子宫内膜间质肉瘤特异性标志物及临床病理分析

The specific markers and clinical pathologic analysis of endometrial stromal scarcoma

目的:探讨子宫内膜间质肉瘤(ESS)中特异性标志物雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体(EGFR)、结蛋白(desmin)、CD10、CD44的表达,并分析ESS的临床病理特征。方法:收集2000～2009年本院收治的32例ESS患者,通过免疫组化染色(SP法)检测ER、PR、EGFR、desmin、CD10和CD44在ESS中的表达,并在镜下观察其病理学特征。另取30例子宫平滑肌瘤作为对照。结果:ESS多为单发,肿瘤类似增生期子宫内膜间质细胞,瘤细胞呈圆形、卵圆形、梭形,排列密集。EGFR在ESS和子宫平滑肌瘤中的阳性表达率差异无统计学意义(P>0.05),ER、PR、desmin、CD10、CD44在ESS和子宫平滑肌瘤中的阳性表达率差异有统计学意义(P<0.05或P<0.01)。结论:诊断ESS时应结合其临床病理特征,CD10可作为诊断ESS的特异指标,CD44可辅助诊断ESS。

Objective：To investigate the expressions of specific markers estrogen receptor（ER） ,progesterone receptor（PR） ,epidermal growth factor receptor（EGFR） ,desmin,CD10 and CD44 in endometrial stromal scarcoma（ESS） ,and analyze the clinical pathologic features of ESS. Methods：A total of 32 cases of patients with ESS from 2000 to 2009 in our hospital were selected,and the expressions of ER,PR,EGFR,desmin,CD10 and CD44 in ESS were detected by using immunohis-tochemical SP assay,and its pathologic features were observed under microscope. 30 cases of leiomyosarcoma uteri were selected as controls. Results：Most ESS were solitary tumors,it was similar to endometrial stroma cells of proliferative phase,cells were round,oval and fusiform,the arrangement was intensive. The positive expression rate of EGFR had no significant difference between ESS and leiomyosarcoma uteri（P0.05） ,the positive expression rates of ER,PR,desmin,CD10 and CD44 had significant difference between ESS and leiomyosarcoma uteri（P0.05 or P0.01） . Conclusion：The clinical pathologic features should be considered when diagnosing ESS,CD10 can serve as the sensitive marker in the diagnosis of ESS,and CD44 can serve as the auxiliary marker in the diagnosis of ESS.