臨床婦人科産科70巻8号

2016年08月発行

今月の臨床 婦人科悪性腫瘍規約改訂のポイントと対応─「何が」「なぜ」「どのように」変わったのか

卵巣腫瘍

WHO 2014年 卵巣腫瘍の改訂のポイント

著者： 清川貴子¹

所属機関： ¹東京慈恵会医科大学病理学講座

ページ範囲：P.726 - P.731

文献概要

●微小浸潤は浸潤巣の最大径が5mm未満と定義され，境界悪性腫瘍に分類する．この概念は，組織型を問わず上皮性腫瘍全体に適用される．

●漿液性癌は，高異型度漿液性癌（HGSC）と低異型度漿液性癌（LGSC）に分けられた．HGSCには卵管癌の卵巣転移例があることが示唆され，その前駆病変として漿液性卵管上皮内癌（STIC）の概念が確立された．

●粘液性腫瘍とは従来の腸型粘液性腫瘍のみを指す．従来の内頸部様（Müller管型）粘液性腫瘍は，新たに設定された漿液粘液性腫瘍に分類される．

参考文献

1）Malpica A, et al : Grading ovarian serous carcinoma using a two-tier system. Am J Surg Pathol 28 : 496─504, 2004

2）Ali RH, et al : Transitional cell carcinoma of the ovary is related to high-grade serous carcinoma and is distinct from malignant brenner tumor. Int J Gynecol Pathol 31 : 499─506, 2012

3）Takeuchi T, et al : Ovarian transitional cell carcinoma represents a poorly differentiated form of high-grade serous or endometrioid adenocarcinoma. Am J Surg Pathol 37 : 1091─1099, 2013

4）Piek JM, et al : Dysplastic changes in prophylactically removed Fallopian tubes of women predisposed to developing ovarian cancer. J Pathol 195 : 451─456, 2001

5）Colgan TJ, et al : Occult carcinoma in prophylactic oophorectomy specimens : prevalence and association with BRCA germline mutation status. Am J Surg Pathol 25 : 1283─1289, 2001

6）Medeiros F, et al : The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol 30 : 230─236, 2006

7）Kindelberger DW, et al : Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma : evidence for a causal relationship. Am J Surg Pathol 31 : 161─169, 2007

8）Callahan MJ, et al : Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction. J Clin Oncol 25 : 3985─3990, 2007

9）Prat J : Ovarian, fallopian tube and peritoneal cancer staging : Rationale and explanation of new FIGO staging 2013. Best Pract Res Clin Obstet Gynaecol 29 : 858─869, 2015

10）Singh N, et al : Assignment of primary site in high-grade serous tubal, ovarian and peritoneal carcinoma : a proposal. Histopathology 65 : 149─154, 2014

11）Singh N, et al : Assessment of a new system for primary site assignment in high-grade serous carcinoma of the fallopian tube, ovary, and peritoneum. Histopathology 67 : 331─337, 2015

12）Vang R, et al : Ovarian atypical proliferative（borderline） mucinous tumors : gastrointestinal and seromucinous（endocervical-like） types are immunophenotypically distinctive. Int J Gynecol Pathol 25 : 83─89, 2006

13）Wu CH, et al : Endocervical-type mucinous borderline tumors are related to endometrioid tumors based on mutation and loss of expression of ARID1A. Int J Gynecol Pathol 31 : 297─303, 2012