宫颈与宫体子宫内膜样腺癌的临床病理及免疫表型分析

目的探讨宫颈子宫内膜样腺癌和宫体子宫内膜样腺癌的临床病理和免疫表型差异。方法采用HE及免疫组化En-Vision两步法对8例宫颈内膜样腺癌和76例宫体内膜样腺癌的组织学形态和免疫表型进行比较观察。结果宫颈子宫内膜样腺癌和宫体子宫内膜样腺癌在组织学形态上相似。两组标本的免疫标记物阳性率分别为vimentin(0,95.45%)、CEA(100%,45.45%)、p53(12.50%,31.82%)、ER(0,54.54%)、PR(0,60.61%)、Ki-67(75.0%,12.12%)、HPV16/18(100%,3.03%)、p16(100%,46.97%)、Cam5.2(12.50%,62.12%)。两者相比,vimentin、CEA、ER、PR、p16、Ki-67、HPV16/18、PAS、Cam5.2的表达差异有显著性(P<0.05),而p53的表达差异无统计学意义(P>0.05)。结论应用免疫标记物vimentin、CEA、ER、PR、p16、Ki-67、HPV16/18、PAS、Cam5.2检测是鉴别宫颈和宫体子宫内膜样腺癌的一种重要的有效方法,p53可作为辅助鉴别的免疫标记物。

Clinical pathology and immunohistochemical phenotype analysis of endometrioid adenocarcinoma of cervix uteri and endometrioid adenocarcinoma of corpus uteri

Purpose To investigate histomorphologial and immunophenotypic differences of endometrioid adenocarcinoma of cervix uter and endometrioid adenocarcinoma of corpus uteri.Methods Histomorphologial and immunohistochemical observation were used in the study to compare 8 cases of cervical endometrioid adenocarcinoma and 76 cases of uterine endometrioid adenocarcinoma.Results Cervical endometrioid adenocarcinoma and uterine endometrioid adenocarcinoma of corpus were similar on morphological,but their positive expression rates of markers were vimentin(0,95.45%),CEA(100%,45.45%),p53(12.50%,31.82%),ER(0,54.54%),PR(0,60.61%),Ki-67(75.0%,12.12%),HPV16/18(100%,3.03%),p16(100%,46.97%),and Cam5.2(12.50%,62.12%).There were significant differences between them in the positive rates of vimentin,CEA,ER,PR,p16,Ki-67,HPV16/18,PAS,Cam5.2(P<0.05).And no significant differences in positive p53 expression were observed(P>0.05).Conclusions The difference of immunologic markers expression,especially including vimentin,CEA,ER,PR,p16,Ki-67,HPV16/18,PAS,and Cam5.2 are a key point for differential diagnosis between endometrioid adenocarcinoma of cervix and uterine endometrioid adenocarcinoma.p53 may be used as an adjunctive immunologic marker in the differential diagnosis.