子宫内膜癌肉瘤4例临床病理学分析

Clinicopathological analysis of 4 cases of endometrial carcinosarcoma

目的子宫内膜癌肉瘤为侵袭性和双相性肿瘤,本文探讨子宫内膜癌肉瘤的临床病理学特征及患者预后情况,为临床诊疗提供依据。方法复习4例子宫内膜癌肉瘤的临床及病理学资料,行常规石蜡包埋切片和免疫组化染色协助诊断。结果显微镜下见肿瘤组织由恶性上皮和间叶2种组织成分构成,相互之间有或穿插移行或分界清楚,上皮成分为子宫内膜样癌,肉瘤成分为横纹肌肉瘤。所有上皮成分AE1/AE3(+)、ER(+),所有肉瘤成分vimentin(+)、MyoD1(+)。结论子宫内膜癌肉瘤是侵袭性肿瘤,预后差。组织形态学结合免疫组化染色对诊断及鉴别诊断有重要的意义。

Objective Endometrial carcinosarcoma is an aggressive and biphasic tumor.This article discusses the clinicopathological features and prognosis of endometrial carcinosarcoma,and provides a basis for clinical diagnosis and treatment.Methods The clinical and pathological data of 4 cases of endometrial carcinosarcoma were reviewed,and routine paraffin sections and immunohistochemical staining were performed to assist in the diagnosis.Results Microscopically,the tumor tissue was composed of malignant epithelium and mesenchyme,which were interspersed with each other or had clear boundaries.The epithelial component was endometrioid carcinoma,and the sarcoma component was rhabdomyosarcoma.All epithelial components AE1/AE3(+),ER(+),all sarcoma components vimentin(+),MyoD1(+).Conclusion Endometrial carcinosarcoma is an aggressive tumor with poor prognosis.Histomorphology combined with immunohistochemical staining is of great significance for diagnosis and differential diagnosis.