免疫组织化学标记在子宫内膜间质肉瘤诊断和治疗中的价值  

Clinical value of immunohistochemistry in diagnosis and treatment of endometrial stromal sarcoma

作　　者：王刚平[1] 任雅丽[2] 赵辉[3] 戴翠华[1] 冯园终[4] 王洪远[5] 邢海燕[6] 梁粉花[1] 李江涛[1] 付青[1] 

机构地区：[1]山东省日照市人民医院病理科,276826 [2]北京大学第一医院电镜室 [3]山东省日照市人民医院外科,276826 [4]甘肃省武威市人民医院病理科 [5]山东省日照市中医医院病理科 [6]山东省日照市人民医院妇产科,276826

出　　处：《肿瘤研究与临床》2007年第3期162-164,共3页Cancer Research and Clinic

摘　　要：目的探讨免疫组织化学标记在子宫内膜间质肉瘤(ESS)中的表达及其在诊断和治疗中的价值。方法用免疫组织化学EnVision二步法对15例原发及3例转移复发ESS进行CD_(10)、SM-MHC、h-caldesmon、AE1/3、CD_(99)、Ki-67、CD_(34)、c-kit、ER、PR的检测,并与其病理组织形态、临床并发症、鉴别诊断及预后对照。结果17例CD_(10)阳性,其中13例强阳性,7例伴平滑肌分化,3例伴上皮样分化,7例伴性索样分化;ER13例阳性,PR16例阳性;Ki-67 36%～78%。结论子宫内膜间质肿瘤可伴多方向分化,主要为平滑肌和性索样分化;CD_(10)是诊断子宫间质肿瘤的特异抗体,结合组织形态及SM-MHC、h-caldesmon等标记可增加其特异性;ER、PR常规检测主要用于指导孕激素辅助治疗。Objective To investigate the expression and clinical value of immunohistochemistry in endometrial stromal tumors.Methods Immunohistochemical technique(Envision method)was applied to de- tect the expression of CD_(10),SM-MHC,h-caldesmon,AE1/3,CD_(99),Ki-67,CD_(34),c-kit,ER and PR in 15 cases of endomertrial stromal sarcoma and 3 metastases.The clinical pathological data,including the histological characteristics,histochemical and immunohistochemical staining features,complication,differential diagnosis and prognosis of endometrial stromal tumours were analyzed.Results Among the 18 cases of endometrial stromal tumor,17 cases had shown positive for CD_(10),including 13 cases diffuse positive and 4 muitifocal,7 cases with smooth muscle differentiation,3 cases with epithelial differentiation,7 cases with sex-cord differ- entiation.13 cases of ER and 16 cases of PR were positive expression in endometrial stromal sarcoma.Ki-67 in range 36 %～78 %.Conclusion Endometrial stromal tumour can display multi-differentiation.They show various pathomorphological features,Smooth muscle and sex-coed differentiation,the most common types. CD_(10) can be expressed consistently in endometrial stromal tumors.CD_(10) with h-caldesmon and SM-MHC can be used to make differential diagnosis between the endometrial stromal tumors and cellular leiomy0ma.ER and PR should be routinely estimated and be a prognostic predictor for endometrial stromal sarcoma.

关 键 词：子宫内膜肿瘤 免疫组织化学 受体 雌激素 受体 孕激素 

分 类 号：R737.33[医药卫生—肿瘤]