钙调蛋白结合蛋白在子宫平滑肌肿瘤诊断中的意义

H-caldesmon in diagnosis of smooth muscle tumors of the uterus

目的 探讨高度敏感和特异的诊断子宫平滑肌肿瘤的指标。方法 选取子宫内膜间质肉瘤 2 6例 ,子宫普通型和富于细胞性平滑肌瘤各 2 5例 ,子宫平滑肌肉瘤 17例 ,正常子宫肌层和正常子宫内膜各 2 5例 ,采用免疫组化 S-P法检测各种组织中结蛋白、平滑肌肌动蛋白、雌激素受体以及重型钙调蛋白结合蛋白 (h-caldesmon)的表达。结果 正常的子宫肌层、子宫普通型平滑肌瘤、富于细胞性平滑肌瘤和子宫平滑肌肉瘤中重型钙调蛋白结合蛋白的表达分别为 10 0 .0 %、10 0 .0 %、96.0 %和 64.7% ,但正常子宫内膜和子宫内膜间质肉瘤细胞中均未见其表达。重型钙调蛋白结合蛋白诊断富于细胞性平滑肌瘤不仅敏感度高于结蛋白 ,而且特异度达 10 0 .0 %。

ObjectiveTo explore more sensitive and specific markers in the diagnosis of smooth muscle tumors of the uterus. MethodsUsing the routine S-P immunohis tochemical technique, the expression of desmin, smooth muscle actin (SMA), estro gen receptor (ER) and h-caldesmon was tested in 25 cases of ordinary leiomyoma , 25 of cellular leiomyoma, 17 of leiomyosarcoma, 26 of endometrial stromal sarc oma, 25 of myometria and 25 of endometria. ResultsThe expressi on of h-caldesmon in myometria, ordinary leiomyomas, cellular leiomyomas, and l eiomyosarcomas was 100 0%, 100 0%, 96 0% and 64 7%, respectively. But no exp ression of h-caldesmon was seen in endometria and endometrial stromal sarcomas. When used to diagnose cellular leiomyoma, h-caldesmon was a more sensitive mar ker than desmin. What' s more notable, its specificity was 100%. Conclus ionH-caldesmon could be used to differentiate cellular leiomyoma from endometrial stromal sarcoma adjuvantly.