Wang M, Xu Y, Zhang T
Department of Pathology, Shandong Medical University, Jinan.
Zhonghua Bing Li Xue Za Zhi. 1996 Oct;25(5):263-5.
To discuss the diagnosis of uterine leiomyosarcoma and leiomyoma of cellular and bizarre type, we reviewed 51 cases and carried out P53 and desmin immunohistochemical staining on 43 cases. We found that in most cases leiomyosarcoma is accompanied by nuclear mitosis, cell atypia and margin infiltration. In a small number of cases, though mitotic figures are scarce, high cell atypia and marked margin infiltration were present. Leiomyoma variants may have high cellular density and bizarre nuclears but have no margin infiltration. Leiomyosarcoma has a high incidence of P53 expression, while no P53 expression was detected in leiomyoma variants. Desmin expression is closely correlated with the differentiation of smooth muscle neoplasms of the uterus. We conclude that nuclear mitotic activity is an important but not independent criteria in the diagnosis of uterine leiomyosarcoma. Cellular atypia and margin infiltration should be considered. P53 and desmin expression can be applied as accessary criteria.
为探讨子宫平滑肌肉瘤及富于细胞性和奇异性平滑肌瘤的诊断,我们回顾了51例病例,并对其中43例进行了P53和结蛋白免疫组化染色。我们发现,大多数情况下平滑肌肉瘤伴有核分裂象、细胞异型性和边缘浸润。少数病例中,虽然核分裂象少见,但细胞异型性高且边缘浸润明显。平滑肌瘤变异型可能有高细胞密度和奇异性核,但无边缘浸润。平滑肌肉瘤P53表达发生率高,而平滑肌瘤变异型未检测到P53表达。结蛋白表达与子宫平滑肌肿瘤的分化密切相关。我们得出结论,核分裂活性是子宫平滑肌肉瘤诊断的重要但非独立标准。应考虑细胞异型性和边缘浸润。P53和结蛋白表达可作为辅助标准。