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目的探讨腹膜原发性腺癌的临床病理特征和鉴别诊断。方法回顾性分析8例腹膜原发性腺癌的临床病理资料,对肿瘤进行光镜观察,并做免疫组化染色。结果患者均为女性,平均年龄55.7岁,以腹胀、腹水为主要临床表现;组织学表现为浆液性乳头状腺癌7例,黏液腺癌1例。免疫组化:8例广谱CK、CK7、EMA和p53(+),7例CA125和CEA(+),CK20、vimentin和calretinin(+)各1例。结论腹膜原发性腺癌被认为是起源于第二苗勒管系统的恶性肿瘤,其组织病理类型与卵巢癌相似,因此诊断前必须证实双侧卵巢、输卵管及子宫无同类型肿瘤。免疫组化染色对于腹膜原发性腺癌与卵巢癌的鉴别无意义,但对除外胃肠道转移癌和恶性间皮瘤有帮助。
Objective To investigate the clinicopathological features and differential diagnosis of primary peritoneal adenocarcinoma. Methods The clinical and pathological data of 8 cases of primary peritoneal adenocarcinoma were retrospectively analyzed. The tumors were observed under light microscope and immunohistochemically. Results The patients were all female, with an average age of 55.7 years old. The main clinical manifestations were abdominal distension and ascites. The histological findings were serous papillary adenocarcinoma in 7 cases and mucinous adenocarcinoma in 1 case. Immunohistochemistry: One case of eight cases of broad spectrum CK, CK7, EMA and p53 (+), seven cases of CA125 and CEA (+), CK20, vimentin and calretinin (+) Conclusions Primary peritoneal adenocarcinoma is considered to be a malignant tumor originating from the second Mullerian ductal system. Its histopathological type is similar to that of ovarian cancer. Therefore, it is necessary to confirm that there is no tumor of the same type in both ovaries, fallopian tubes and uterus before diagnosis. Immunohistochemical staining of peritoneal primary adenocarcinoma and ovarian cancer is not meaningful, but except for gastrointestinal metastases and malignant mesothelioma helpful.