Bi Rui, Bai Qian-Ming, Yang Fei, Wu Li-Jing, Cheng Yu-Fan, Shen Xu-Xia, Cai Xu, Zhou Xiao-Yan, Yang Wen-Tao
Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Histopathology. 2015 Dec;67(6):872-9. doi: 10.1111/his.12722. Epub 2015 Jun 4.
To analyse the clinicopathological, immunohistochemical and β-catenin (CTNNB1) mutation characteristics of six cases of microcystic stromal tumour of the ovary (MCST).
Six Chinese patients with MCST who ranged in age from 29 to 69 years (mean 50 years) were included in the study. Five patients were detected with a pelvic mass during routine health examinations and one patient presented initially with opsomenorrhoea. All tumours involved the left ovary, with solid-cystic cut surface in five cases and cystic cut surface in one case. Microscopically, microcysts, solid nests and hyaline degenerated fibrous stroma were variably mixed. Immunohistochemically, the tumour cells in all cases were diffusely positive for CD10, vimentin and WT-1 and negative for α-inhibin and calretinin. β-catenin expression was observed in both the nucleus and the cytoplasm in five cases and only in the cytoplasm in one case. The results of CTNNB1 mutation analysis revealed four missense point mutations in four cases, which were c.97T>C, c.101G>A, c.110C>G and c.122C>T.
MCST shows a unique morphology with characteristic immunophenotype. β-catenin expression in the nucleus and β-catenin mutations were identified in the majority of cases, which suggests that the Wnt/β-catenin pathway may play a crucial role in the tumorigenesis of MCST.
分析6例卵巢微囊性间质瘤(MCST)的临床病理、免疫组化及β-连环蛋白(CTNNB1)突变特征。
本研究纳入6例年龄在29至69岁(平均50岁)的中国MCST患者。5例患者在常规健康检查中发现盆腔肿块,1例患者最初表现为经量增多。所有肿瘤均累及左侧卵巢,5例为实性-囊性切面,1例为囊性切面。显微镜下,微囊肿、实性巢状结构及透明变性的纤维性间质以不同方式混合存在。免疫组化显示,所有病例的肿瘤细胞CD10、波形蛋白和WT-1弥漫性阳性,α-抑制素和钙视网膜蛋白阴性。5例病例的β-连环蛋白在细胞核和细胞质均有表达,1例仅在细胞质表达。CTNNB1突变分析结果显示,4例病例存在4个错义点突变,分别为c.97T>C、c.101G>A、c.110C>G和c.122C>T。
MCST具有独特的形态学及特征性免疫表型。大多数病例中发现β-连环蛋白在细胞核表达及β-连环蛋白突变,提示Wnt/β-连环蛋白通路可能在MCST的肿瘤发生中起关键作用。