子宫内膜间质肉瘤中BCOR、CD10和Cyclin D1的诊断意义

目的探讨子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)中BCOR、CD10和Cyclin D1的表达及其诊断意义。方法收集38例ESS,其中低级别子宫内膜间质肉瘤(low-grade endometrial stromal sarcoma,LG-ESS)23例、高级别子宫内膜间质肉瘤(high-grade endometrial stromal sarcoma,HG-ESS)12例和未分化子宫肉瘤(undifferentiated uterine sarcoma,UUS)3例,另收集6例子宫平滑肌肉瘤(包括2例黏液性平滑肌肉瘤)和20例子宫富于细胞性平滑肌瘤作为对照组,采用免疫组化EnVision法检测BCOR、CD10和Cyclin D1在不同子宫组织中的表达,分析三者的差异表达并复习相关文献。结果BCOR在HG-ESS、LG-ESS、UUS、平滑肌肉瘤和富于细胞性平滑肌瘤中的表达分别为7、1、0、0和0例,CD10在HG-ESS、LG-ESS、UUS、平滑肌肉瘤和富于细胞性平滑肌瘤中的表达分别为8、21、1、2和4例,Cyclin D1在HG-ESS、LG-ESS、UUS、平滑肌肉瘤和富于细胞性平滑肌瘤中的表达分别为5、4、1、1和0例。结论BCOR在HG-ESS中具有较高的敏感性与特异性,特别是在Cyclin D1阴性和伴黏液样背景的HG-ESS中,可联合CD10和Cyclin D1用于HG-ESS的诊断及鉴别诊断。

Significance of BCOR,CD10 and Cyclin D1 in the diagnosis of endometrial stromal sarcoma

Purpose To investigate the significance of BCOR,CD10 and Cyclin D1 in the diagnosis of endometrial stromal sarcoma(ESS).Methods A total of 38 patients with pathologically confirmed ESS,including 23 cases of low-grade endometrial stromal sarcoma(LG-ESS),12 cases of high-grade endometrial stromal sarcoma(HG-ESS)and 3 cases of undifferentiated uterine sarcoma(UUS).Meanwhile,6 cases of uterine leiomyosarcoma(including 2 cases of mucinous leiomyosarcoma)and 20 cases of uterine cellular leiomyoma were also collected.Immunohistochemical EnVision method was used to detect the expression of BCOR,CD10 and Cyclin D1 in the above cases,the difference in expression was analyzed with review of the literature.Results The positive expression of BCOR in HG-ESS,LG-ESS,UUS,leiomyosarcoma and cell-rich leiomyoma was 7,1,0,0 and 0 cases,respectively.The distribution of CD10 expression in ESS,LG-ESS,UUS,leiomyosarcoma and cell-rich leiomyoma were 8,21,1,2 and 4 cases,and that of Cyclin D1 was 5,4,1,1,and 0 cases,respectively.Conclusion BCOR has high sensitivity and specificity in HG-ESS,especially in the case of Cyclin D1 negative and HG-ESS with mucin-like background.It can be combined with CD10 and Cyclin D1 for the diagnosis and differential diagnosis of HG-ESS.