黑色素瘤优先表达抗原免疫组织化学染色在子宫内膜癌及宫颈腺癌鉴别诊断中的应用  

Application of PRAME immunohistochemistry in the differential diagnosis of primary endometrial and endocervical adenocarcinomas

作　　者：韦笑 郑重[1] 史倩芸 王朝姗 孟凡青[1] 陈玲[1] Wei Xiao;Zheng Zhong;Shi Qianyun;Wang Chaoshan;Meng Fanqing;Chen Ling(Department of Pathology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院病理科,南京210008

出　　处：《中华病理学杂志》2024年第6期552-556,共5页Chinese Journal of Pathology

摘　　要：目的探讨黑色素瘤优先表达抗原(PRAME)免疫组织化学染色在子宫内膜癌及宫颈腺癌鉴别诊断中的应用价值。方法收集南京大学医学院附属鼓楼医院病理科2018年5月至2023年11月全子宫切除标本中确诊的子宫内膜癌病例87例和宫颈腺癌病例63例,分别进行PRAME免疫组织化学染色,比较其在子宫内膜癌和宫颈腺癌中的表达差异。结果子宫内膜癌87例,年龄35~71岁(平均59岁,中位59岁);宫颈腺癌63例,年龄28~80岁(平均49岁,中位47岁)。78例(78/87,89.7%)子宫内膜癌和2例(2/63,3.2%)宫颈腺癌表现为PRAME阳性表达,且2例宫颈腺癌均为透明细胞癌。PRAME在鉴别子宫内膜癌及宫颈腺癌的灵敏度和特异度分别为89.7%和96.8%,在鉴别子宫内膜和宫颈的非透明细胞癌的灵敏度和特异度高达91%和100%。结论PRAME免疫组织化学染色在子宫内膜癌及宫颈腺癌中表达差异具有统计学意义,可作为鉴别原发宫颈腺癌和原发子宫内膜癌(尤其是非透明细胞癌)的辅助诊断标志物。Objective To investigate the diagnostic value of preferentially expressed antigen in melanoma(PRAME)immunohistochemical staining in differential diagnosis of primary endometrial and endocervical adenocarcinomas.Methods Eighty‐seven cases of endometrial adenocarcinoma and sixty-three cases of cervical adenocarcinoma were collected from May 2018 to November 2023 in the Department of Pathology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School and all the cases were subject to PRAME immunohistochemical staining.The difference of PRAME expression between endometrial and endocervical adenocarcinomas was analyzed.Results In 87 cases of endometrial adenocarcinoma,patients′age ranged from 35 to 71 years(average 59 years,median 59 years);in 63 cases of cervical adenocarcinoma patients′age ranged from 28 to 80 years(average 49 years,median 47 years).Seventy-eight cases(78/87,89.7%)of endometrial adenocarcinoma;2 cases(2/63,3.2%)of cervical adenocarcinoma showed positive PRAME staining,and both cases of cervical adenocarcinoma were clear cell carcinoma.The sensitivity and specificity of PRAME in distinguishing between endometrial and cervical adenocarcinoma in the cohort were 89.7%and 96.8%,while those in differentiating non-clear cell carcinoma of the uterus from that of the cervix reached up to 91% and 100%,respectively.Conclusions Immunohistochemical staining for PRAME demonstrates statistically significant differences between endometrial and cervical carcinomas,making it a useful auxiliary diagnostic marker for differentiating cervical and endometrial adenocarcinoma,especially non-clear cell carcinoma.

关 键 词：子宫肿瘤 免疫组织化学 诊断 鉴别 黑色素瘤优先表达抗原 

分 类 号：R737.33[医药卫生—肿瘤]