Goh C, Farah B L, Ho W Y, Wong S L, Goh C H R, Chew S H, Nadarajah R, Lim Y K, Ho T H
Gynaecologic Oncology Department, KK Women's and Children's Hospital, Singapore.
Pathology Department, Singapore General Hospital, Singapore.
Gynecol Oncol Rep. 2020 Jan 30;32:100538. doi: 10.1016/j.gore.2020.100538. eCollection 2020 May.
Introduction Dedifferentiated endometrioid adenocarcinoma (DEAC) was first described in 2007. However, it has only been recognised as a distinct subtype of endometrioid adenocarcinoma in the last 1-2 years. DEAC is a more aggressive histological subtype and carries a poorer prognosis. Patients with DEAC tend to present with advanced disease compared the other endometrioid adenocarcinomas. Methodology The study is a retrospective review of patients with DEAC diagnosed in two institutions in Singapore between January 2012 and October 2017. Results 7 patients were diagnosed with DEAC. The mean age was 56.4 years. All patients presented with either abnormal uterine bleeding or post menopausal bleeding. Out of the 7 patients, one was diagnosed with Stage 2 disease, 5 were diagnosed with Stage 3 disease and 1 was diagnosed with Stage 4 disease. One patient had neoadjuvant chemotherapy, followed by surgery, and completion chemotherapy post surgery. The other 6 patients (87.5%) underwent primary debulking surgery. Out of these 6 patients, 5 patients had adjuvant chemotherapy post surgery and one patient had both adjuvant chemotherapy and radiotherapy. Lymphovascular invasion was found in 71.4% of the cases. Conclusion DEAC is a more aggressive histological subtype of endometrioid adenocarcinomas. Better awareness of this condition can lead to proper diagnosis and treatment.
引言 去分化子宫内膜样腺癌（DEAC）于2007年首次被描述。然而，在过去1至2年中它才被确认为子宫内膜样腺癌的一种独特亚型。DEAC是一种侵袭性更强的组织学亚型，预后较差。与其他子宫内膜样腺癌相比，DEAC患者往往表现为疾病进展期。
方法 本研究是对2012年1月至2017年10月期间在新加坡两家机构诊断为DEAC的患者进行的回顾性研究。
结果 7例患者被诊断为DEAC。平均年龄为56.4岁。所有患者均表现为子宫异常出血或绝经后出血。7例患者中，1例被诊断为2期疾病，5例被诊断为3期疾病，1例被诊断为4期疾病。1例患者接受了新辅助化疗，随后进行手术，并在术后完成化疗。其他6例患者（87.5%）接受了初次肿瘤细胞减灭术。在这6例患者中，5例患者术后接受了辅助化疗，1例患者同时接受了辅助化疗和放疗。71.4%的病例发现有淋巴血管浸润。
结论 DEAC是子宫内膜样腺癌中一种侵袭性更强的组织学亚型。提高对这种疾病的认识有助于进行正确的诊断和治疗。
