Chen Xiaowei, Arend Rebecca, Hamele-Bena Diane, Tergas Ana I, Hawver Melanie, Tong Guo-Xia, Wright Thomas C, Wright Jason D
Departments of Pathology and Cell Biology (X.C., D.H.-B., T.C.W.) Obstetrics and Gynecology, Division of Gynecology Oncology (A.I.T., J.D.W.), Columbia University Medical Center Department of Pathology and Laboratory Medicine, Staten Island University Medical Center, Northwell Health (G.-X.T.), New York Department of Pathology, St. Peter Hospital, Albany (M.H.), New York Department of Obstetrics and Gynecology, Alabama University of Alabama School Medicine, Birmingham, Alabama (R.A.).
Int J Gynecol Pathol. 2017 Sep;36(5):412-419. doi: 10.1097/PGP.0000000000000346.
Carcinosarcomas (malignant mixed Müllerian tumors or MMMT) are rare malignant tumors in the female genital tract composed of both malignant epithelial and malignant mesenchymal components. They comprise <5% of all neoplasms in the gynecologic tract and have an aggressive clinical course. The purpose of this study is to evaluate the immunophenotype and possible histogenesis of carcinosarcomas of the uterus. Sixty-two cases of uterine carcinosarcomas diagnosed between 1995 and 2011 were retrieved from the gynecologic pathology files at Columbia University Medical Center. Representative tissue blocks containing both epithelial and mesenchymal components were selected from each case for histologic and immunohistochemical studies. Clinical data from each case were retrieved. The epithelial component was poorly differentiated adenocarcinoma in the majority (80.7%) of cases; in 17.7%, the carcinoma was moderately differentiated, and in only 1.6% the carcinoma was well differentiated. 53% of the tumors had homologous stromal elements and 47% displayed heterologous stromal elements. Immunohistochemical study revealed almost equal staining in both epithelial and mesenchymal components of carcinosarcomas for p16 and p53. PAX8 positivity was noted in 73% of epithelial components, but only 13% of stromal components, and PAX8 stromal positivity was never seen in the absence of PAX8 epithelial positivity. Expression of p16, p53, and PAX8 in both malignant components lends support to the monoclonal theory of uterine carcinosarcoma tumorigenesis. The roles of these tumor markers in the diagnosis and pathogenesis of this tumor and associations between clinical characteristics, tumor pathologic features, and prognosis are discussed.
癌肉瘤（恶性混合性苗勒管肿瘤或MMMT）是女性生殖道中罕见的恶性肿瘤，由恶性上皮成分和恶性间叶成分组成。它们占妇科肿瘤的比例不到5%，临床病程具有侵袭性。本研究的目的是评估子宫癌肉瘤的免疫表型和可能的组织发生。从哥伦比亚大学医学中心的妇科病理档案中检索出1995年至2011年间诊断的62例子宫癌肉瘤病例。从每个病例中选取包含上皮和间叶成分的代表性组织块进行组织学和免疫组织化学研究。检索每个病例的临床资料。大多数病例（80.7%）的上皮成分是低分化腺癌；17.
