SATB2和p16表达以及组织形态学特征在非典型息肉样腺肌瘤诊断中的价值  

Role of SATB2 and p16 expression and histomorphological features in the diagnosis and differential diagnosis of atypical polypoidal adenomyoma

作　　者：汪稳庚 李明[2] 周炜根 张巧惠 程平 窦红漫[1] Wang Wengeng;Li Ming;Zhou Weigen;Zhang Qiaohui;Cheng Ping;Dou Hongman(Department of Pathology,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China;Department of Pathology,Bozhou Hospital Affiliated to Anhui Medical University,Bozhou 236000,China;Department of Pathology,Jiaxing Maternal and Child Health Hospital,Jiaxing 314009,China)

机构地区：[1]安徽中医药大学第一附属医院病理科,合肥230031 [2]安徽医科大学附属亳州医院病理科,亳州236000 [3]嘉兴市妇幼保健院病理科,嘉兴314009

出　　处：《临床与实验病理学杂志》2025年第4期464-468,473,共6页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨联合免疫组化SATB2和p16以及组织形态学特征在非典型息肉样腺肌瘤(atypical polypoid adenomyoma,APAM)、肌层浸润性内膜样癌(myometrial infiltrating endometrioid carcinoma,MIEC)及伴有间质纤维化的子宫内膜息肉(interstitial fibrotic endometrial polyps,IFEP)诊断和鉴别诊断中的作用。方法收集32例APAM、20例MIEC和25例IFEP,采用免疫组化EnVision两步法检测SATB2和p16在3组病例间质细胞中的表达;评估3组病例中4项形态学特征:复杂腺体结构、成熟鳞化和桑葚样化生、纤维肌性间质、细胞非典型性。结果SATB2在APAM(31/32)间质中的表达明显高于MIEC(1/20)和IFEP(0/25),差异有统计学意义。p16在APAM(32/32)间质中的表达明显高于MIEC(3/20),差异有统计学意义;而与IFEP(21/25)相比差异无统计学意义。组织形态学特征:与MIEC相比,APAM具有明显的成熟鳞化和桑葚样化生(APAM组31/32,MIEC组4/20),差异有统计学意义;而在复杂腺体结构(APAM组22/32,MIEC组20/20)、纤维肌性间质(APAM组32/32,MIEC组20/20)、细胞非典型性(APAM组32/32,MIEC组20/20)方面,两组差异无统计学意义。与IFEP组相比,APAM具有典型的复杂腺体结构(APAM组20/32,IFEP组0/25)、成熟鳞化和桑葚样化生(APAM组32/32,IFEP组2/25)、细胞非典型性(APAM组32/32,IFEP组0/25),差异有统计学意义。而两组病例纤维肌性间质(APAM组32/32,IFEP组25/25)差异无统计学意义。结论联合免疫组化SATB2和p16以及组织形态学特征有助于APAM的诊断,以及和MIEC和IFEP的鉴别诊断。Purpose To investigate the role of combined immunohistochemical expression of SATB2 and p16 and pathological histomorphological features in the diagnosis and differential diagnosis of atypical polypoid adenomyoma(APAM),myometrial infiltrating endometrioid carcinoma(MIEC)and interstitial fibrotic endometrial polyps(IFEP).Methods A total of 32 cases of APAM,20 cases of MIEC and 25 cases of IFEP were collected.The expression of SATB2 and p16 in the stromal cells of the three groups of cases was detected by immunohistochemical EnVision two-step method.Four morphological features were evaluated in the three groups:complex glandular structure,squamous and mulberry metaplasia,fibromuscular stroma and cellular atypia.Results The expression of SATB2 in the stroma of APAM(31/32)was significantly higher than that of MIEC(1/20)and IFEP(0/25),and the difference was statistically significant.The expression of p16 in APAM(32/32)stroma was significantly higher than that in MIEC(3/20),and the difference was statistically significant,while compared with IFEP(21/25),the difference was not statistically significant.Histomorphological characteristics:compared with the MIEC group,APAM had obvious squamous and mulberry metaplasia(APAM group 31/32,MIEC group 4/20),and the difference was statistically significant;However,there was no statistically significant difference between the two groups in terms of complex glandular structure(APAM group 22/32,MIEC group 20/20),fibromuscular stroma(APAM group 32/32,MIEC group 20/20),and cellular atypia(APAM group 32/32,MIEC group 20/20).Compared with the IFEP group,APAM had typical complex glandular structure(APAM group 20/32,IFEP group 0/25),squamous and mulberry metaplasia(APAM group 32/32,IFEP group 2/25),and cellular atypia(APAM group 32/32,IFEP group 0/25),and the difference was statistically significant.However,there was no statistically significant difference in fibromuscular stroma(APAM group 32/32,IFEP group 25/25)between the two groups.Conclusion The combined immunohistochemical analysis o

关 键 词：非典型息肉样腺肌瘤 子宫内膜样癌 肌层浸润 子宫内膜息肉 间质纤维化 SATB2 p16 

分 类 号：R711.7[医药卫生—妇产科学]