子宫内膜间质肉瘤的临床病理与预后

Uterine Endometrial Stromal Sarcoma:Clinicopathological Study and Prognosis

目的 观察子宫内膜间质肉瘤的临床及病理学形态特点 ,并探讨其与预后的关系。方法 对 3 2例子宫内膜间质肉瘤进行光镜观察 ,并对其中 15例行免疫组化染色 ,结合随访资料进行对比分析。结果 瘤体多位于左、右侧子宫肌壁内 (2 1例 ) ,瘤体直径为 1.5～ 2 3 .0cm ,镜下瘤细胞多呈圆形或梭形。核呈圆形或不规则形。核分裂像多少不等 ,上皮样瘤细胞呈巢状、条索、腺管样排列 ,梭形瘤细胞呈漩涡状、血管外皮瘤样排列 ,间质血管丰富。免疫组化结果 :actin阳性率为 80 .0 % ,Vim阳性率为 66.6% ,desmin阳性率为 40 .0 % ,上皮性抗原呈阴性反应。结论 子宫内膜间质肉瘤的预后与瘤体大小、临床分期密切相关 ,而与核分裂像的多少无明显的关系。

Objective To investigate the clinicopathological characteristics and prognosis of uterine endometrial stromal sarcoma(UESS).Methods Thirty-two cases of UESS were investigated with light microscope and immunohistochemical techniques.Results The tumors were mostly located in the left and right wall of uterine(21 cases).The diamiter of tumors ranged from 1.5 cm to 23.0 cm.Microscopically,the tumor cells showed round and/or spindle shape,nuclei showed round or irregular shape.Mitotic figures varied in numbers,epithelioid tumor cells ranked as nest,cord and adnoid.Spindle cell ranked as whirlpool.There was abundant blood vessel in stroma.The positive rates of the tumors cells for actin,vimentin and desmin were 80.0%,66.6% and 40.0% respectively.Conclusion The prognosis of the tumor is closely correlatd with clinical stage,tumor size and growing pattern of the tumor,but not with the number of mitotic figures.