摘要
目的探讨类似卵巢性索肿瘤的子宫肿瘤(UTROSCT)的临床、病理特征以及相关基因组学变化,以期更好地了解其性质,有助于精确的治疗和预测患者的预后。方法通过对10例患者做UTROSCT镜检及免疫组化分析,对患者进行随访,并查阅相关文献。结果患者平均年龄48岁,范围为26~69岁。肿瘤直径0.5~8 cm,切面多为灰白、灰黄色。首发症状常为经期紊乱或异常阴道出血,肿瘤位于黏膜下或者肌间多见。10例患者均预后良好,无病生存,随访时间2~125个月。镜检:肿瘤可多种方式排列,如条索、巢状、小管样、网状或小梁状,间质常可见玻璃样变。细胞呈圆形或卵圆形,核仁较常见,偶见核分裂象。免疫表型:肿瘤多向分化,10例肿瘤性索分化的标记均有不同程度表达,大部分表达平滑肌、上皮标记,ER、PR和CD10也常为阳性。结论UTROSCT是一种多表型且少见的肿瘤,临床特征无特异性,预后一般较好,也可转移复发。目前主要依靠组织病理结合免疫组化,分子病理是明确诊断及判断患者预后的重要手段。治疗方式主要为手术切除。
Objective To investigate the clinical,pathological features,and related genomic changes of uterine tumor resembling ovarian sex cord tumor(UTROSCT),in order to better understand their nature and contribute to accurate treatment and prediction of patient prognosis.Methods Through microscopic examination and immunohistochemical analysis of ten cases of UTROSCT,patients were followed up and relevant literature was reviewed.Results The average age of the patients was 48 years,ranging from 26 to 69 years.Tumor diameter was 0.5-8 cm,and the cut surface was mostly gray white or gray yellow.The initial symptoms were often menstrual disorders or abnormal vaginal bleeding,with tumors often located under the mucosa or between muscles.All ten patients had a good prognosis and disease-free survival,with a follow-up period of 2-125 months.Microscopic examination showed that tumors were arranged in various ways,such as corded,nested,tubular,reticular,or trabecular,with often visible glassy changes in the stroma.The cells were circular or ovoid in shape,with more common nucleoli and occasional mitotic figures.Immunophenotypically the tumor was multidirectional,and the markers of sex cord differentiation in all ten cases were expressed to varying degrees.Most of them expressed smooth muscle and epithelial markers,while ER,PR,and CD10 were also often positive.Conclusion UTROSCT is a rare tumor with multiple phenotypes,non-specific clinical features,generally good prognosis,and can also metastasize and recur.At present,it mainly relies on tissue pathology combined with immunohistochemistry,and molecular pathology is an important means of clear diagnosis and judgment of patient prognosis.The main treatment method is surgical resection.
作者
郑晓娟
马宏
潘地铃
陆婷
许淑霞
ZHENG Xiao-juan;MA Hong;PAN Di-ling;LU Ting;XU Shu-xia(Department of Pathology,Fujian Provincial Obstetrics and Gynecology Hospital,Fuzhou 350011,China)
出处
《诊断病理学杂志》
2024年第6期527-531,共5页
Chinese Journal of Diagnostic Pathology
关键词
类似卵巢性索肿瘤的子宫肿瘤
临床病理学特征
分子分型
免疫组化
诊断
Uterine tumor resembling ovarian sex cord tumor
Clinical pathological characteristics
Molecular typing
Immunohistochemistry
Diagnosis
