本文關(guān)鍵詞： 卵巢腫瘤 子宮腫瘤 透明細胞癌 內(nèi)膜樣癌 NapsinA TTF- PAX CA　出處：《臨床與實驗病理學雜志》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)膜透明細胞癌,卵巢和子宮內(nèi)膜樣癌及卵巢漿液性癌中的表達及在診斷及鑒別診斷中的價值。方法選取23例卵巢透明細胞癌、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)膜透明細胞癌、35例子宮內(nèi)膜樣癌,利用免疫組化法評估Napsin A、TTF-1、PAX8及CA125在上述腫瘤中的表達,并復習相關(guān)文獻。結(jié)果 Napsin A在卵巢透明細胞癌及子宮內(nèi)膜透明細胞癌中的陽性率較高,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。Napsin A在卵巢透明細胞癌、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)計學意義(P0.01)。在子宮內(nèi)膜透明細胞癌及子宮內(nèi)膜樣癌中的敏感度差異亦有統(tǒng)計學意義(P0.01)。TTF-1在卵巢透明細胞癌中不表達,在卵巢子宮內(nèi)膜樣癌、漿液性癌、子宮內(nèi)膜透明細胞癌、子宮內(nèi)膜樣癌中的陽性率分別為30%(3/30)、4.4%(2/45)、9.1%(1/11)、5.7%(2/35)。PAX8在124例腫瘤中均陽性。18.2%(2/11)的子宮內(nèi)膜透明細胞癌及5.7%(2/35)的子宮內(nèi)膜樣癌中CA125均陰性,其余均陽性。1例子宮內(nèi)膜透明細胞癌為Napsin A/TTF-1雙陽性。所有Napsin A和(或)TTF-1陽性病例均表達PAX8及CA125。結(jié)論Napsin A在卵巢透明細胞癌中的陽性率最高,其次為子宮內(nèi)膜透明細胞癌,在卵巢和子宮子宮內(nèi)膜樣癌中的陽性率較低,在卵巢漿液性癌中不表達。在診斷起源不明的轉(zhuǎn)移性癌時,鑒別診斷時應(yīng)當把肺腺癌及婦科腫瘤考慮在內(nèi),此時聯(lián)合檢測Napsin A、TTF-1及PAX8的表達有助于確診。
[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】：R737.3
【正文快照】： n A;TTF-1;PAX8;CA125卵巢腫瘤是婦科常見的惡性腫瘤之一,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、透明細胞癌等[1]。正確的組織分型對臨床選擇治療方案非常重要。典型的卵巢透明細胞癌診斷不困難,但局灶性透明細胞也可見于卵

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