摘要
探讨卵巢成熟型囊性畸胎瘤(MCT)恶变为鳞状细胞癌(SCC)和原发性卵巢鳞状细胞癌(POSCC)的临床病理学特征。回顾性分析5例卵巢鳞状细胞癌(OSCC)患者的临床及病理特征、免疫表型和预后,并对其中1例POSCC进行二代测序(NGS),分析其分子遗传学特征。5例OSCC(4例卵巢MCT恶变为SCC、1例POSCC)患者年龄为43~68岁。累及双侧卵巢者1例,左侧者1例,右侧者3例。肿瘤常规镜检组织学示4例由卵巢MCT和浸润性SCC等两种成分构成,1例仅见SCC成分,周围未见伴发病变。免疫表型示5例癌组织p40、细胞角蛋白5/6(CK5/6)、p63均为阳性,2例p53阳性,增殖细胞相关核抗原(Ki-67)指数为30%~50%。1例POSCC的NGS检测存在12个体细胞突变,其中3个具有明确或潜在临床意义,包括BRCA1基因(p.G263fs)、TP53基因(p.R273C)、ERBB2基因(拷贝数扩增)。4例患者行卵巢癌减灭术,1例行卵巢癌根治术,术后辅以铂类药物为主的联合化疗。随访3~10个月,3例死亡,1例存活,1例失访。OSCC发病率低,主要来源于畸胎瘤恶变,POSCC罕见。OSCC治疗以完整手术切除为主,术后辅以铂类药物为主的联合化疗,临床进展迅速,预后差。
To explore the clinical and pathological characteristics of squamous cell carcinoma arising in ovary mature cystic teratoma(MCT)and primary ovarian squamous cell carcinoma(POSCC).Retrospective analysis was conducted on the clinical and pathological characteristics,immunophenotype and prognosis of five cases of ovarian squamous cell carcinoma(OSCC).Next generation sequencing(NGS)test was performed on one case of POSCC to analyze its molecular genetic characteristics.The age of five patients(including four MCTs and one POSCC)ranged from 43 to 68 years.There were one case of simultaneous involvement of both ovaries,one case of left ovary,and three cases of right ovary.Microscopically,four cases of tumors were composed of MCT and squamous cell carcinoma.Among which,one case only showed squamous cell carcinoma components and no accompanying lesions were found in the surrounding area.Immunohistochemistry staining showed that all cases were positive for p40,CK5/6,p63;P53 was positively expressed in two cases;and the proliferation index Ki-67 ranged from 30%to 50%.One POSCC NGS test harbored 12 somatic mutations,among which 3 mutations with clear or potential clinical significance were BRCA1 gene(p.G263fs),TP53 gene(p.R273C),and ERBB2 gene(copy number amplification).Four patients underwent ovarian cancer debulking surgery;one patient underwent radical resection of ovarian cancer and platinum-based chemotherapy was given after surgery.During 3-10 months of follow-up,3 patients died;1 patient was alive;and 1 patient was lost to follow-up.OSCC is a kind of ovarian cancer with low incidence rate.Most of these tumors arise from malignant transformation of MCT.POSCC is extremely rare.The treatment mainly involves surgical resection,supplemented by platinum-based combination chemotherapy after surgery.OSCC progresses rapidly,and has a poor prognosis.
作者
展瑞
姚义兴
巩婵婵
张永胜
邓立峰
Zhan Rui;Yao Yixing;Gong Chanchan;Zhang Yongsheng;Deng Lifeng(Department of Pathology,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou 215200,China; Department of Pathology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China; Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第34期3252-3255,共4页
National Medical Journal of China
关键词
畸胎瘤
卵巢鳞状细胞癌
原发性
病理特征
Teratoma
Ovarian squamous cell carcinoma
Primary
Pathological features
作者简介
通信作者:邓立峰,Email:348049831@qq.com
