摘要
目的探讨病理组织形态学及免疫组化在子宫内膜间质肉瘤诊断中的应用价值。方法选取10例子宫内膜间质肉瘤(ESS)患者和10例子宫高度富于细胞平滑肌瘤(HCL)患者作为观察对象,使用高倍显微镜和免疫组化法进行观察,并将2组患者之间的观察结果进行对比分析。结果 10例子宫内膜间质瘤患者中,有8例为低度恶性子宫内膜间质肉瘤(LGESS),2例为高度恶性子宫内膜间质肉瘤(HGESS)。在8例LGESS中有3例肿瘤为息肉状且进入宫腔,5例肿瘤为基层中或浆膜下独立结节,且呈膨胀性发展,与周围组织的界限模糊,肿瘤直径为3~7 cm,质地细腻,多呈灰黄、灰白色,无出血性倾向,核分裂像为1~4个/10HPF,其中有1例伴随子宫平滑肌瘤。在2例HGESS中,1例呈息肉状进入宫腔,另1例与LGESS相似,切面为灰黄色,切片细腻且伴随大量出血坏死,核分裂像>9个/10HPF。HCL的直径为2.5~10 cm,实性且肿瘤组织呈灰白色,质地不细腻也不粗糙,中等水平。免疫组化SP法检测发现,ESS肿瘤细胞CD10、SMA、MSA以及Desmin的阳性率分别为100.0%、30.0%、30.0%和20.0%,而HCL肿瘤细胞CD10、SMA、MSA以及Desmin的阳性率分别为30.0%、100.0%、100.0%和100.0%,2组间各抗体表达差异均有统计学意义(P<0.05)。结论子宫内膜间质肉瘤患者具有特殊的组织形态学特点,可向平滑肌分化。CD10、SMA、MSA以及Desmin的联合检测是诊断和鉴别ESS与HCL的有效方法,有助于提高临床诊断的准确率。
Objective To explore the application value of histomorphology and immunohistochemistry in the diagnosis of endometrial stromal sarcoma. Methods 10 patients with endometrial stromal sarcoma（ ESS） and 10 patients with high uterine leiomyoma（ HCL） were enrolled in this study. High-power microscopy and immunohistochemistry were used to observe the 2 groups. Results Of the 10 patients with endometrial stromal tumors,8 had low grade endometrial stromal sarcoma（ LGESS） and2 had high malignant endometrial stromal sarcoma（ HGESS）. In 8 cases of LGESS,3 cases of tumors were polyp and into the uterine cavity,5 cases of primary or subserosal tumor under the basic nodules,and the expansion of development,and the surrounding tissue boundaries blurred,the tumor diameter of 3 to 7 cm,fine texture,mostly grayish yellow,gray,no bleeding tendency,mitotic as 1 to 4/10 HPF,of which 1 case with uterine leiomyoma. In 2 cases of HGESS,1 case of polypoid into the uterine cavity,and the other 1 case and LGESS similar to the section was grayish yellow,sliced and accompanied by a large number of bleeding necrosis,mitotic like 9/10 HPF. HCL diameter of 2. 5 ~ 10 cm,solid and tumor tissue was gray,not fine texture was not rough,moderate level. Immunohistochemical SP method showed that the positive rates of CD10,SMA,MSA and Desmin were 100. 0%,30. 0%,30. 0% and 20. 0%,respectively. The positive rates of CD10,SMA,MSA and Desmin in HCL tumor cells were 30. 0%,100. 0%,100. 0% and 100. 0%,respectively,and the difference was statistically significant（ P〈0. 05）. Conclusion Endometrial stromal sarcoma patients have special histomorphological characteristics,can be differentiated with smooth muscle. Combined detection of CD10,SMA,MSA and Desmin is an effective method to diagnose and identify ESS and HCL,which can improve the accuracy of clinical diagnosis.
作者
管春鸾
GUAN Chunluan(Shanxi Province Shangzhou District People＇s Hospital,Shangluo,72600)
出处
《实用癌症杂志》
2018年第5期763-765,共3页
The Practical Journal of Cancer
关键词
病理组织形态学
免疫组化
子宫内膜间质肉瘤
诊断效果
应用价值
Histopathology
Immunohistochemistry
Endometrial stromal sarcoma
Diagnostic effect
Application value
