子宫内膜样腺癌的内分泌分化及意义

目的：探讨子宫内膜样腺癌的内分泌分化及意义。方法：临床手术切除或活检的子宫内膜样腺癌标本50例，另取20例正常子宫内膜及12例子宫内膜增生症标本作对照。采用嗜铬素A(chromograninA，CgA)免疫组化染色法显示内分泌细胞(endocrine cell，EC)，采用显微图像分析系统计算EC密度(个／mm^2)。结果：正常子宫内膜组织仅见极少量的EC，子宫内膜样腺癌组织中EC的数量及染色强度均高于正常子宫内膜组及子宫内膜增生症组。子宫内膜样腺癌组织中CgA阳性率为44．0％，明显高于正常子宫内膜组(15．0％，P＜0．05)。高分化的内膜样腺癌组织中CgA阳性率及EC密度高于中、低分化的内膜癌组织。结论：子宫内膜样腺癌的内分泌分化是肿瘤异质性的表现，EC可能通过内分泌、旁分泌和腔分泌的方式，调节肿瘤的生长及分化。

Endocrine differentiation in endometrioid adenocarcinoma and its significance

Objective To investigate endocrine differentiation and its significance in endometrioid adenocarcinoma. Methods Endocrine cells(EC) were identified by immunohistochemical staining of chromogranin A in 50 cases of endometrioid adenocarcinoma, 20 of normal endometrium and 12 of endometrial hyperplasia. The number of EC was assessed by micro image analyzing system. Results Scanty ECs were present in normal endometrium. The quantity and staining intensity of EC in endometrioid adenocarcinoma were greater than those in normal and hyperplastic endometrium. The positive rate of CgA in endometrioid adenocarcinoma was 44.0%, significantly higher than that in normal endometrium (15.0%) ( P <0.05). The positive rate of CgA and the density of EC in G 1 were higher than those in G 2 and G 3. Conclusions The presence of endocrine cells in endometrioid adenocarcinoma shows atypia of tumors. Endocrine cells of endometrioid adenocarcinoma may regulate tumor growth and differentiation in endocrine, paracrine or lumenocrine fashion.