子宫内膜间质肉瘤和低分化子宫内膜样腺癌SMA、Desmin、ER、P53的病理分析对比

目的 探讨子宫内膜间质肉瘤和低分化子宫内膜样腺癌临床病理特征,以期提高鉴别和诊断的准确性.方法 回顾性分析2015年1月至2017年1月我院收治的30例子宫内膜间质肉瘤,以及30例低分化子宫内膜样腺癌患者,分别从巨检、镜检、免疫组化三方面进行病理分析与总结.结果 巨检结果发现,子宫内膜间质肉瘤肿块切面多数表现为灰白色,并且未发现明显细胞坏死现象.低分化子宫内膜样腺癌表面内膜粗糙、质脆,可见明显溃疡、出血坏死或肌层浸润现象.镜检结果发现,子宫内膜间质肉瘤呈现不规则舌状现象、肿瘤细胞排列密集,无核分裂或者核分裂不明显,血管周围肿瘤细胞呈现同心圆样排列.低分化子宫内膜样腺癌的腺体呈现多腺管状,腺体排列不规则,大小不一致,腺上皮细胞增生出现排列紊乱,并且增生细胞出现堆积现象,核分裂明显.免疫组化结果发现,低分化子宫内膜样腺癌ER表达阳性率高于子宫内膜间质肉瘤ER表达阳性率(100.00％＞ 66.67％),差异有统计学意义(P＜0.05).两组患者SMA、Desmin、P53表达阳性率之间无明显差别,差异无统计学意义(P＞0.05).结论 子宫内膜问质肉瘤和低分化子宫内膜样腺癌在巨检、镜检和免疫组化上可予区分.

Pathological Analysis of SMA,Desmin, ER,P53 in Patients with Endometriai Stromal Sarcoma and Poorly-differentiated Endometrial Adenocarcinoma

Objective The aim of this study was to evaluate the pathological analysis of SMA,Desmin,ER and P53 in patients with endometrial stromal sarcoma and poorly-differentiated endometrial adenocarcinoma.Methods 30 cases of patients with endometrial stromal sarcoma and 30 cases of patients with poorly-differentiated endometrial adenocarcinoma in our hospital from 2015 January to 2017 January were analyzed.Autopsy,micmscopy,immunohistochemistry were used to analyze the the pathological in patients with endometrial stromal sarcoma and poorly-differentiated endometrial adenocarcinoma.Results Autopsy results showed that tumor section was mostly gray,and there was no significant bleeding and necrosis in patients with endometrial stromal sarcoma.There showed slice surface intimal thickening,brinle,rough,uneven surface,uterine section some visible muscle invasive in poorly-differentiated endometrial adenocarcinoma.Microscopy results showed tongue irregular island myometrial invasion in patients with endometrial stromal sarcoma.Tumor cells were arranged in a densely packed.There were non-nuclear abnormal,and tumor cells were arranged in concentric circles.Poorly-differentiated endometrial adenocarcinoma showed multi tubular glands,irregularly arranged glands,different size,glandular epithelial cell hyperplasia in disordered arrangement,accumulation phenomenon in proliferating cells and notable nuclear fission.Immunohistochemistry showed that ER positive expression rate in patients with endomeWial stromal sarcoma was significantly higher in disease group compared to poorly-differentiated endometdal adenocarcinoma(100.00％ ＞ 66.67％)(P ＜ 0.05).There were no differences in the positive expression rates of SMA,Desmin,P53 between two groups.Conclusion Endometrial stmmal sarcoma and poorly-differentiated endometrial adenocarcinoma can be distinguished by autopsy,micmscopy,immunohistochemistry.