CD10 imunostaining does not distinguish endometrial carcinoma invading myometrium from carcinoma involving adenomyosis.
CD10 免疫染色不能区分侵入子宫肌层的子宫内膜癌和涉及子宫腺肌病的子宫内膜癌。

摘要

The distinction of involvement of adenomyosis by endometrial carcinoma from endometrial carcinoma invading the myometrium can at times be difficult. This distinction, however, is important from the standpoint of staging, treatment, and prognosis because the outcome of carcinoma invading the myometrium as compared with involving adenomyosis is significantly worse. CD10 has been recently reported to be expressed by normal and neoplastic endometrial stromal cells. We therefore hypothesized that CD10 may be helpful in distinguishing carcinoma within adenomyosis from endometrial carcinoma directly invading the myometrium. Twenty-two cases of invasive endometrioid adenocarcinoma were identified from the surgical pathology files of the Johns Hopkins Hospital and consultation files of one of the authors (R.J.K.) and immunostained for CD10, desmin, and caldesmon. The pattern of staining was compared with five cases in which carcinoma was confined to adenomyosis. As a control, 14 cases of adenomyosis unassociated with carcinoma were included in the analysis. All 22 endometrial carcinomas that invaded the myometrium expressed CD10 to some extent in cells immediately surrounding the neoplastic glands. In 18, all of the invasive nests displayed CD10 in surrounding cells, but in four cases the staining was patchier, involving the surrounding cells of approximately 50-75% of the invasive nests. In four cases of myoinvasive carcinoma, the CD10-positive cells surrounding the nests of invasive carcinoma were also positive for desmin and caldesmon. In the remaining 18 cases with myoinvasive carcinoma, the cells surrounding the carcinomas failed to react with desmin and caldesmon. All five endometrial carcinomas involving adenomyosis displayed CD10 positivity in what appeared to be endometrial stromal cells surrounding the neoplastic glands. The stromal cells were negative for desmin and caldesmon. The control cases of adenomyosis were all positive for CD10, although in four cases the staining was patchy compared with 10 cases in which it was diffuse. Desmin and caldesmon were negative in all of these cases. Although CD10 identifies endometrial stromal cells in the endometrium and in adenomyosis and endometriosis, this study demonstrates that CD10 does not aid in distinguishing myometrial invasion of endometrial carcinoma from involvement of adenomyosis by endometrial carcinoma because the cells surrounding the tumor in the myoinvasive group express CD10.

译文

子宫内膜癌参与子宫腺肌病与子宫内膜癌侵入子宫肌层的区分有时是困难的。然而,从分期、治疗和预后的角度来看,这种区别是重要的,因为与子宫腺肌病相比,侵入子宫肌层的癌的结果要差得多。CD10 最近被报道由正常和肿瘤的子宫内膜基质细胞表达。因此,我们假设 CD10 可能有助于区分子宫腺肌病中的癌和直接侵入子宫肌层的子宫内膜癌。22 例浸润性子宫内膜样腺癌是从约翰·霍普金斯医院的手术病理档案和其中一位作者的咨询档案中鉴定出来的 j. k.) 并对 CD10 、结蛋白和 caldesmon 进行免疫染色。将染色模式与 5 例癌局限于子宫腺肌病的病例进行了比较。作为对照,14 例与癌无关的子宫腺肌病被纳入分析。所有侵入子宫肌层的 22 个子宫内膜癌在一定程度上在肿瘤腺体周围的细胞中表达 CD10。在 18 例中,所有入侵巢在周围细胞中显示 CD10,但在 4 例中,染色更加斑驳,涉及大约 50-75% 的入侵巢的周围细胞。在 4 例肌浸润性癌中,浸润性癌巢周围的 CD10-positive 细胞结蛋白和 caldesmon 也呈阳性。在其余 18 例肌层浸润性癌中,癌周围的细胞未能与结蛋白和 caldesmon 反应。所有五个涉及子宫腺肌病的子宫内膜癌在肿瘤腺体周围似乎是子宫内膜基质细胞的地方都显示出 CD10 阳性。基质细胞对结蛋白和 caldesmon 呈阴性。子宫腺肌病的对照组病例 CD10 均呈阳性,尽管有 4 例染色呈片状,而 10 例染色呈弥漫性。Desmin 和 caldesmon 在所有这些情况下都是阴性的。尽管 CD10 可以识别子宫内膜以及子宫腺肌病和子宫内膜异位症中的子宫内膜基质细胞, 这项研究表明,CD10 并不有助于区分子宫内膜癌的肌层侵袭和子宫内膜癌引起的子宫腺肌病,因为在肌层侵袭组中,肿瘤周围的细胞表达 CD10。

adenomyosis

妇产 妇科常见并发症 疾病
概述  :  

 子宫腺肌病是指有生长功能的子宫内膜腺体与间质侵入子宫肌层导致子宫肌层局限性或弥漫性增生肥大的一种雌激素依赖性妇科良性疾病。该病多发于生育年龄妇女,近年发病率呈现上升趋势,但发病机制至今仍然不清楚。子宫腺肌病的诊断技术包括超声与磁共振等影像技术,但因其最后诊断仍然依赖于病理组织学。同时,1/3患者可无任何临床症状。因此,如果单纯按影像技术来诊断子宫腺肌病,那么就可预见相当部分较轻微的子宫腺肌病在临床上被忽略了。显然,具有典型子宫腺肌病患者的临床症状与体征对于病灶轻微的子宫腺肌病的临

adenomyosis[ædnomaɪ'osɪs]

       n. 子宫腺肌症

       Results: The quality of adenomyosis patients?life had improved significantly by the surgery. 结果:子宫腺肌症患者经该手术治疗,生活质量明显提高。

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