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子宫去分化子宫内膜样癌：4例报告并文献复习

Dedifferentiated endometrioid carcinoma of the uterus : report of four cases and review of literature.

作者信息

Han Jiheun, Ki Eun Young, Rha Sung Eun, Hur SooYoung, Lee Ahwon

机构信息

Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.

Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

World J Surg Oncol. 2017 Jan 10;15(1):17. doi: 10.1186/s12957-016-1093-0.

DOI:10.1186/s12957-016-1093-0
PMID:28069049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5223350/
Abstract

BACKGROUND

Dedifferentiated endometrioid adenocarcinoma (DEAC) is rare and is known to be more aggressive than high-grade endometrioid carcinoma. Differentiating between the two is important to provide appropriate treatment for patients.

CASE PRESENTATION

This is a retrospective study including four cases of DEAC of the uterus, which was diagnosed and treated in our Obstetrics and Gynecology department between January 2013 and December 2015. Clinical, pathological, and immunohistochemical staining features are discussed. Each tumor was composed of undifferentiated carcinoma (UC) and low-grade endometrioid carcinoma with abrupt transition between them. Two patients showed recurrence or progression within one month postoperatively and died at the last follow-up. An immunohistochemical study showed PAX-8, ER, PR, and E-cadherin expression in UC component.

CONCLUSIONS

DEAC should not be underdiagnosed as conventional endometrioid adenocarcinoma due to its fulminant clinical course. Therefore, UC, including DEAC, should be further categorized to provide intensive treatment to improve patient survival.

摘要

背景

去分化子宫内膜样腺癌（DEAC）较为罕见，且已知其比高级别子宫内膜样癌更具侵袭性。区分这两者对于为患者提供恰当治疗很重要。

病例报告

这是一项回顾性研究，纳入了4例子宫DEAC病例，这些病例于2013年1月至2015年12月在我们的妇产科进行诊断和治疗。讨论了临床、病理及免疫组化染色特征。每个肿瘤均由未分化癌（UC）和低级别子宫内膜样癌组成，两者之间有突然转变。2例患者术后1个月内出现复发或进展，最后一次随访时死亡。免疫组化研究显示UC成分中有PAX - 8、雌激素受体（ER）、孕激素受体（PR）及E - 钙黏蛋白表达。

结论

由于DEAC临床病程凶险，不应将其误诊为传统子宫内膜样腺癌。因此，包括DEAC在内的UC应进一步分类，以便提供强化治疗以提高患者生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/ed9439da191f/12957_2016_1093_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/29df67db2402/12957_2016_1093_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/8c3361cbc166/12957_2016_1093_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/9b25d9c910d3/12957_2016_1093_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/ed9439da191f/12957_2016_1093_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/29df67db2402/12957_2016_1093_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/8c3361cbc166/12957_2016_1093_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/9b25d9c910d3/12957_2016_1093_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5dc/5223350/ed9439da191f/12957_2016_1093_Fig4_HTML.jpg

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