摘要目的观察卵巢转移癌的临床资料、病理形态和免疫组织化学改变，为鉴别卵巢转移癌与原发癌提供依据。方法对27例卵巢转移癌(其中胃癌12例，结肠癌11例，其他4例)进行了临床和病理形态观察，同时采用免疫组织化学（SP法）对其分别进行细胞角蛋白［CK（AE1/AE3)］、细胞角蛋白7 （ CK7）、细胞角蛋白20（CK20）、癌胚抗原、波形蛋白、nm23抗原检测。结果卵巢转移性胃癌12例中11例为双侧实性，卵巢转移性结肠癌11例中7例为单侧囊实性。组织学检查胃癌卵巢转移12例全部以印戒细胞癌或低分化腺癌散在分布为特征，而结肠癌卵巢转移则11例中8例与子宫内膜样癌相似。CK20阳性染色使卵巢转移性胃癌7例及结肠癌8例得到明确诊断，在转移性结肠癌中CK20有稳定的表达。卵巢转移性胃肠道癌中CK7多数阴性。癌胚抗原、波形蛋白、nm23的联合使用使转移性胃癌11例，结肠癌10例得到明确诊断。结论 C K7和CK20在鉴别来自胃肠道的卵巢转移癌中具有重要意义，当几种抗体联合使用时意义更大。

abstractsObjective　 To study the distinctive clinicopathologic and immunohis tochemical difference between ovarian metastatic carcinomas and primary ovarian carcinom as. Methods　 The clinical and pathological features of 27 cases of ovaria n metastatic carcinomas (gastric carcinomas 12 cases, colon carcinomas 11 cases, others 4 cases) obtained from our department were reviewed. Immunostaini ngs for CK(AE1/AE3), CK7, CK20,CEA, vimentin, nm23 were performed with SP staini ng methods. Results　 On gross examination, metastasis from gastric adenocarcinoma were usually bilateral, while solid (11/12) and metastases from colonic adenoca rcinoma were more often unilateral and cystic (7/11). Microscopically, metastases fr om gastric adenocarcinoma revealed signet ring cells or poorly differentiated adenocarcinom as (12/12), whereas metastases from colonic adenocarcinomas showed similar morph ology of endometrioid adenocarcinoma (8/11). The majority of ovarian metastases of gastr ic car cinoma (7/12) and colon carcinoma (8/11) were CK20 positive. In particular, CK20 was invariably expressed in colon cancer metastases. Most of the ovarian metastatic carcinomas from the gastrointestinal tract failed to react with immunostaining of CK7. A combined use of CEA, vimentin and nm23 had made a correct classification for 11/ 12 cases of the gastric carcinoma, 10/11 cases of the colonic cancer. Conclusions　 CK7 and CK20 have been proved to be useful antibodies in distinguishing b etween metastatic carcinomas and primary carcinomas of the ovary. Combined use of a panel of antibodies can give more significant results.