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恶性苗勒管混合瘤临床病理分析
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Abstract:
目的：探讨子宫恶性苗勒管混合瘤(Malignant Müllerian Mixed Tumor, MMMT)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法：采用HE染色及免疫组化染色对4例MMMT进行检测并复习相关文献。结果：肿瘤由上皮和间质两种成分构成，2例上皮成分为子宫内膜样腺癌，1例间质成分为子宫内膜间质肉瘤，1例间质成分为高级别肉瘤。免疫表型：上皮成分CKpan (2/2)，间质成分vimentin (2/2)、CD10 (2/2)均阳性，上皮成分和间质成分p16 (2/2)和p53 (2/2)均阳性。结论：子宫MMMT是一种少见的高度恶性上皮和间质混合性肿瘤，具有独特的临床病理学特征，预后差。
Objective: To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of malignant mixed Müllerian tumor (MMMT) of the uterus. Methods: Four cases of MMMT were examined by HE staining and immunohistochemical staining, and relevant literatures were reviewed. Results: The tumors were composed of two components, namely epithelial and stromal components. In 2 cases, the epithelial component was endometrioid adenocarcinoma. In 1 case, the stromal component was endometrial stromal sarcoma, and in another 1 case, the stromal component was high-grade sarcoma. Immunophenotype: CKpan (2/2) was positive in the epithelial component, while vimentin (2/2) and CD10 (2/2) were positive in the stromal component. Both p16 (2/2) and p53 (2/2) were positive in both the epithelial and stromal components. Conclusion: Uterine MMMT is a rare, highly malignant mixed tumor of epithelium and stroma with unique clinicopathological features and a poor prognosis.
| [1] | Visvalingam, G., Lee, W.K.R., Wong, C.F. and Lim, Y.K. (2016) Primary Malignant Mixed Müllerian Tumour (MMMT) of the Vagina and Review of the Literature. BMJ Case Reports, 2016, bcr2016214856. https://doi.org/10.1136/bcr-2016-214856 |
| [2] | Sharma, N.K., Sorosky, J.I., Bender, D., Fletcher, M.S. and Sood, A.K. (2005) Malignant Mixed Mullerian Tumor (MMMT) of the Cervix. Gynecologic Oncology, 97, 442-445. https://doi.org/10.1016/j.ygyno.2005.01.022 |
| [3] | Duman, B.B., Kara, I.O., Günaldi, M. and Ercolak, V. (2011) Malignant Mixed Mullerian Tumor of the Ovary with Two Cases and Review of the Literature. Archives of Gynecology and Obstetrics, 283, 1363-1368. https://doi.org/10.1007/s00404-011-1845-6 |
| [4] | D’Angelo, E. and Prat, J. (2011) Pathology of Mixed Müllerian Tumours. Best Practice & Research Clinical Obstetrics & Gynaecology, 25, 705-718. https://doi.org/10.1016/j.bpobgyn.2011.05.010 |
| [5] | Yao, R., Wu, P., Sung, C.J., Lamson, J.A. and Zhang, C. (2022) Malignant Mixed Mullerian Tumor Arising from Endometriosis in the Groin: A Case Report and Literature Review. International Journal of Surgical Pathology, 31, 338-342. https://doi.org/10.1177/10668969221105618 |
| [6] | 谢明, 梁红, 陈凯, 等. 卵巢恶性苗勒管混合瘤6例临床病理分析[J]. 诊断病理学杂志, 2012, 19(1): 29-31. |
| [7] | 姚娟, 苑红梅, 赵红梅, 等. 子宫恶性苗勒管混合瘤4例临床病理分析[J]. 临床与实验病理学杂志, 2020, 36(1): 86-88. |
| [8] | Pyra, A., AdamiakGodlewska, A., Lewkowicz, D., Bałon, B., Cybulski, M., SemczukSikora, A., et al. (2022) Inter-Component Immunohistochemical Assessment of Proliferative Markers in Uterine Carcinosarcoma. Oncology Letters, 24, Article No. 363. https://doi.org/10.3892/ol.2022.13483 |
| [9] | Makk, E., Bohonyi, N., Oszter, A., Éles, K., Tornóczky, T., Tóth, A., et al. (2023) Comparative Analysis of EZH2, P16 and P53 Expression in Uterine Carcinosarcomas. Pathology and Oncology Research, 29, Article ID: 1611547. https://doi.org/10.3389/pore.2023.1611547 |
| [10] | Shen, Y., Xie, Y., Xu, L., Yang, K., Yu, N., Yu, Y., et al. (2009) Malignant Mixed Müllerian Tumor of the Fallopian Tube: Report of Two Cases and Review of Literature. Archives of Gynecology and Obstetrics, 281, 1023-1028. https://doi.org/10.1007/s00404-009-1331-6 |
