Faquin W C, Fitzgerald J T, Lin M C, Boynton K A, Muto M G, Mutter G L
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115USA.
Am J Clin Pathol. 2000 Apr;113(4):576-82. doi: 10.1309/4mgm-fmrc-6awk-yqy2.
Microsatellite instability is a frequent (13%-24%) finding in sporadic endometrial adenocarcinoma and its precursor lesions, but most studies are limited to patients who already have malignant or premalignant endometrial disease. We performed retrospective testing for microsatellite instability in women in whom cancers showing microsatellite instability developed later and prospective testing in randomly selected normal and anovular endometrial biopsy specimens. Microsatellite instability in cancer-bearing biopsy specimens accurately reflected that seen in matched malignant tissues obtained at hysterectomy. In 1 patient, microsatellite instability developed in a scanty sample of fragmented endometrial tissues 7 years before the onset of endometrial cancer. Prospective testing for microsatellite instability in the endometria of women unselected for subsequent appearance of endometrial cancer showed a very low rate of microsatellite instability. Only 1 endometrial specimen showing microsatellite instability was found among 75 anovulatory endometrial specimens, and none were found in 377 normal endometrial specimens and 46 polyps examined. Microsatellite instability may precede the onset of histologically diagnosed carcinoma but is rare in randomly sampled histologically normal endometrial tissues.
微卫星不稳定性在散发性子宫内膜腺癌及其前驱病变中很常见（13%-24%），但大多数研究仅限于已经患有恶性或癌前子宫内膜疾病的患者。我们对后来发生微卫星不稳定性癌症的女性进行了微卫星不稳定性的回顾性检测，并对随机选择的正常和无排卵性子宫内膜活检标本进行了前瞻性检测。有癌活检标本中的微卫星不稳定性准确反映了在子宫切除术中获得的匹配恶性组织中所见的情况。在1例患者中，微卫星不稳定性在子宫内膜癌发病前7年出现在少量破碎的子宫内膜组织样本中。对未因后续出现子宫内膜癌而被选择的女性子宫内膜进行微卫星不稳定性的前瞻性检测显示，微卫星不稳定性发生率非常低。在75例无排卵性子宫内膜标本中仅发现1例显示微卫星不稳定性的子宫内膜标本，在377例正常子宫内膜标本和46例息肉中均未发现。微卫星不稳定性可能在组织学诊断的癌发病之前出现，但在随机抽样的组织学正常的子宫内膜组织中很少见。
