子宫高级别神经内分泌癌25例临床病理分析

发布时间：2018-02-28 19:34

  本文关键词： 子宫肿瘤 神经内分泌肿瘤 高级别 免疫组织化学 超微结构　出处：《临床与实验病理学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨子宫原发性高级别神经内分泌癌的组织病理学形态及诊断。方法观察25例子宫原发性高级别神经内分泌癌的临床表现、病理学形态和免疫表型,并复习相关文献。结果 25例子宫原发性高级别神经内分泌癌,患者年龄24~72岁,平均44岁。临床表现多为阴道流血或占位性病变。组织学上示84%病例具有神经内分泌特征性结构,电镜观察可见神经内分泌颗粒。小细胞型和大细胞型神经内分泌癌的细胞核特征典型,核分裂象≥20/10 HPF(64%)、10~20/10 HPF(28%)及10/10 HPF(8%),常伴凋亡(72%)及坏死(92%)。小细胞神经内分泌癌13例,复合性小细胞神经内分泌癌5例(合并CIN3级1例、鳞癌1例和腺癌3例)。大细胞神经内分泌癌4例,复合型大细胞神经内分泌癌3例(合并鳞癌2例、腺癌1例)。Syn阳性率96%(24/25),Cg A阳性率70.5%(12/17),CD56阳性率78.6%(11/14),CKpan阳性率76.9%(10/13),CKpan染色呈核旁点状或线性阳性,Ki-67增殖指数60%~90%。13例行根治术并辅以化疗,5例患者2年内死亡。结论子宫高级别神经内分泌癌少见,与消化道和肺系统的命名一致,诊断参数标准稍有差异,治疗首选手术切除,术后辅以放、化疗。
[Abstract]:Objective to investigate the histopathological features and diagnosis of primary high grade neuroendocrine carcinoma of the uterus. Methods the clinical manifestations, pathological morphology and immunophenotype of 25 cases of primary high grade uterine neuroendocrine carcinoma were observed. Results 25 cases of primary high grade neuroendocrine carcinoma of the uterus, aged 24 to 72 years, were reviewed. The average age was 44 years. The clinical manifestations were mostly vaginal bleeding or space-occupying lesions. Histologically, 84% cases had neuroendocrine characteristic structure. The nuclear characteristics of small cell and large cell type neuroendocrine carcinoma were typical. The mitotic image 鈮，

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