早期子宫内膜腺癌及其癌前病变的超微结构研究  

The ultrastructuralstudyonthe early endometrialadenocarcinomaanditsprema┐lignantlesions.

作　　者：张友忠[1,2] 江森[1,2] 殷立基[1,2] 张文尧 张家驹[1,2] 杜景云 

机构地区：[1]山东医科大学附属医院 [2]山东省医学科学院

出　　处：《现代妇产科进展》1996年第3期220-223,共4页Progress in Obstetrics and Gynecology

摘　　要：目的：研究早期子宫内膜腺癌及其癌前病变（腺瘤型增生及非典型增生）的超微结构，为早期鉴别诊断提供依据。方法：对８例子宫内膜腺瘤型增生，６例非典型增生，１２例Ⅰａ期子宫内膜高分化腺癌进行了扫描电镜及透射电镜检查。结果：腺瘤型增生细胞表面的纤毛、微绒毛明显增加，基膜完整，胞浆内初级溶酶体增加，细胞核异型性不明显。高分化腺癌细胞表面的纤毛、微绒毛明显减少且形态异常，基膜不完整，胞浆内初级溶酶体减少，次级溶酶体增多，粗面内质网和线粒体的形态及排列异常，细胞核异型性较明显，有的瘤细胞核内见核小体及核包涵体。非典型增生细胞表面及胞浆内的超微结构与高分化腺癌相似，但基膜基本完整，核内未见核小体及核包涵体。结论：诊断和鉴别早期子宫内膜腺癌及其癌前病变，电镜比光镜更有价值。bjectiveTostudyontheearlyen-dometrialadenocarcinomaanditsprema-lignantlesionsbycomparisonoftheirul-trastructuralfeatures.Methods8specimensofendometrialadenomatoushyperplasis,6specimensofendometrialatypicalhyperplasiaand12specimensofearlyendometrialadenocarci-noma(stagela,wel-diferentiatedcarcino-ma)wereexaminedwithscanningelectronmicroscope(SEM)andtransmissioneletronmicroscope(TEM).ResultsTherewerediferentul-trastructuralcharacteristicsinearlyen-dometrialadenocarcinomaanditsprema-lignantlesions.Inendometrialadenoma-tonshyperplasia,celsshowedasignifi-cantincreaseincilia,surfacemicrovili,primarylysomes,ribosomes,mitochordri-a,roughendoplasmicreiculumandGolgicomplex,andtheirshapesappearednor-mal,thebasallaminawascompleteandcontinuous,thenuclearatypiawasless.Inearlyadenocarcinoma,celsshowedasig-nificantdecreaseincilia,surfacemicroviliandprimarylysosomes,andciliadefectswerehigherproportionthanthatinadeno-matoushyperplasia,thebasallaminawasimcompleteandincontinuous,celsshowedasignificantincreaseinnuclearatypia,au-tophagocyticlysomes,organelarpleomor-phism;besides,nuclearbodiesandpseudo-inclusionbodieswerefoundinsomespeci-mens.Inatypicalhyperplasia,theultra-structuralfeaturesofcelweresimilartothatofcarlyadenocarcinoma,butnuclearbodiesandpseudo-inclusionbodieswerenotfoundinatypicalhyperplasia,thebasallaminawasmuchmorecompletethanthatofinearlyadenocarcinoma.ConclusionElectronmicroscopyhasmoresignificantefectindifferentiateddi-agnosisbetweenearlyendometrialadeno-carcinomaanditspremalignantlesionsthanopticalmicroscopy.

关 键 词：子宫肿瘤 子宫内膜癌 腺癌 癌前病变 超微结构 

分 类 号：R737.330.2[医药卫生—肿瘤]