伴MELF生长方式的子宫内膜样癌临床病理特征及免疫表型的研究

Clinical and Pathological Characteristics and Immunophenotype of Endometrial Carcinoma with MELF Growth Pattern

目的探讨伴微囊性、伸长、碎片状(MELF)生长方式的子宫内膜样癌的临床病理特征及免疫表型特点。方法收集2013年9月—2019年1月新疆巴州人民医院行子宫全切除+双侧附件切除+盆腔淋巴清扫术的72例子宫内膜样癌患者的临床病理资料,判定MELF浸润情况,调查患者的一般资料、临床病理特点、免疫组化染色结果并进行比较分析,随访患者的预后情况。结果在72例患者中,病理诊断为伴MELF生长方式的子宫内膜样癌(伴MELF浸润组)占16.7%(12/72);不伴MELF生长方式的子宫内膜样癌(不伴MELF浸润组)占83.3%(60/72)。不伴MELF浸润组的年龄、绝经状态比较,差异有统计学意义(P<0.05)。伴MELF浸润组的病理分级、淋巴脉管间质浸润、淋巴结转移等与不伴MELF浸润组比较,差异有统计学意义(P<0.05)。伴MELF浸润组中,ER、PR、Ki-67、P16、CK阳性表达率分别为8.3%、16.7%、91.6%、100.0%、100.0%。不伴MELF浸润组中,ER、PR、Ki-67、P16、CK呈棕黄色强阳性表达,阳性表达率均为100.0%。随访期内患者均无肿瘤转移与肿瘤复发情况发生。结论MELF浸润在子宫内膜样癌中比较常见,伴MELF生长方式的子宫内膜样癌ER与PR表达阳性率显著降低,淋巴结转移阳性率、LVSI阳性率明显增高。

Objective To investigate the clinical pathological and immunophenotypic characteristics of endometrial carcinoma with microcystic,elongated,and fragmented growth patterns(MELF).Methods The clinical and pathological data of 72 cases of patients with endometrioid carcinoma who underwent hysterectomy,bilateral adnexectomy,and pelvic lymph node dissection at Bazhou People's Hospital in Xinjiang from September 2013 to January 2019 were collected,and were to determine the infi ltration of MELF.The general information,clinical and pathological characteristics,immunohistochemical staining results of the patients were investigated and compared,and the prognosis of the patients were followed up.Results In the 72 patients,there were 12 cases(16.7%)were pathologically diagnosed as endometrial carcinoma with MELF growth pattern(with MELF infi ltration group);There were 60 patients with endometrioid carcinoma without MELF growth pattern(without MELF infi ltration group),accounted for 83.3%(60/72).There were no signifi cant diff erence in body mass index,educational years,etc.compared between the group with MELF infi ltration and the group without MELF infi ltration(P>0.05),but there were signifi cant diff erence in age and menopausal status compared between the two groups(P<0.05).There were signifi cant diff erences in pathological grading,lymphatic vessel interstitial infi ltration,and lymph node metastasis compared between the group with MELF infiltration and the group without MELF infiltration(P<0.05).In the group with MELF infi ltration,the positive expression rates of ER,PR,Ki-67,P16,and CK were 8.3%,16.7%,respectively 91.6%,100.0%,and 100.0%.In the group with MELF infi ltration,ER,PR,Ki-67,P16,and CK showed strong brown yellow positive expression,with the positive expression rate of 100.0%.During the follow-up period,patients did not experience any tumor metastasis or recurrence.Conclusion MELF infi ltration is a special infi ltration pattern that occurs in low-grade endometrial carcinoma.Patients with MELF growth pattern in endometrial carcinoma have a signifi cantly higher LVSI positive rate and lymph node metastasis positive rate,the positive rates of ER and PR expression were signifi cantly reduced.