Ovarian Low-grade Serous Carcinoma A Clinicopathologic Study of 33 Cases With Primary Surgery Performed at a Single Institution
Ovarian Low-grade Serous Carcinoma A Clinicopathologic Study of 33 Cases With Primary Surgery Performed at a Single Institution
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DOI：
10.1097/pas.0000000000000615
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发表时间：
2016-05-01
影响因子：
5.6
通讯作者：
Malpica, Anais
中科院分区：
文献类型：
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作者：
Okoye, Ekene;Euscher, Elizabeth D.;Malpica, Anais
卵巢低级别浆液性癌(LGSC)是一种具有鲜明病理和临床特征的实体。关于这类肿瘤的研究数量有限。在这篇文章中，我们报告了33例卵巢LGSC初次手术治疗的经验。为了进行比较，还研究了一组卵巢高级别浆液性癌(HGSC)。临床信息从患者的病历或从治疗医生那里获得。回顾28例LGSC的苏木精-伊红切片，记录下列参数：浆液性交界性肿瘤(SBT)的存在/不存在，微乳头/筛状结构(MP/CP)的存在/不存在，侵袭性成分的构筑模式，以及结缔组织增生或纤维化的存在/不存在。卵巢LGSC的发生率为4.7%。LGSC患者的年龄从19岁到79岁(平均52岁)，其中21.2%的患者年龄在40岁以下。HGSC患者年龄从38岁到90岁(平均62岁)，其中1.6%的患者年龄在40岁以下。LGSC分期如下：I期(2)、III期(23)、IV期(8)。33例LGSC中有28例合并SBT，其中15例合并SBT；占肿瘤的50%。另有19例出现MP/CP。侵犯类型包括小乳头(93%)、筛状巢(74%)、细长乳头(26%)、腺体(44.4%)、中型乳头(33.3%)、实心巢(22.2%)、大乳头(19%)和单细胞(19%)。此外，结缔组织增生症(44.4%)和纤维化(37%)也被发现。33例LGSC患者中有30例获得13~195个月(中位数61.2个月)的随访资料，其中18例(60%)死于疾病，1例(3.3%)死于其他原因，5例(16.7%)带病存活，6例(20%)无疾病迹象。对185例HGSC患者进行了1~169个月(中位48个月)的随访，其中132例(71.4%)死于疾病，3例(1.6%)死于其他原因，21例(11.4%)带病存活，29例(15.7%)无疾病迹象。卵巢LGSC是一种罕见的疾病，相对于HGSC而言，更倾向于年轻患者。大多数LGSC病例与伴有MP/CP的SBT相关，其侵袭性成分通常含有微乳头型。大多数卵巢LGSC患者表现为晚期疾病，与HGSC患者相比有短期生存优势(估计5年生存率：62.3%对43.9%)。然而，随着时间的延长，这种生存优势会下降(估计10年存活率：21.2%对22.7%)。
Ovarian low-grade serous carcinoma (LGSC) is an entity with distinct pathologic and clinical features. The number of studies on this type of tumor is limited. In this article, we present our experience with 33 cases of ovarian LGSC with primary surgical treatment at our institution. For comparison, a cohort of ovarian high-grade serous carcinoma (HGSC) was also studied. Clinical information was obtained from the patients' charts or from the treating physicians. Hematoxylin and eosin slides were reviewed of 28 available LGSCs, and the following parameters were recorded: presence/absence of a serous borderline tumor (SBT), presence/absence of micropapillary/cribriform pattern (MP/CP), architectural pattern in the invasive component, and presence/absence of desmoplasia or fibrosis. The incidence of ovarian LGSC was 4.7%. LGSC patients ranged in age from 19 to 79 years (mean, 52 y), with 21.2% younger than 40 years. HGSC patients ranged in age from 38 to 90 years (mean, 62 y), with 1.6% younger than 40 years. LGSCs were staged as follows: stage I (2), stage III (23), and stage IV (8). Twenty-eight of 33 LGSC cases had concurrent SBT, with this component accounting for > 50% of the neoplasm in 15 cases. In addition, MP/CP was noted in 19 cases. Invasion patterns included micropapillae (93%), cribriform nests (74%), elongated papillae (26%), glandular (44.4%), medium-sized papillae (33.3%), solid nests (22.2%), macropapillae (19%), and single cells (19%). In addition, desmoplasia (44.4%) and fibrosis (37%) were noted. Follow-up data ranging from 13 to 195 months (median 61.2 mo) were available on 30/33 LGSC patients: 18 (60%) were dead of disease; 1 (3.3%) was dead of other cause; 5 (16.7%) were alive with disease; and 6 (20%) had no evidence of disease. Follow-up data from 1 to 169 months (median 48 mo) were available on 185 HGSC patients: 132 (71.4%) were dead of disease; 3 (1.6%) were dead of other cause; 21 (11.4%) were alive with disease; and 29 (15.7%) had no evidence of disease. Ovarian LGSC is rare with a predilection for younger patients relative to HGSC. Most LGSC cases are associated with SBT with an MP/CP, and their invasive component usually contains a micropapillary pattern. Most patients with ovarian LGSC present with advanced-stage disease and have a short-term survival advantage over patients with HGSC (estimated 5 y survival: 62.3% vs. 43.9%). However, over a prolonged period of time, this survival advantage decreases (estimated 10 y survival: 21.2% vs. 22.7%).