【摘要】 目的 探讨卵巢浆液性腺癌与卵巢透明细胞癌的临床病理特征及预后差异，为临床鉴别诊断和个体化治疗提供参考依据。方法 回顾性分析昆山市第一人民医院2019年1月—2024年1月收治并经病理确诊的20例卵巢浆液性腺癌患者（卵巢浆液性腺癌组）和13例卵巢透明细胞癌患者（卵巢透明细胞癌组）的临床资料和随访结果。比较2组患者的一般临床特征、术后病理特征、免疫组化指标表达情况及预后结局。结果 2组患者在年龄、异常子宫出血、生育史、糖尿病、高血压、肥胖或超重情况以及国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）手术病理分期手术病理分期方面差异均无统计学意义（P > 0.05）。大网膜转移率、淋巴结转移率及肿瘤级别（高级别/低级别）差异无统计学意义（P > 0.05）。2组患者的雌激素受体（estrogen receptor,ER）、孕激素受体（progesterone receptor,PR）、细胞角蛋白7(cytokeratin 7,CK7)、糖蛋白125(cancer antigen 125,CA125)、核转录因子-8(paired box gene 8,PAX-8)和急性淋巴母细胞共同抗原（cluster of differentiation 10,CD10）阳性率差异无统计学意义（P > 0.05）。卵巢浆液性腺癌组患者的肿瘤抑制基因/转录因子（wilms tumor 1,WT1）阳性率、抑癌基因53(tumor protein 53,P53)突变率和增殖指数（Ki-67 proliferation index,Ki-67）依次为50.00%、65.00%和（50.02±10.05），均高于卵巢透明细胞癌组的7.69%、23.08%和（42.50±5.23），差异均有统计学意义（P<0.05）。卵巢浆液性腺癌组患者的抑癌基因16(cyclin-dependent kinase inhibitor 2a,P16)阳性率为35.00%，低于卵巢透明细胞癌组的100%，差异有统计学意义（P<0.05）。2组患者预后无进展生存率与总体生存率差异均无统计学意义（P > 0.05）。结论 卵巢浆液性腺癌与卵巢透明细胞癌在临床表现及基础病理侵袭、转移潜能方面存在一定相似性，但在WT1、P53、P16及Ki-67等分子标志物表达和增殖调控机制方面存在明显差异，上述指标可作为二者鉴别诊断的重要分子参考。更多还原

【Abstract】 Objective To investigate the clinicopathological characteristics and prognostic differences between ovarian serous adenocarcinoma and ovarian clear cell carcinoma, so as to provide a reference for clinical differential diagnosis and individualized treatment. Methods A retrospective analysis was conducted on the clinical data, pathological findings and follow-up results of 20 patients with ovarian serous adenocarcinoma(ovarian serous adenocarcinoma group) and 13 patients with ovarian clear cell carcinoma(ovarian clear cell carcinoma group) who were admitted to the First People’s Hospital of Kunshan from January 2019 to January 2024 and pathologically confirmed. The two groups were compared in terms of general clinical features, postoperative pathological characteristics, immunohistochemical marker expression and prognostic outcomes. Results There were no statistically significant differences between the two groups in age, abnormal uterine bleeding, parity history, diabetes, hypertension, obesity or overweight, or FIGO surgical-pathological stage(P > 0.05). The rates of omental metastasis, lymph node metastasis and tumor grade(high-grade vs. low-grade) were also not significantly different between the two groups(P > 0.05). The positive rates of estrogen receptor(ER), progesterone receptor(PR), cytokeratin 7(CK7), cancer antigen 125(CA125), paired box gene 8(PAX-8) and cluster of differentiation 10(CD10) showed no significant differences between the two groups(P > 0.05). In the ovarian serous adenocarcinoma group, the WT1 positivity rate was 50.00%, the P53 mutation rate was 65.00%, and the Ki-67 proliferation index was(50.02 ± 10.05); all were higher than the corresponding values in the ovarian clear cell carcinoma group, which were 7.69%, 23.08%, and(42.50 ± 5.23), respectively. The differences were statistically significant(P < 0.05). The positive rate of cyclin-dependent kinase inhibitor 2A(P16) in the ovarian serous adenocarcinoma group was 35.00%, which was significantly lower than that in the ovarian clear cell carcinoma group(100%)(P < 0.05). There were no statistically significant differences in progression-free survival rate or overall survival rate between the two groups(P > 0.05). Conclusion Ovarian serous adenocarcinoma and ovarian clear cell carcinoma show certain similarities in clinical manifestations as well as in basic pathological invasiveness and metastatic potential, but they exhibit marked differences in the expression of molecular markers such as WT1, P53, P16 and Ki-67 and in proliferation-related regulatory mechanisms. These indicators may serve as important molecular references for the differential diagnosis of the two tumor types.更多还原