Chiarelli Silvia, Buriticá Catalina, Litta Piero, Ciani Susana, Guarch Rosa, Nogales Francisco F
Department of Oncological and Surgical Sciences (Pathology), Università degli Studi di Padova, Padova, Italy.
Clin Cancer Res. 2006 Jul 15;12(14 Pt 1):4251-6. doi: 10.1158/1078-0432.CCR-06-0398.
To analyze immunohistochemically morules in endometrioid lesions to show that CD10 is a sensitive marker for morular metaplasia.
Immunohistochemical analysis of 53 instances of morular metaplasia comprising 1 cyclic endometrium and 52 endometrioid lesions associated with focal glandular complexity corresponding to 9 polyps, 4 atypical polypoid adenomyomas, 24 complex endometrial hyperplasias (18 with and 6 without atypia), 12 grade 1 endometrioid adenocarcinomas in early clinical stages of both uterus and ovary, and three ovarian adenofibromas. Immunohistochemistry in paraffin sections was done for CD10, beta-catenin, estrogen and progesterone receptors, and cytokeratins 5-6, 7, 8, 13, 18, 19, 20, and 34beta-E12.
Morules were negative for estrogen and progesterone receptors and had beta-catenin-positive nuclei. Cytokeratins 8, 18, 19 were positive; cytokeratins 7 and 20 were negative; and cytokeratins 5-6, 13, and 34beta-E12 were weakly positive. All cases revealed strongly positive membranous CD10 staining in morules, which was absent in glands. CD10 positivity allowed easy identification of morules at low power in various types of surgical specimens and in curettings. CD10 also highlighted early morular metaplasia in glandular epithelium. In cases associated with squamous, keratinizing metaplasia, CD10 discriminated between both types of metaplasia.
CD10 staining represents a useful marker of morules in endometrioid neoplasms of the female genital tract, permitting identification of lesions usually associated with an attenuated malignancy. Considering the immunohistochemical and genetic similarities of morules in tumors of different organs, it is likely that this marker may be also useful to diagnose morular metaplasia in similar neoplasms of extragenital locations.
通过免疫组织化学分析子宫内膜样病变中的桑葚体，以表明CD10是桑葚样化生的敏感标志物。
对53例桑葚样化生进行免疫组织化学分析，包括1例周期性子宫内膜和52例与局灶性腺体复杂性相关的子宫内膜样病变，分别对应9例息肉、4例非典型息肉样腺肌瘤、24例复杂性子宫内膜增生（18例伴有不典型增生，6例无不典型增生）、12例子宫和卵巢早期临床阶段的1级子宫内膜样腺癌以及3例卵巢腺纤维瘤。对石蜡切片进行免疫组织化学检测，检测指标包括CD10、β-连环蛋白、雌激素和孕激素受体以及细胞角蛋白5-6、7、8、13、18、19、20和34β-E12。
桑葚体雌激素和孕激素受体呈阴性，细胞核β-连环蛋白呈阳性。细胞角蛋白8、18、19呈阳性；细胞角蛋白7和20呈阴性；细胞角蛋白5-6、13和34β-E12呈弱阳性。所有病例中，桑葚体CD10膜染色均呈强阳性，腺体中无此现象。CD10阳性有助于在低倍镜下轻松识别各种手术标本和刮宫标本中的桑葚体。CD10还突出显示了腺上皮中的早期桑葚样化生。在伴有鳞状、角化化生的病例中，CD10可区分这两种化生类型。
CD10染色是女性生殖道子宫内膜样肿瘤中桑葚体的有用标志物，有助于识别通常与恶性程度降低相关的病变。考虑到不同器官肿瘤中桑葚体的免疫组织化学和遗传学相似性，该标志物可能也有助于诊断生殖器外类似肿瘤中的桑葚样化生。
