【精品】子宫内膜间质肉瘤特异性标志物及临床病理分析
子宫内膜间质肉瘤特异性标志物及临床
病理分析
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作者:黄世勇 黄传胜 梁运龙
[摘要] 目的:探讨子宫内膜间质肉瘤(ESS)中特异性标志物雌激素受体
(ER)、孕激素受体(PR)、
表
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皮生长因子受体(EGFR)、结蛋白(desmin)、
CD10、CD44的表达,并分析ESS的临床病理特征。方法:收集2000,2009年
本院收治的32例ESS患者,通过免疫组化染色(SP法)检测ER、PR、EGFR、
desmin、CD10和CD44在ESS中的表达,并在镜下观察其病理学特征。另取30
例子宫平滑肌瘤作为对照。结果:ESS多为单发,肿瘤类似增生期子宫内膜间质细
胞,瘤细胞呈圆形、卵圆形、梭形,排列密集。EGFR在ESS和子宫平滑肌瘤中的
阳性表达率差异无统计学意义(P>0.05),ER、PR、desmin、CD10、CD44在
ESS和子宫平滑肌瘤中的阳性表达率差异有统计学意义(P<0.05或P<0.01)。
结论:诊断ESS时应结合其临床病理特征,CD10可作为诊断ESS的特异指
标,CD44可辅助诊断ESS。
[关键词] 子宫内膜间质肉瘤;特异性标志物;病理分析
[Abstract] Objective: To investigate the expressions of specific markers estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor (EGFR), desmin, CD10 and CD44 in endometrial stromal scarcoma
(ESS), and analyze the clinical pathologic features of ESS. Methods: A total of 32 cases of patients with ESS from 2000 to 2009 in our hospital were selected, and the expressions of ER, PR, EGFR, desmin, CD10 and CD44 in ESS were detected by using immunohistochemical SP assay, and its pathologic features were observed under microscope. 30 cases of
leiomyosarcoma uteri were selected as controls. Results: Most ESS were solitary tumors, it was similar to endometrial stroma cells of proliferative phase, cells were
round, oval and fusiform, the arrangement was intensive. The positive expression rate of EGFR had no significant difference between ESS and leiomyosarcoma uteri (P>0.05), the positive expression rates of ER, PR, desmin, CD10 and CD44 had significant difference between ESS and
leiomyosarcoma uteri (P<0.05 or P<0.01). Conclusion: The clinical pathologic features should be considered when diagnosing ESS, CD10 can serve as the sensitive marker in the diagnosis of ESS, and CD44 can serve as the auxiliary
marker in the diagnosis of ESS.
[Key
word
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s] Endometrial stromal scarcoma; Specific marker; Pathologic analysis
子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)是来源于子宫
内膜间质细胞的一种罕见的妇科恶性肿瘤,占子宫肉瘤的7%,15%,好发于绝经前
后妇女。临床上主要表现为不规则阴道流血、绝经后阴道流血、子宫增大、腹痛、
腹部包块等[1-3]。笔者收集2000,2009年本院收治的32例ESS患者,对其
特异性标志物的表达及临床病理特征进行分析,为临床上正确诊断ESS提供依据。
1 资料与方法
1.1 一般资料
2000,2009年本院收治32例ESS患者,年龄26,71岁,平均42.6岁;既
往月经均正常。临床表现:21例有不规则阴道流血,2例月经过多,4例绝经后阴
道流血,5例下腹部疼痛。查体示19例子宫增大。B超提示子宫、卵巢或盆腔内
低、中回声团。另取30例同期子宫平滑肌瘤患者作为对照组。
1.2 试剂与仪器
免疫组化SP法试剂盒,雌激素受体(ER)、孕激素受体(PR)、表皮生长因子
受体(EGFR)、结蛋白(desmin)、CD10、CD44一抗(1?100)为鼠抗人单克隆抗
体,二抗(1?500)为羊抗鼠抗体,均购自福建省福州市迈新生物技术开发公司。英
国珊顿石蜡切片机(型号325)。