原发性子宫内膜浆液性癌17例临床病理观察

发布时间：2018-04-27 12:42

本文选题：子宫肿瘤 + 浆液性癌　；参考：《临床与实验病理学杂志》2017年11期

【摘要】：目的探讨子宫内膜浆液性癌(uterine serous carcinoma,USC)的临床病理学特征、诊断与鉴别诊断。方法对17例USC进行临床病理分析、组织形态学及免疫组化En Vision法染色,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果患者年龄46~75岁,肿瘤位于子宫宫腔,浸润深度从内膜至子宫肌壁全层,累及子宫颈管7例,双侧附件未见累及,盆腔及腹主动脉旁淋巴结转移各1例。肿瘤组织呈腺管状或实性排列,乳头状结构常见,细胞核异型性明显,核分裂象易见,部分病例可见砂粒体形成。免疫表型:瘤细胞表达p53、p16、PTEN,不表达WT1,较少表达ER、PR,Ki-67增殖指数40%~90%。结论原发性USC临床罕见,侵袭性高,预后差,其组织形态复杂多样,需与子宫内膜样腺癌、透明细胞癌等子宫内膜恶性肿瘤鉴别。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of endometrial serous carcinoma (USC). Methods 17 cases of USC were studied by clinicopathological analysis, histomorphology and immunohistochemical en Vision staining. The clinical manifestations, histopathological features and differential diagnosis were discussed in combination with literature. Results the tumor was located in uterine cavity in 46 ~ 75 years old. The depth of invasion was from the endometrium to the whole layer of the myometrium. The cervical canal was involved in 7 cases, the bilateral adnexa was not involved, and the pelvic cavity and abdominal aorta lymph node metastasis were 1 case each. The tumor tissues were arranged in tubular or solid glandular form, papillary structure was common, nuclear heterogeneity was obvious, mitosis was easy to be seen, sand grains were formed in some cases. Immunophenotype: the tumor cells expressed p53 p16 PTEN, not WT1, but less ERG PRI Ki-67 proliferative index (PTEN). Conclusion Primary USC is rare in clinic, high in invasion and poor in prognosis. It is necessary to differentiate primary USC from endometrial malignant tumors such as endometrial adenocarcinoma, clear cell carcinoma and so on.
【作者单位】：南京医科大学第一附属医院病理科;徐州医科大学附属医院病理科;
【分类号】：R737.33

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