子宫内膜透明细胞癌组织学和免疫组织化学研究  

Histologic and immunohistochemical features of endometrial clear-cell carcinoma

作　　者：钟传庆[1] 魏宝秀[1] 张佳立[1] 郭华伦[1] 张南[1] 付秋风[1] 

机构地区：[1]江西省妇幼保健院病理科,南昌330006

出　　处：《临床与实验病理学杂志》2003年第2期149-151,共3页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的　观察子宫内膜透明细胞癌 (ECCC)的组织学和免疫组织化学表现 ,并与其它类型的子宫内膜癌比较 ,了解其生物学特点。方法　收集ECCC 10例 ,子宫内膜乳头状浆液性癌 (UPSC) 12例 ,子宫内膜样癌 (UEC) 4 4例 ,比较组织学改变 ,并用S P免疫组织化学方法研究 p5 3蛋白、ER、PR的表达。 结果　 10例ECCC占子宫内膜癌的 3 14 %。各组平均年龄ECCC6 3 5岁 ,UEC 5 1 7岁 ,UPSC 6 0 0岁。ECCC与UEC比较 ,差异有显著性 (P <0 0 1)。ECCC与UPSC比较 ,差异无显著性(P >0 0 5 )。肿瘤组织学Ⅲ级 ,ECCC占 30 % ,UEC占 17 1% ,UPSC占 10 0 %。ECCC与UEC比较 ,P >0 0 5 ,ECCC与UPSC比较 ,P <0 0 1。 10例ECCC ,5例瘤细胞成分单纯 ,其中 1例含红染的透明小体 ;其余 5例中 2例含少数瘤巨细胞 ,3例伴有UEC成分。未见肿瘤伴同UPSC或EIC(endometrialintraepithelialcarcinoma)的组织象。 3例ECCC呈p5 3蛋白表达 ,全部EC CCER染色阴性 ,仅 1例呈PR阳性。 7例随访 5年以上 ,4例生存 ,3例死亡 ,5年生存率为 6 6 6 %。结论　ECCC的临床病理学和生物学既不同于UPSC也不同于UEC 。Purpose To study histology and immunhistochemistry of endometrial clear cell carcinoma (ECCC), and to compare them with other type of endometrial carcinoms to understand the biologic feature of ECCC. Methods Ten cases of ECCC, 12 cases of uterine papillary serous carcinoma (UPSC) and 44 cases of endometrioid carcinoma (UEC) were analyzed. Their histology was compared and their expression of p53 protein, estrogen and progesterone receptors (ER and PR) were detected by S P immunohistochemical technique. Results Ten cases of ECCC accounted for 3 14% of carcinoma of uterine endometrium. Their average age was 63 6 years in ECCC, 51 7 years in UEC and 60 0 years in UPSC. The difference between ECCC and UEC was statistically significant ( P <0 01). Five cases were identified as pure type of ECCC with one case having red clear bodies, while among the other 5 cases, three as mixed of ECCC and UEC. Two cases were associated with some neoplastic giant cells. None of ECCC was mixed with UPSC or EIC (endometrial intraepithelial carcinoma). Overepression of p53 protein was observed in 3 of 10 ECCC cases (30%), none of ECCC was ER positive and positive PR in one case. Seven of 10 ECCC cases were followed up for more than 5 years. Among them there were 3 deaths of the disease and 4 alive with the 5 year survived rate being 66 6%. Five years survival rate of UEC and UPSC were 90% and 22 2% respectively. Conclusions Clincopathologic and biologic features of ECCC differ from those of UEC and UPSC. The relationship of carcinogenesis among ECCC, UEC and UPSC needs further study.

关 键 词：UPSC 子宫内膜癌 透明细胞癌 免疫组织化学 PR 癌组织 ER 结论 生物学 显著性 

分 类 号：R737.33[医药卫生—肿瘤] R735[医药卫生—临床医学]