子宫腺瘤样瘤67例临床病理分析  

Clinicopathologic an analysis of 67 cases of uterine adenomatoid tumors

作　　者：陈勇[1] 冯艺 赵彩霞[1] 汪勤[1] 唐曼[1] 张卫琴[1] 刘婷珽 娄蓉 张和平[1] CHEN Yong;FENG Yi;ZHAO Caixia;WANG Qin;TANG Man;ZHANG Weiqin;LIU Tingting;LOU Rong;ZHANG Heping(Department of Pathology,Anhui Women and Child Health Care Hospital(Women and Child Health Care Affiliated Hospital of Anhui Medical University),Hefei,Anhui 230001,China)

机构地区：[1]安徽省妇幼保健院(安徽医科大学附属妇幼保健院)病理科,安徽合肥230001

出　　处：《安徽医药》2020年第10期1992-1995,I0002,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨子宫腺瘤样瘤(Adenomatoid Tumors,ATs)临床病理特征、免疫表型、鉴别诊断、治疗及预后。方法回顾性分析安徽医科大学附属妇幼保健院病理科2012年1月至2018年1月67例子宫ATs的临床特点、病理形态学及免疫表型特征,并复习相关文献。结果病人均为女性,年龄范围24~64岁,中位年龄39岁。肿瘤位于子宫浆膜下或肌壁间,其中66例呈结节状(直径1.0~8.0 cm),平均直径2.7 cm,1例呈巨大囊实性(直径12.0 cm)。肿块切面灰白,质韧,类似平滑肌瘤,与周围组织界限不清。肿瘤由大小不等的管腔或乳头状结构构成,被覆扁平或立方上皮细胞,呈单个或巢状分布于平滑肌组织之间。所有病例肿瘤细胞均无明显异型性,核分裂象罕见。免疫组织化学结果显示肿瘤细胞角蛋白广谱抗体(CKAE1/AE3)、钙网膜蛋白(Calretinin)、跨膜唾液酸糖蛋白(D2-40)、细胞角蛋白(CK5/6)的阳性率分别为100.0%(67/67)、100.0%(67/67)、100.0%(67/67)、19.4%(13/67),肿瘤增殖抗原(Ki-67)增殖指数低,约1%~5%之间,高度糖基化的i型跨膜糖蛋白(CD34)不表达。结论子宫ATs是一种少见的间叶来源的良性肿瘤,但组织学特征多样,尤其出现腺腔样结构难与腺癌相鉴别,结合镜下形态特点及免疫组化有助于提高诊断准确率,治疗以手术切除为主。Objective To investigate the clinicopathologic characteristics,immunophenotypes,differential diagnosis,treatment andprognosis of uterine adenomatoid tumors(ATs).MethodsClinicopathologic findings and immunophenotypes of 67 cases of uterineATs in the Department of Pathology,Affiliated Maternal and Child Health Hospital of Anhui Medical University from January 2012 to January 2018 were retrospectively analyzed,and the relevant literatures were also reviewed.ResultsThe patients were all fe-male,ranging in age from 24 to 64 years,with a median age was 39 years.Most of uterine ATs located in subserous membrane ormuscle intramural.The 66 cases of uterine ATs ranged from 1.0 cm to 8.0 cm with an average diameter of 2.7 cm and 1 large cystictumor was 12.0 cm in diameter.Macroscopically,the tumor had a grayish white cut surface with a firm texture like leiomyoma,butthe margin was not clear.Tumors are composed of lumens or papillary structures of varying sizes,covered with flat or cubic epitheli-al cells,distributed in single or nested form among smooth muscle tissues.The tumor cells with no atypia and mitotic figures wererare.Immunohistochemistry staining showed that the positive rates of CKAE1/AE3,Calretinin,D2-40 and CK5/6 in tumor cells were100.0%(67/67),100.0%(67/67),100.0%(67/67),and 19.4%(13/67),respectively.The tumor proliferation antigen(Ki-67)indexwaslow,about 1%-5%.the highly glycosylated i-type transmembrane glycoprotein(CD34)is not expressed.ConclusionsUterineATs is a rare benign tumor originating from mesenchymal tissue.However,the histologic characteristics are diverse,especially theadenoid structure is difficult to distinguish from adenocarcinoma.The morphological features with immunohistochemical staining canimprove the diagnostic accuracy.Surgical resection is the mainly treatment.

关 键 词：腺瘤样瘤 子宫肿瘤 临床病理特征 上皮 角蛋白5 角蛋白6 唾液糖蛋白类 免疫组织化学 

分 类 号：R737.33[医药卫生—肿瘤]