伴MELF浸润模式子宫内膜样癌临床病理特征分析  

Clinicopathological features of endometrioid endometrial carcinoma with microcystic,elongated,and fragmented(MELF)inva-sion pattern

作　　者：戈文舜 张鹏[1] 蔡红光[1] 李美平[1] GE Wenshun;ZHANG Peng;CAI Hongguang;LI Meiping(Department of Pathology,Shaoxing Maternity and Child Health Care Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市妇幼保健院病理科,312000

出　　处：《浙江医学》2024年第19期2084-2088,I0006,共6页Zhejiang Medical Journal

摘　　要：目的 探讨伴微囊性、伸长及碎片状(MELF)浸润模式的子宫内膜样癌(EEC)的临床病理特征。方法 回顾性收集2020年1月至2024年3月绍兴市妇幼保健院收治的90例EEC患者临床资料,根据浸润模式分为MELF组(13例)和非MELF组(77例)。观察伴MELF浸润模式EEC患者临床病理特征和免疫表型,比较两组患者临床病理特征,采用多因素logistic回归分析影响患者出现MELF浸润模式的因素。结果 MELF组患者中国际妇产科联盟(FIGO)分期为Ⅱ/Ⅲ期、组织学类型为非侵袭性组,盆腔淋巴结转移灶为微转移和孤立性肿瘤细胞占比较高,FIGOⅡ期较2009 FIGO分期提高了15.4%(2/13)。免疫组化染色显示,肿瘤标志物在EEC组织和MELF中存在不同表达状态。MELF组中病灶最大径≥2.0 cm、FIGOⅡ/Ⅲ期、子宫肌层浸润≥1/2层、淋巴血管间隙侵犯(LVSI)及盆腔淋巴结转移患者比例显著高于非MELF组;多因素logistic回归分析显示广泛性LVSI是EEC患者出现MELF浸润模式的独立危险因素(P<0.05)。结论 伴MELF浸润模式EEC患者更易出现病灶最大径≥2.0 cm、FIGOⅡ/Ⅲ期、子宫肌层浸润≥1/2层、LVSI及盆腔淋巴结转移,广泛性LVSI是EEC患者出现MELF浸润模式的独立危险因素。病理医师应重点关注2023 FIGO分期中的形态学指标和淋巴结转移的评估。Objective To investigate the clinicopathologic features of endometrioid endometrial carcinoma(EEC)with microcystic,elongated,and fragmented(MELF)invasion pattern.Methods Ninety patients with EEC admitted to Shaoxing Maternal and Child Health Care Hospital from January 2020 to March 2024 were retrospectively analyzed,including 13 cases of MELF invation pattern and 77 cases of non-MELF invation pattern.The clinicopathological features of the two groups were compared according to the staging criteria of the 2023 International Federation of Obstetrics and Gynecology(FIGO)for endometrial cancer,and the influencing factors of MELF invation pattern were analyzed.Results In MELF group,the proportion of patients with FIGO stage II/III and non-invasive histological type was higher;the micrometastasis and solitary tumor cells in pelvic lymph node metastasis were also higher.Patient with FIGO stageⅡwas 15.4%higher than it was evaluated by FIGO 2009 standard(2/13).Immunohistochemical staining showed that the tumor markers had different express states in EEC and MELF tissues.Compared with non-MELF group,the maximum diameter of lesion≥2.0 cm,FIGO II/III stage,myometrium infiltration≥1/2 layer,lymphatic vascular space infiltration(LVSI)and pelvic lymph node metastasis in MELF group were significantly higher.Multivariate logistic regression analysis showed that extensive LVSI was an independent influencing factor for MELF infiltration pattern(P<0.05).Conclusion EEC with MELF invasion pattern is more likely to have lesions with maximum diameter≥2.0 cm,FIGO II/III stage,myometrial infiltration≥1/2 layer,LVSI and pelvic lymph node metastasis,among which extensive LVSI is an independent risk factor for MELF invasion pattern.

关 键 词：子宫内膜样癌 微囊性、伸长及碎片状浸润模式 国际妇产科联盟分期 

分 类 号：R737.33[医药卫生—肿瘤]