本文關(guān)鍵詞： 卵巢腫瘤 子宮腫瘤 透明細(xì)胞癌 內(nèi)膜樣癌 NapsinA TTF- PAX CA　出處：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討Napsin A、TTF-1、PAX8及CA125在卵巢、子宮內(nèi)膜透明細(xì)胞癌,卵巢和子宮內(nèi)膜樣癌及卵巢漿液性癌中的表達(dá)及在診斷及鑒別診斷中的價(jià)值。方法選取23例卵巢透明細(xì)胞癌、10例卵巢子宮內(nèi)膜樣癌、45例卵巢漿液性癌、11例子宮內(nèi)膜透明細(xì)胞癌、35例子宮內(nèi)膜樣癌,利用免疫組化法評(píng)估Napsin A、TTF-1、PAX8及CA125在上述腫瘤中的表達(dá),并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 Napsin A在卵巢透明細(xì)胞癌及子宮內(nèi)膜透明細(xì)胞癌中的陽(yáng)性率較高,分別為95.7%(22/23)、72.7%(8/11),在卵巢和子宮內(nèi)膜樣癌中的陽(yáng)性率較低,分別為10%(1/10)、5.7%(2/35),在卵巢漿液性癌中不表達(dá)。Napsin A在卵巢透明細(xì)胞癌、卵巢子宮內(nèi)膜樣癌及卵巢漿液性癌中的敏感度差異有統(tǒng)計(jì)學(xué)意義(P0.01)。在子宮內(nèi)膜透明細(xì)胞癌及子宮內(nèi)膜樣癌中的敏感度差異亦有統(tǒng)計(jì)學(xué)意義(P0.01)。TTF-1在卵巢透明細(xì)胞癌中不表達(dá),在卵巢子宮內(nèi)膜樣癌、漿液性癌、子宮內(nèi)膜透明細(xì)胞癌、子宮內(nèi)膜樣癌中的陽(yáng)性率分別為30%(3/30)、4.4%(2/45)、9.1%(1/11)、5.7%(2/35)。PAX8在124例腫瘤中均陽(yáng)性。18.2%(2/11)的子宮內(nèi)膜透明細(xì)胞癌及5.7%(2/35)的子宮內(nèi)膜樣癌中CA125均陰性,其余均陽(yáng)性。1例子宮內(nèi)膜透明細(xì)胞癌為Napsin A/TTF-1雙陽(yáng)性。所有Napsin A和(或)TTF-1陽(yáng)性病例均表達(dá)PAX8及CA125。結(jié)論Napsin A在卵巢透明細(xì)胞癌中的陽(yáng)性率最高,其次為子宮內(nèi)膜透明細(xì)胞癌,在卵巢和子宮子宮內(nèi)膜樣癌中的陽(yáng)性率較低,在卵巢漿液性癌中不表達(dá)。在診斷起源不明的轉(zhuǎn)移性癌時(shí),鑒別診斷時(shí)應(yīng)當(dāng)把肺腺癌及婦科腫瘤考慮在內(nèi),此時(shí)聯(lián)合檢測(cè)Napsin A、TTF-1及PAX8的表達(dá)有助于確診。
[Abstract]:Objective to investigate the role of Napsin Agna TTF-1, PAX8 and CA125 in clear cell carcinoma of ovary and endometrium. Expression and differential diagnosis of ovarian endometrioid carcinoma and ovarian serous carcinoma. Methods 23 cases of ovarian clear cell carcinoma and 10 cases of ovarian endometrioid carcinoma were selected. 45 cases of ovarian serous carcinoma and 11 cases of endometrial clear cell carcinoma (endometrial clear cell carcinoma) were evaluated by immunohistochemical method for Napsin TTF-1 in 35 cases of endometrial carcinoma. The expression of PAX8 and CA125 in these tumors was reviewed. Results the positive rate of Napsin A was higher in ovarian clear cell carcinoma and endometrial clear cell carcinoma. The positive rate in ovarian and endometrioid carcinoma was 10 / 10 / 10 / 10 / 57 / 35, respectively. Napsin A was not expressed in ovarian clear cell carcinoma. There were significant differences in sensitivity between ovarian endometrial carcinoma and ovarian serous carcinoma (P0.01), and in endometrial clear cell carcinoma and endometrial carcinoma (. P0.01TTF-1 was not expressed in clear cell carcinoma of ovary. The positive rates of ovarian endometrial carcinoma, serous carcinoma, endometrial clear cell carcinoma and endometrial carcinoma were 30 / 3 / 30 / 4 / 4 / 4 / 45 respectively. 9 / 1 / 1 / 11). 5.72% 35% PAX8 positive in 124 cases of endometrial clear cell carcinoma and 5.775% 2 / 35). CA125 was negative in endometrial carcinoma. All other cases were positive for Napsin A / TTF-1. All Napsin A and / or TTF-1 were positive in all cases of endometrial clear cell carcinoma. TTF-1 positive cases all expressed PAX8 and CA125.Conclusion Napsin A has the highest positive rate in ovarian clear cell carcinoma. The second was clear cell carcinoma of endometrium, the positive rate was lower in ovarian and endometrioid carcinoma, but not expressed in ovarian serous carcinoma. Lung adenocarcinoma and gynecologic tumors should be taken into account in differential diagnosis. The expression of TTF-1 and PAX8 in combination with Napsin is helpful for diagnosis.
【作者單位】： 浙江省嘉興市中醫(yī)醫(yī)院病理科;
【分類號(hào)】：R737.3
【正文快照】： n A;TTF-1;PAX8;CA125卵巢腫瘤是婦科常見(jiàn)的惡性腫瘤之一,約90%的原發(fā)惡性卵巢腫瘤為卵巢表面上皮-間質(zhì)腫瘤,包括漿液性癌、黏液性癌、子宮內(nèi)膜樣癌、透明細(xì)胞癌等[1]。正確的組織分型對(duì)臨床選擇治療方案非常重要。典型的卵巢透明細(xì)胞癌診斷不困難,但局灶性透明細(xì)胞也可見(jiàn)于卵

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