本文關(guān)鍵詞： 子宮腫瘤 神經(jīng)內(nèi)分泌腫瘤 高級(jí)別 免疫組織化學(xué) 超微結(jié)構(gòu)　出處：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的探討子宮原發(fā)性高級(jí)別神經(jīng)內(nèi)分泌癌的組織病理學(xué)形態(tài)及診斷。方法觀察25例子宮原發(fā)性高級(jí)別神經(jīng)內(nèi)分泌癌的臨床表現(xiàn)、病理學(xué)形態(tài)和免疫表型,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 25例子宮原發(fā)性高級(jí)別神經(jīng)內(nèi)分泌癌,患者年齡24~72歲,平均44歲。臨床表現(xiàn)多為陰道流血或占位性病變。組織學(xué)上示84%病例具有神經(jīng)內(nèi)分泌特征性結(jié)構(gòu),電鏡觀察可見(jiàn)神經(jīng)內(nèi)分泌顆粒。小細(xì)胞型和大細(xì)胞型神經(jīng)內(nèi)分泌癌的細(xì)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%)及壞死(92%)。小細(xì)胞神經(jīng)內(nèi)分泌癌13例,復(fù)合性小細(xì)胞神經(jīng)內(nèi)分泌癌5例(合并CIN3級(jí)1例、鱗癌1例和腺癌3例)。大細(xì)胞神經(jīng)內(nèi)分泌癌4例,復(fù)合型大細(xì)胞神經(jīng)內(nèi)分泌癌3例(合并鱗癌2例、腺癌1例)。Syn陽(yáng)性率96%(24/25),Cg A陽(yáng)性率70.5%(12/17),CD56陽(yáng)性率78.6%(11/14),CKpan陽(yáng)性率76.9%(10/13),CKpan染色呈核旁點(diǎn)狀或線性陽(yáng)性,Ki-67增殖指數(shù)60%~90%。13例行根治術(shù)并輔以化療,5例患者2年內(nèi)死亡。結(jié)論子宮高級(jí)別神經(jīng)內(nèi)分泌癌少見(jiàn),與消化道和肺系統(tǒng)的命名一致,診斷參數(shù)標(biāo)準(zhǔn)稍有差異,治療首選手術(shù)切除,術(shù)后輔以放、化療。
[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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