摘要
目的 探讨子宫内膜中肾样腺癌临床病理特征及预后情况。方法 回顾性分析2018年1月至2023年4月郑州大学第一附属医院病理科确诊的8例子宫内膜中肾样腺癌患者,病变组织均行HE常规染色、免疫组化染色,4例行KRAS分子检测,3例行子宫内膜癌分子分型检测。分析患者临床资料、病理学特征、免疫表型及分子特征,并复习相关文献。结果 患者发病年龄48~82岁,主要临床症状为绝经后阴道出血。1例为刮宫标本,7例为手术标本,肿物均位于宫腔。光镜下肿瘤显示多种构型,常显示腺样、管状、乳头状、网状、实性结构,腔内常见嗜酸性分泌物,肿瘤细胞核成角重叠,具有中度异型性。免疫组化示雌激素受体、孕激素受体阴性,P53呈野生型表达,GATA3及甲状腺转录因子-1呈相反的表达模式。4例行KRAS分子检测均检测到突变,3例行子宫内膜癌分子检测均未检测到POLE、MSI及P53突变。本组手术标本4例为Ⅲc期,3例Ⅰa期,其中外院术后1例为Ⅰa期,4 a后发生肺转移。结论 子宫内膜中肾样腺癌是一种新近发现的女性生殖系统肿瘤,组织学形态易造成低诊,本组病例显示出较高的侵袭性,免疫组化检查及KRAS分子检测有助于正确诊断。
Objective To investigate the clinicopathologic features and prognosis of 8 cases of endometrial mesonephric-like adenocarcinoma.Methods A total of 8 cases of endometrial mesonephric-like adenocarcinoma diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2018 to April 2023 were retrospectively included.HE stain,immunohistochemistry were performed,KRAS mutation were performed in 4 cases,molecular typing detection were performed in 3 cases.The clinical data,pathological features,immune phenotype and molecular characteristics of patients were analyzed,and the relevant literature were reviewed.Results All the patient with the age from 48-82 years old were most postmenopausal bleeding.One case was curettary specimen, 7 cases were radical excision specimens. All tumor located in the uterine corpus. Tumors exhibited various configurations. Tumor cells showed an admixture of glandular, tubular, papillary, retiform and solid patterns. Luminal eosinophilic colloid-like materials were seen. Tumor cells had moderately atypical vesicular nuclei, often showed angulation and overlapping. Immunohistochemistry showed estrogen receptor, progestogen receptor negative, p53 showed wildtype pattern, GATA3 and thyroid transcription factor-1 showed positive staining with inverse pattern. Four cases showed KRAS mutation. POLE, microsatellite instability and TP53 mutation were negative in 3 cases. Four cases of FIGO staging were Ⅲc, 3 cases were Ⅰa . One case of FIGO staging Ⅰa from other hospitals occurred pulmonary metastasis after 4 years. Conclusion Endometrial mesonephric-like adenocarcinoma is a recently reported rarely female reproductive system tumor. Histological morphology can easily lead to low diagnosis. It suggest aggressive behavior. Immunohistochemistry and KRAS mutation can avoid misdiagnose.
作者
许跃
严淑萍
陈奎生
XU Yue;YAN Shuping;CHEN Kuisheng(Department of Pathology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《肿瘤基础与临床》
2023年第4期313-317,共5页
journal of basic and clinical oncology
基金
河南省科技攻关项目(222102310099)。
关键词
中肾样腺癌
子宫内膜
预后
mesonephric-like
endometrial
prognosis
