女性生殖系统中肾样腺癌临床病理分析  

作　　者：罗兰 代娇 张源[1] 叶王炜 程晔[2] 金菊 徐海苗[2] 

机构地区：[1]浙江中医药大学,310053 [2]浙江省肿瘤医院,310022

出　　处：《浙江临床医学》2025年第2期272-275,共4页Zhejiang Clinical Medical Journal

摘　　要：目的探讨女性生殖系统中肾样腺癌临床病理特点、免疫表型、腹水细胞学特征及分子病理检测结果。方法回顾性分析2022年4月至2023年12月本院接受治疗的11例中肾样腺癌的临床病理资料。结果9例中肾样腺癌患者发生于子宫体,占82%,2例发生于卵巢。6例因绝经后阴道出血就诊,其余患者因腹胀和腹痛就诊。发病中位年龄为58岁。肿瘤组织学多样,均呈腺管状和筛网状、5例呈乳头样,部分病例可见实性生长区域(5/11)和肾小球样结构(2/11),部分合并肉瘤及交界性黏液性肿瘤成分。所有11例肿瘤组织阳性表达CD10,8例阳性表达GATA-3,11例阳性表达TTF-1,并呈反向染色。2例子宫体中肾样腺癌患者伴有盆腔及腹腔癌转移腹水。5例经分子检测,发现2例TP53突变,1例KRAS突变,1例PIK3CA突变。结论女性生殖系统中肾样腺癌与宫颈中肾腺癌和子宫内膜样腺癌的临床表现相似,需结合免疫标记分子CD10、TTF-1、GATA-3及癌基因分子KRAS、PIK3CA检测以提高诊断率。Objective To investigate the clinical pathological characteristics,immunophenotypes,ascitic cytology features,and molecular pathology test results of mesonephric-like adenocarcinoma in the female reproductive system.Methods A retrospective analysis was conducted on the clinical pathological data of 11 cases of mesonephric-like adenocarcinoma treated at Zhejiang Cancer Hospital from April 2022 to December 2023.Results Among the 11 patients,9 cases(82%,9/11)of mesonephric-like adenocarcinoma occurred in the uterine body,and 2 cases occurred in the ovaries.Six cases presented due to postmenopausal vaginal bleeding,while the remaining patients sought medical attention due to abdominal bloating and pain.The median age at onset was 58 years.The tumor tissue morphology was diverse,all exhibiting glandular(11/11)and sieve-like(11/11)patterns,with 5 cases showing papillary patterns.Some cases had solid growth areas(5/11)and glomerular-like structures(2/11),and some were combined with sarcoma and borderline mucinous tumor components.All 11 cases showed positive expression for CD10,8 cases showed positive expression for GATA-3,and 11 cases showed positive expression for TTF-1,with a reverse staining pattern.Two cases of uterine body mesonephric-like adenocarcinoma were accompanied by pelvic and abdominal cancerous ascites.In 5 cases subjected to molecular testing,2 cases had TP53 mutations,1 case had a KRAS mutation,and 1 case had a PIK3CA mutation.Conclusion Mesonephric-like adenocarcinoma in the female reproductive system has similar clinical manifestations to cervical renal adenocarcinoma and endometrial adenocarcinoma.The diagnostic rate can be improved by combining immunomarkers CD10,TTF-1,GATA-3,and cancer gene molecules KRAS,PIK3CA.

关 键 词：中肾样腺癌 女性生殖系统 免疫组化 腹水细胞学 分子检测 

分 类 号：R737.3[医药卫生—肿瘤]