引用本文:陈慧玲,莫祥兰.女性生殖道苗勒腺肉瘤9例临床病理学分析[J].中国临床新医学,0,():-.
chen huiling,mo xianglan.女性生殖道苗勒腺肉瘤9例临床病理学分析[J].中国临床新医学,0,():-.
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女性生殖道苗勒腺肉瘤9例临床病理学分析
陈慧玲, 莫祥兰
广西壮族自治区人民医院
摘要:
目的 探讨9例女性生殖道苗勒腺肉瘤( female genital tract mullerian adenosarcoma，FGTMA) 的临床病理特点、免疫表型，提高对该病的认识。方法回顾性分析病理确诊的9例FGTMA 临床和组织学特征及免疫表型，并随访观察。 结果 临床主要表现为阴道不规则流血、盆腔包块和子宫颈肿物。全部行手术治疗，5例术后辅以化疗，1例放疗。肿瘤由良性腺上皮和肉瘤性间质组成。5例伴有异源性成分，其中4例同时伴肉瘤样过度生长。免疫表型: 腺上皮CK均阳；间质Vimentin均阳，2例P53均≥75%细胞弥漫阳性，5例P16阳，MSH2、MSH6、MLH1 1例同时阴性。Ki-67 增殖指数5%-45%。 结论 FGTMA临床无特异性，确诊依赖病检。早期且完整切除病灶者预后较好，晚期且合并肉瘤样过度生长者预后差。
关键词:  腺肉瘤  女性生殖道肿瘤  形态学  免疫表型  预后
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基金项目:广西科学研究与技术开发计划项目(编号：桂科攻1140003B-68)
Mullerian adenosarcoma of the female genital tract: a clinicopathologic analysis of 9 cases
chen huiling, mo xianglan
the People’ s Hospital of Guangxi Zhuang Autonomous Region
Abstract:
[Abstract] Objective To investigate the clinicopathologic features and im-munophenotypes of 9 cases female genital tract mullerian adenosarcoma (FGTMA) and improve understanding of the disease. Methods A retrospective study was conducted on the clinicopathologic features and immunophenotypes of 9 cases FGTMA. All patients were received postoperative follow-up. Results The major clinical symptoms of FGTMA were abnormal vaginal bleeding, pelvic mass and cervical lesions. All patients received surgical treatment, 5 combined with postoperative chemotherapy, one with radiotherapy. Histopathologically, tumors were composed of benign glandular epitheliums and malignant mesenchymal tissues. The sarcomatous stroma contained heterologous elements in 5 cases, 4 of them with sarcomatous overgrowth. Immunohistochemically, glandular epitheliums showed expression of CK and mesenchymal tissues showed Vimentin expression in all cases, 2 of them showed strong expression of p53, 5 were p16 expression, 1 was negative to MSH2, MSH6 and MLH1. The proliferation index of Ki-67 was 5%-45%. Conclusions There is no specific clinical features of FGTMA. Accurate diagnosis of the disease rely on pathological examination. Patients who received early diagnosis and completely surgical treatment have better outcomes than those with advance disease and sarcomatous overgrowth.
Key words:  Mullerian adenosarcoma  Female genital tract tumor  Morpho-logy  Immunophenotypes  Prognosis