子宫腺瘤样瘤的临床病理分析_医学论文.docVIP

子宫腺瘤样瘤的临床病理分析_医学论文 子宫腺瘤样瘤的临床病理分析_医学论文 【摘要】 目的 探讨子宫腺瘤样瘤的发生、免疫组织化学表达的特征及鉴别诊断。方法 对17例子宫腺瘤样瘤进行临床病理及免疫组织化学观察。结果 17例子宫腺瘤样瘤占同期子宫标本的1.16%，肿瘤位于子宫肌壁间或浆膜下，直径0.8～6 cm，临床表现类似平滑肌瘤。肿瘤以形成不规则腺样和裂隙样结构，内衬扁平或立方上皮为组织学特点，伴有平滑肌组织增生。免疫组织化学染色显示，波形蛋白及细胞角蛋白(AE1/ AE3) 均为阳性，呈双相表达； S2100 蛋白14 例阳性(82.35%)。结论 女性生殖系统腺瘤样瘤为间皮起源，子宫为最常见部位。免疫组织化学染色结果可作为诊断及鉴别诊断的重要参考依据；其生物学行为为良性，预后良好。 【关键词】 子宫肿瘤 腺瘤样瘤 免疫组织化学 【Abstract】 Objective To study the immunohistochemical feature and the differential diagnosis of adenomatoid tumors in uterus.Methods Clinical pathological analysis and immunohistochemical studies were performed on 24 cases of adenomatoid tumors in the uterus and ovaries.Results 17 cases of uterine adenomatoid tumor were diagnosed accounting for 1.16% of all hysterectomy for same period.The tumors were located in the uterine muscle walls or under serosa.The masses ranged from 0.8 to 6 cm in size.The clinical characteristics were similar to the leiomyoma.Microscopically,the tumor consisted of various glandlike or vessellike pattens. Immunohistochemical staining showed the tumor cells positive for vimentin , AE1/ AE3 and calretinin , S2100 were positive in 14 cases (82.35 %).Conclusion Adenomatoid tumor of the female genital tract is mesothelial in origin and uterus is considered as the most common site of occurance.Immunohistochemcal phenotypes can be used as an important evidence for differential diagnosis. The biological behavior of adenomatoid tumor is benign with a good prognosis. 【Key words】 uterine neoplasms,adenomatoid tumor,immunohistochemistry 女性生殖系统腺瘤样瘤是一种少见的良性肿瘤，通常发生于子宫、输卵管及卵巢，也被认为是输卵管最常见的良性肿瘤，其组织发生一直有争议，由于临床无特征性主诉及表现，术前难以诊断。我院2001—2004年收检子宫切除标本共1 466例，从中检出子宫腺瘤样瘤17例，本文对17例子宫腺瘤样瘤进行临床和病理分析，探讨其组织发生和鉴别诊断要点，以提高诊断水平，现总结如下。 1 资料与方法 1.1 临床资料 17例子宫腺瘤样瘤患者均行手术治疗。年龄27～54岁，平均40.5岁。临床表现为子宫不规则出血6例，痛经2例，下腹部包块2例，无自觉症状，但在查体时经B超检查发现子宫包块6例，剖宫产发现子宫浆膜下多发性结节1例。临床诊断为子宫平滑肌瘤13例，子宫肌腺病4例。所有病例在B超检查时均未能正确诊断。 1.2 方法 所有标本均在最初收检时经中性甲醛固定，常规石蜡切片，HE染色。免疫组化采用SP法，标记抗体为即用型CK（AE1/AE3），抗体和SP试剂盒购自福州迈新生物技术开发公司。使用0.01 M柠檬