子宫内膜间质肉瘤特异性标志物的研究

The study of the specific markers of endometrial stromal sarcoma

目的 :探讨子宫内膜间质肉瘤的特异性标志物。方法 :选取子宫内膜间质肉瘤 2 6例 (低度恶性 2 1例 ,高度恶性 5例 ) ,普通型和富于细胞平滑肌瘤各 2 5例 ,正常子宫肌层和正常子宫内膜各 2 5例 ,用免疫组化SP法检测各种组织中雌、孕激素受体 ,结蛋白 ,调宁蛋白 (calponinh1 ) ,以及CD1 0和CD44v3的表达。结果 :子宫内膜间质肉瘤和富于细胞平滑肌瘤均表达雌、孕激素受体和结蛋白。调宁蛋白在所有正常子宫肌层和平滑肌瘤中强表达 ,在 9例子宫内膜间质肉瘤中亦有表达。所有正常子宫内膜间质和 2 1例低度恶性子宫内膜间质肉瘤均弥漫强表达CD1 0 ,而富于细胞平滑肌瘤中仅 1例局灶表达。富于细胞平滑肌瘤中均可见CD44v3表达 ,而在子宫内膜间质肉瘤中仅 2例表达 ,用CD44v3缺如诊断子宫内膜间质肉瘤的敏感性为 92 .3 %,特异性达 1 0 0 %。结论 :CD1 0是低度恶性子宫内膜间质肉瘤较特异的指标。

Objective:To investigate the specific markers of endometrial stromal sarcoma.Methods:Using the routine SP immunohistochemical technique,the expression of estrogen receptor (ER),progesterone receptor (PR),desmin,calponin h1,CD10 and CD44v3 was studied in 26 endometrial stromal sarcoma (ESS),including 21 low grade cases and 5 high grade cases,25 usual leiomyoma (UL),25 cellular leiomyoma (CL),25 myometria and 25 endometria.Results:A substantial portion of cases of ESS and CL were positive for desmin,ER and PR.The strong expression of calponin h1 was present in all CL,myometria and UL,while 9 cases of ESS were also positive for calponin h1.CD10 was diffusely positive in 21 of 22 cases of low grade ESS and all endometria. In contrast,only 1 case of 25 CL was focal expression.CD44v3 immunoreactivity was detected in all CL as compared to only 2 cases of 26 ESS.The sensitivity and specificity of the absence of CD44v3 for ESS were 92.3% and 100% respectively.Conclusions:CD10 is specific immunohistochemical marker of low grade ESS.Calponin h1 and CD44v3 offer some aids in distinguishing between ESS and CL.