摘要目的 探讨卵巢原发性类癌的临床病理学特征、诊断及鉴别诊断.方法 回顾性分析2007至2017年间复旦大学附属肿瘤医院收治的15例卵巢原发性类癌患者的临床病理资料,行光镜观察和免疫组织化学检测.结果 3例为岛状类癌,1例小梁状类癌,1例黏液性类癌,10例甲状腺肿类癌.岛状类癌和小梁状类癌形态与其他部位的相同起源的神经内分泌肿瘤类似,甲状腺肿类癌由不同比例的甲状腺组织与类癌成分构成.类癌成分多为混合性类癌,以小梁状类癌多见,黏液性类癌形态与Krukenberg瘤类似,极难鉴别.所有的类癌至少表达1 种神经内分泌标志物,以突触素及CD56的表达比例最高,分别为14/14及9/10. 14例获得术后随访资料,中位随访时间53个月,除1例黏液性类癌患者过世,1例合并宫颈鳞状细胞癌患者术后37个月阴道残端复发,其余患者均无病生存.结论 卵巢原发性类癌是一种少见的低度恶性卵巢单胚层起源的肿瘤,其诊断及鉴别诊断主要依靠组织病理学特征及免疫表型.除黏液类癌外其他类型,预后良好.

abstractsObjective To describe the clinicopathologic features, diagnosis and differential diagnosis of ovarian carcinoid tumors. Methods A retrospective chart review was performed of all patients diagnosed with primary ovarian carcinoid tumors at Fudan University Shanghai Cancer Centre from 2007 to 2017. Results The histologic analysis of these carcinoid tumors revealed 3 were insular, 1 was trabecular, 1 was mucinous, and 10 were strumal. Histologic features of insular and trabecular carcinoid were similar to other parts of the neuroendocrine tumor. Strumal carcinoid was composed of thyroid tissue intimately admixed with carcinoid tumor, showing trabecular pattern. Mucinous carcinoid was resembles Krukenberg tumor. Most ovarian carcinoid tomours were diffusely positive with at least one neuroendocrine marker, especially synaptophysin ( 14/14) and CD56 ( 9/10). The median follow-up time was 53 months, 1 patient with squamous-cell carcinoma of cervixrecur rence in vaginal after 37 months, and only 1 patient died of disease. The remaining patients were disease-free survival. Conclusions Primary carcinoid of the ovary is a very rare low grade malignant monodermal teratomas and somatic-type tumours arising from a dermoid. The diagnosis and differential diagnosis mainly relies on the histopathologic characteristics and the immuno-phenotype. Primary ovarian carcinoid almost always exhibit a benign clinical behavious except mucinous carcinoid.