46例消化道来源卵巢转移性肿瘤的临床病理特征

摘要

目的 探讨三种不同病理类型的消化道来源卵巢转移性肿瘤(印戒细胞癌、腺癌、粘液性腺癌)的临床病理特征.方法 回顾性对比分析2009年1月-2012年8月就诊于吉林大学第二医院妇科的46例消化道来源卵巢转移性肿瘤-印戒细胞癌(18例)、腺癌(16例)、粘液性腺癌(12例)患者的临床病理特征.结果 所有患者的平均年龄为50岁(23-91).35例(76.1%)患者发现消化道原发灶,包括胃17例(48.6%),结直肠18例(51.4%).印戒细胞癌大多来源于胃 (93.8%),腺癌及粘液性腺癌的原发灶多位于结直肠(89.4%),两者比较具有统计学意义(P＝0.000).31例(67.4%)出现双侧卵巢转移,三者中分别有16例(88.9%)、7例(43.8%)、8例(66.7%),印戒细胞癌和腺癌比较有统计学意义(P＝0.000).三者中CK7表达阳性者分别为7例(7/8,87.5%)、2例(2/9,22.2%)、7例(7/11,63.6%),整体比较有统计学意义(P＝0.022),两两比较印戒细胞癌与腺癌有统计学意义(P＝0.015).CK7(+)/CK20(+) 在三者中分别为7例(87.5%)、2例(22.2%)、5例(45.5%),整体比较有统计学意义(P＝0.037),印戒细胞癌与腺癌比较有统计学意义(P＝0.015),印戒细胞癌与(腺癌+粘液性腺癌)比较有统计学意义(P＝0.033).CK7(-)/CK20(+)在三者中分别为1例(12.5%)、6例(66.7%)、4例(36.4%),三者比较无统计学意义(P＝0.079).结论 印戒细胞癌多来源于胃,多CK7(+)/CK20(+),常见双侧转移.腺癌多来源于结直肠,多CK7(-)/CK20(+).粘液性腺癌多来源于结直肠.%Objective To analyze and summarize the clinical and pathological features of three kinds of different pathological metastatic ovarian tumors (signet ring cell carcinoma, gland carcinoma, mucous adenocarcinoma) , which from digestive tract. Methods Patients with ovarian metastases from digestive tract which were treated in the Second Hospital of Ji-lin University from Jan. 2009 to Aug. 2012 were retrospectively collected. A total of 46 cases were identified and pathological types were signet ring cell carcinoma(18 cases), gland carcinoma(16 cases) , mucous adenocarcino-ma(12 cases). The pathological and clinical features were evaluated. Results All patients with an average age of 50 years old (23 - 91). 35 cases (76. 1%) patients found the primary focal of digestive tract,including 17 cases (48. 6%) from stomach, 18 cases (51. 4%) from colorcctal. Signet ring cell carcinoma were largely originated from the stomach (93. 8%) ,adenocarcinoma and mucous adenocarcinoma's primary focal is located in colorcctal (89. 4%) mostly,both of which have statistical significance (P=0. 000). Tumor of both ovaries was found in 31 cases, accounting for 67. 4% (31/46) , there were 16 cases (88. 9%) ,7 cases (43. 8%) ,8 cases (66. 7%) respectively , there is statistically significant between signet ring cell carcinoma and adenocarcinoma (P = 0. 000). Of the three types CK7 were expressed positively in 7 cases (7/8,87. 5%) ,2 cases (2/9,22. 2%) ,7 cases (7/11 ,63. 6%) respectively,overall comparison have statistical significance (P=0. 022) ,there is statistical significance between signet ring cell carcinoma and adenocarcinoma (P= 0.015). There were 7 cases (87. 5%), 2 cases (22. 2%), 5 cases (45. 5%) expressed CK7( ± )/CK20( ± ) re-spectivcly,overall comparison have statistical significance (P= 0. 037),there is statistical significance between signet ring cell carcinoma and adenocarcinoma (P = 0. 015) ,and between signet ring cell carcinoma and (adcnocarcinoma±mucous adenocarcinoma) (P = 0. 033). CK7 (-)/CK20 ( ± ) in three types is expressed in 1 case (12. 5%), 6 cases (66.7%),and 4 cases (36. 4%) respectively, there is no statistical significance overall comparison (P = 0. 079).rnConclusion Signet ring cell carcinoma is more from stomach,more expressed CK7( ± )/CK20( ± ) ,and more bilateral. Adenocarcinoma is more from colorectal and more expressed CK7(-)/CK20( ± ). Mucous adenocarcinoma is more from colorectal.