本文選題：子宮腫瘤 + 漿液性癌��； 參考：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2017年11期

【摘要】：目的探討子宮內(nèi)膜漿液性癌(uterine serous carcinoma,USC)的臨床病理學(xué)特征、診斷與鑒別診斷。方法對(duì)17例USC進(jìn)行臨床病理分析、組織形態(tài)學(xué)及免疫組化En Vision法染色,結(jié)合文獻(xiàn)對(duì)其臨床表現(xiàn)、病理形態(tài)特點(diǎn)及鑒別診斷進(jìn)行探討。結(jié)果患者年齡46~75歲,腫瘤位于子宮宮腔,浸潤(rùn)深度從內(nèi)膜至子宮肌壁全層,累及子宮頸管7例,雙側(cè)附件未見累及,盆腔及腹主動(dòng)脈旁淋巴結(jié)轉(zhuǎn)移各1例。腫瘤組織呈腺管狀或?qū)嵭耘帕?乳頭狀結(jié)構(gòu)常見,細(xì)胞核異型性明顯,核分裂象易見,部分病例可見砂粒體形成。免疫表型:瘤細(xì)胞表達(dá)p53、p16、PTEN,不表達(dá)WT1,較少表達(dá)ER、PR,Ki-67增殖指數(shù)40%~90%。結(jié)論原發(fā)性USC臨床罕見,侵襲性高,預(yù)后差,其組織形態(tài)復(fù)雜多樣,需與子宮內(nèi)膜樣腺癌、透明細(xì)胞癌等子宮內(nèi)膜惡性腫瘤鑒別。
[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.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院病理科;徐州醫(yī)科大學(xué)附屬醫(yī)院病理科;
【分類號(hào)】：R737.33

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