表达１２％，其表达率及强度与预后和病理分化无明显关系。在交界瘤、良性瘤中无表达。     

胰腺囊性病变的鉴别诊断与治疗

胰腺囊性病变绝大部分是假性囊肿（ＰＣ）,１０％为胰管来源的囊性肿瘤,主要是浆液性囊腺瘤（ＳＣＡ）和粘液性囊性肿瘤（ＭＣＮ）,后者包括粘液性囊腺瘤（ＭＣＡ）和粘液性囊腺癌（ＭＣＡＣ）。近年逐渐被证实的胰管内乳头状粘液瘤（ＩＰＭＴ）亦可产生胰管囊性损害〔...     

结直肠黏液腺癌与非黏液腺癌化疗疗效差异及其机制

结直肠癌的病理类型众多,而黏液腺癌是结直肠癌中一种特殊的病理类型。与结直肠非黏液腺癌相比,黏液腺癌的化疗疗效通常不理想,两者疗效差异的机制可能与结直肠黏液腺癌的分子生物学特征及黏液的物理性质有关。本文对结直肠黏液腺癌和非黏液腺癌化疗疗效差异及其机制作一综述,以期对临床上结直肠黏液腺癌的治疗起到积极的指导作用。     

TNM Stages and Prognostic Features of Colorectal and Mucinous Adenocarcinoma Patients: a Meta Analysis

Aim: The significance of the mucinous adenocarcinoma in TNM staging and prognosis for colorectal tumorpatients is still controversial. The aim was to provide a meta-analysis for TNM staging and prognostic featuresof colorectal tumors. Methods: 30 individual case-control studies were finally included into this meta-analysis,involving a total of 444,489 cancer cases and 45,050 mucinous adenocarcinomas, of relations with TNM stagingand prognostic features. Results: Compared to non-mucinous adenocarcinoma patients, the TNM IV stageaccounted for a larger percentage of mucinous adenocarcinomas (OR=1.48, 95%CI 1.28-1.71, POR<0.001) andthe prognosis was significantly poor (HR=1.06, 95%CI 1.04-1.08, P<0.001). After heterogeneity testing, the resultswas similar to the holistic approach outcome (HR=1.48, 95%CI 1.35-1.62, P<0.001). Conclusion: Compared topatients with non-mucinous adenocarcinomas, mucinous adenocarcinoma patients with later TNM staging makeup a big percentage, and mucinous adenocarcinoma is an independent risk factor for poor prognosis.     

PAX2, PAX8 and CDX2 Expression in Metastatic Mucinous,Primary Ovarian Mucinous and Seromucinous Tumors and Review of the Literature

Ovarian cancer is the most common cause of gynecologic cancer death. Both morphologically and immunohistochemically, metastatic mucinous tumors are the best mimickers of mucinous ovarian tumors; its pathogenesis still remains a mystery. PAX2 and PAX8 immunohisyochemistries are useful for differentiating numerous primary tumour types from metastatic ones. There are few studies in literature about PAX expressions in mucinous and seromucinous tumors. None of these are takes into account the histologic type (whether it is seromucinous or mucinous) or the metastatic origin. With this purpose hematoxylin and eosine slides of ovarian mucinous and seromucinous tumors were re-evaluated and one block was chosen for each case. The study included 76 ovarian mucinous and seromucinous tumors of the ovary reported in Hacettepe University department of pathology between 2000 and 2013. Tissue microarray (TMA) was designed from the chosen blocks, PAX2, PAX8, CDX2 immunostains was preformed to the TMA slides. As a result, most of the metastatic cases were negative for PAX2 (91.2 %) and PAX8 (86.3 %), many were diffusely and strongly positive for CDX2 (68.2 %). Seromucinous tumors were devoid of CDX2 expression; but all cases (except one) displayed strong and diffuse positivity with PAX8. In other words differing from mucinous tumors, seromucinous tumors show strong PAX8 positivity–similar to serous tumors. This study shows that PAX8 and CDX2 could be useful in differentiating primary mucinous from metastatic tumor. Furthermore unlike the homogeneity in seromucinous tumors for PAX8 and CDX2 mucinous tumors shows heterogeneity with different expression patterns.     

Advanced stage mucinous adenocarcinoma of the ovary is both rare and highly lethal

BACKGROUND:

Primary mucinous adenocarcinomas of the ovary are uncommon, and their biological behavior is uncertain. Retrospective studies have suggested that many mucinous carcinomas initially diagnosed as primary to the ovary have in fact metastasized from another site. A prospective randomized trial provided an opportunity to estimate the frequency of mucinous tumors, diagnostic reproducibility, and clinical outcomes.

METHODS:

A phase 3 trial enrolled 4000 women with stage III or IV ovarian carcinoma, treated by surgical staging and debulking, with randomization to one of five chemotherapeutic arms. Slides and pathology reports classified as primary mucinous carcinoma were reviewed independently by three pathologists. Cases were reclassified as primary or metastatic to the ovary according to two methods. Overall survival (OS) of reclassified groups was compared within the groups and with that of patients with serous carcinomas.

RESULTS:

Forty‐four cases were classified as mucinous adenocarcinoma upon review. Using either method, only about one third were interpreted by the three reviewers as primary mucinous carcinomas. Reproducibility of interpretations among the reviewers was high, with unanimity of opinion in 30 (68%) cases. The median survival (MS) did not differ significantly between the groups interpreted as primary or metastatic, but the OS was significantly less than that for women with serous carcinoma (14 vs 42 months, P < 0.001).

CONCLUSION:

Advanced stage mucinous carcinoma of the ovary is very rare and is associated with poor OS. Many mucinous adenocarcinomas that are diagnosed as primary ovarian neoplasms appear to be metastatic to the ovary. Cancer 2011. © 2010 American Cancer Society.     

Whole-genome allelotyping identified distinct loss-of-heterozygosity patterns in mucinous ovarian and appendiceal carcinomas.

PURPOSE: Mucinous adenocarcinoma of the ovary is one of the common histologic types of ovarian cancer. Its pathogenesis is largely unknown. In addition, the differential diagnosis of metastatic mucinous carcinomas to the ovaries, particularly those originating from the appendix, remains challenging. The purpose of this study is to identify molecular biomarkers for mucinous ovarian adenocarcinoma and compare them with those of appendiceal origin. EXPERIMENTAL DESIGN: Genome-wide loss-of-heterozygosity (LOH) analysis was done on DNA isolated from 28 microdissected primary mucinous ovarian carcinomas and five appendiceal adenocarcinomas. Markers from high-loss regions were selected for further analysis on a total of 32 ovarian and 14 appendiceal cancers. RESULTS: High levels of LOH rates (>40%) were detected on chromosome arms 9p, 17p, and 21q in mucinous ovarian carcinoma cases. The frequency of allelic loss was similar between high-grade and low-grade mucinous ovarian carcinoma cases but was significantly higher in ovarian versus appendiceal cases. In addition, LOH rates on five chromosomal loci were statistically different between ovarian and appendiceal carcinomas. CONCLUSION: A high frequency of LOH can be found in mucinous ovarian adenocarcinomas independent of grade. Despite histologic similarities between mucinous ovarian carcinomas and metastatic appendiceal carcinomas, they have distinct LOH profiles, which may be used for distinguishing the two diseases.     

ras and myc analysis in primary and metastatic colorectal carcinomas

Paired primary colorectal adenocarcinoma and normal frozen tissue samples from 60 patients were prospectively studied to determine the frequency of point mutations in K-ras and the occurrence of structural alterations in c-myc. Parallel investigations were performed on liver metastatic specimens from 16 of the patients. 47% of the primary tumors presented point mutations in K-ras; 71% of these were in codon 12. Significant associations were found between codon 13 ras mutations and Dukes' D stage (p<0.05), and between mutations in codon 12 and mucinous type (p<0.01). The c-myc gene structure was altered in 5/60 cases (8%). In 4/16 cases, the K-ras gene status in the primary carcinoma and in the metastatic tissue from the same patient was found to be different. Our results suggest that codon 13 I-as mutations may be associated with an increased invasive and metastatic potential, while codon 12 mutations may have a role in the mucinous differentiation pathway.     

MEK1在结直肠癌中表达及临床意义的研究

Objective: The aim of this study was to investigate the relationship between expression of MEK1 protein in the mitogen-activated protein kinase (MAPK) signaling pathway and liver as well as lymph node metastasis in colorectal cancer patients.Methods: Immunohistochemistry was performed to detect the expression of MEK1 protein in primary cancer, normal colonic mucosa, lymph nodes and liver metastatic foci from 86 colorectal cancer patients.Life table analysis was employed to evaluate the association between MEK1 expression and patients' survival.Results: The positive rate of MEK1 expression in the primary cancer, normal colonic mucosa, metastatic lymph nodes and liver metastatic foci was 52.3%, 32.6%, 71.4% and 78.3%, respectively.The positive rate of MEK1 expression in the primary cancer, metastatic lymph nodes and liver metastatic foci was significantly higher than that in the normal colonic mucosa (P < 0.01).Furthermore, the positive rate of MEK1 expression in stage III and IV colorectal cancer patients was dramatically higher than that in stage I and II colorectal cancer patients (P < 0.01).The positive rate of MEK1 expression in patients with poorly differentiated adenocarcinoma and mucinous adenocarcinoma was significantly higher than patients with well or moderately differentiated adenocarcinoma (P < 0.01).The 3-year disease-free survival rate was 41.3% in MEK1 positive patients and 73.1% in MEK1 negative patients.The survival rate of MEK1 positive patients was significantly lower than that of MEK1 negative patients (P < 0.05).Conclusion: The increased expression of MEK1 was associated with lymph node metastasis and liver metastasis of colorectal cancer.Therefore, detection of MEK1 expression may have important significance in the evaluation of patients' prognosis.     

Metastatic mucinous ovarian cancer and treatment decisions based on histology and molecular markers rather than the primary location

Approximately 22,000 cases of ovarian cancer occur each year in the United States, and likely fewer than 2000 cases of mucinous ovarian cancers. Although 90% of patients with mucinous ovarian cancer present with stage I disease and have curative surgeries, advanced-stage disease is known to have a poor response to standard platinum- and taxane-based chemotherapy. Despite limited enthusiasm, standard chemotherapy is still recommended for most patients with advanced-stage mucinous malignancies of the ovary. This report presents an unusual case of a woman with HER2-positive metastatic mucinous carcinoma of the ovary treated with chemotherapy regimens typically used for colorectal malignancies, followed by epidermal growth factor receptor-targeted therapies.     

Adjunct to the diagnostic distinction between adenocarcinomas of the ovary and the colon utilizing a monoclonal antibody (COL-4) with restricted carcinoembryonic antigen reactivity

Malignant ovarian tumors may represent either primary ovarian cancers or metastatic lesions (from patients with demonstrated primary cancers at other body sites) whose distinction may be difficult using clinical, surgical, and pathological criteria. Monoclonal antibody (MAb) COL-4, reactive with carcinoembryonic antigen, has previously been shown to react preferentially with adenocarcinomas of the colon versus a variety of normal tissues. We report here that MAb COL-4 is strongly reactive with primary colonic carcinomas (N = 50), as well as regional (N = 42), and distant (N = 20) metastases of colonic adenocarcinoma. In contrast, MAb COL-4 demonstrated little to no reactivity with primary (N = 53) and metastatic carcinomas of the ovary (N = 23) including serous, mucinous, and poorly differentiated adenocarcinomas using immunohistochemical techniques. This differential reactivity was statistically significant (P less than 0.001), suggesting the potential clinical utility of MAb COL-4 in the differentiation of ovarian from colonic adenocarcinoma. Solid-phase quantitative radioimmunoassays and Western blotting techniques confirmed these results. Data are also presented that the carcinoembryonic antigen molecules or epitopes recognized by a more classical broadly reactive anti-carcinoembryonic antigen MAb are distinct from those recognized by MAb COL-4. Other carcinomas which also metastasize to the ovary and may be confused clinically with a primary ovarian tumor such as adenocarcinomas of the stomach and breast were also evaluated for reactivity with MAb COL-4. COL-4 was also reactive with all gastric carcinomas evaluated, but failed to react with breast carcinomas. Hence, COL-4 can now be utilized as an immunohistochemical adjunct for the differentiation of ovarian from gastrointestinal adenocarcinoma which can be difficult to distinguish by clinical, surgical, and histological parameters.