具有MELF浸润的低级别子宫内膜样癌的临床病理特征及分子分型相关蛋白表达  

Clinicopathological features and expression of molecular classification related protein in low-grade endometrioid carcinoma with microcystic,elongated,and fragmented myometrial invasion

作　　者：冯晓敏[1] 汤永峰[1] 徐娟[1] 李惠 可飞 韩梅 Feng Xiaomin;Tang Yongfeng;Xu Juan;Li Hui;Ke Fei;Han Mei(Department of Pathology,Women's Hospital of Nanjing Medical University,Nanjing Maternal and Child Health Care Hospital,Nanjing 210029,China;Department of Pathology,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学附属妇产医院南京市妇幼保健院病理科,江苏210029 [2]南京中医药大学附属医院江苏省中医院病理科,210029

出　　处：《国际医药卫生导报》2021年第21期3348-3353,共6页International Medicine and Health Guidance News

基　　金：南京市卫生科技发展基金项目(YKK18160)。

摘　　要：目的分析具有微囊性、拉长及碎片状(microcystic,elongated,and fragmented,MELF)肌层浸润特征的低级别子宫内膜样癌患者的临床病理学特征及分子分型相关蛋白表达水平。方法统计出江苏省中医院及南京市妇幼保健院于2016年4月至2020年12月收治的183例低级别子宫内膜样癌患者的临床病理资料,筛选出伴MELF浸润的低级别子宫内膜样癌24例(研究组),分析对比其与无MELF浸润的低级别子宫内膜样癌(对照组,159例)的深肌层浸润发生率、脉管癌栓阳性率和淋巴结转移率等临床病理特征及分子分型相关蛋白表达水平。结果183例患者年龄(57.6±6.2)岁(48~69岁),MELF浸润的发生率为13.1%(24/183)。研究组患者低级别子宫内膜样癌的深肌层浸润发生率、脉管癌栓阳性率和淋巴结转移率分别为91.7%(22/24)、87.5%(21/24)、62.5%(15/24),对照组分别为17.6%(28/159)、24.5%(39/159)、2.5%(4/159),两组相比,差异均有统计学意义(均P<0.01)。研究组和对照组患者的突变型p53表达率分别为16.7%(4/24)和6.3%(10/159),MSH2-MSH6缺失率分别为8.3%(2/24)和1.3%(2/159),MLH1-PMS2缺失率分别为4.2%(1/24)和7.5%(12/159),两组相比,差异均无统计学意义(均P>0.05)。随访时间为(32.2±6.5)个月(7~56个月),研究组有2例患者复发,对照组1例复发,两组相比,差异有统计学意义(P<0.05)。结论具有MELF浸润的低级别子宫内膜样癌的深肌层浸润发生率、脉管癌栓阳性率及淋巴结转移率均明显高于无MELF浸润的低级别子宫内膜样癌,提示其可能是预后不良因子。Objective To analyze the clinical pathological features and the expression of molecular classification related protein in patients with low-grade endometrioid carcinoma characterized by the microcystic,elongated and fragmented(MELF)myometrial invasion.Methods The clinicopathological data of 183 cases of low-grade endometrioid cancer treated in Jiangsu Province Hospital of Chinese Medicine and Nanjing Maternal and Child Health Care Hospital from April 2016 to December 2020 were statistically analyzed.Twenty-four cases of low-grade endometrioid cancer with MELF myometrial invasion were selected as a study group.The clinicopathological features,such as the incidence of deep muscle infiltration,the positive rates of vascular thrombus and lymph node metastasis,and the expression levels of proteins related to molecular typing were analyzed and compared with those of the patients with low-grade endometrioid carcinoma without MELF myometrial invasion(a control group with 159 cases).Results The 183 patients were 48-69(57.6±6.2)years old.The incidence of MELF myometrial invasion was 13.1%(24/183).The incidence of deep muscle infiltration and the positive rates of vascular thrombus and lymph node metastasis of low-grade endometrioid carcinoma were 91.7%(22/24),87.5%(21/24),and 62.5%(15/24)in the study group,and were 17.6%(28/159),24.5%(39/159),and 2.5%(4/159)in the control group(all P<0.01).The expression rate of mutant p53 was 16.7%(4/24)in the study group and 6.3%(10/159)in the control group.The deletion rate of MSH2-MSH6 was 8.3%(2/24)in the study group and 1.3%(2/159)in the control group.The deletion rate of MLH1-PMS2 was 4.2%(1/24)in the study group and 7.5%(12/159)in the control group(all P>0.01).The follow-up time was(32.2±6.5)months(7-56 months).Two patients had recurrence in the study group,and one in the control group(P<0.05).Conclusions The incidence of deep muscle infiltration,positive rates of vascular thrombin and lymph node metastasis in patients with low-grade endometrial carcinoma and MELF myometrial inva

关 键 词：子宫内膜样癌 MELF 分子分型相关蛋白 

分 类 号：R737.33[医药卫生—肿瘤]