上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

绝经后妇女子宫浆液性癌及其癌前病变的临床病理研究

周小斐1,2，钟一村1   

  1. 1.上海交通大学 医学院附属仁济医院妇产科  上海市妇科肿瘤重点实验室， 上海 200127; 2.吉林省人民医院妇产科， 长春 130021
  • 出版日期:2014-01-28 发布日期:2014-01-29
  • 通讯作者: 钟一村, 电子信箱: 13661807316@163.com。
  • 作者简介:周小斐（1971—）， 女， 副主任医师， 硕士; 电子信箱: zhourose@hotmail.com。

Clinical and pathological study of uterine serous carcinoma and its precancerous lesions in postmenopausal women

ZHOU Xiao-fei1,2, ZHONG Yi-cun1   

  1. 1.Department of Obstetrics and Gynecology, Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2.Department of Obstetrics and Gynecology, People′s Hospital of Jilin Province, Changchun 130021, China
  • Online:2014-01-28 Published:2014-01-29

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摘要：

目的 研究绝经后妇女子宫浆液性癌（USC）及其相应癌前病变的子宫内膜腺体异型增生（EmGD）在组织形态学及免疫组织化学等方面的相关性。方法 回顾性分析14例USC和EmGD的临床和病理学表现，应用免疫组织化学SP法检测其组织内P53蛋白、Ki67指数、雌激素受体（ER）和孕激素受体（PR）的表达。并以10例正常绝经后的子宫内膜作为对照。结果 USC和EmGD均有特征性的临床和病理学表现。与正常子宫内膜相比，USC局部表达P53蛋白和Ki-67指数最高，而EmGD局部表达的P53蛋白强度和Ki-67指数介于USC与正常子宫内膜之间。结论 EmGD与USC有显著的相关性，前者可被视为USC的癌前病变，临床上除了综合性诊治USC患者外，还应对EmGD患者采取积极有效的措施以阻断USC的发生。

关键词: 子宫浆液性癌, 子宫内膜腺体异型增生, 癌前病变, P53蛋白, Ki-67指数

Abstract:

Objective To study the correlationship of morphology and immunohistochemistry of uterine serous carcinoma (USC) and its precancerous lesion of endometrial glandular dysplasia (EmGD) in the postmenopausal women. Methods The clinical and pathological manifestations of 14 cases of USC and EmGD were analyzed retrospectively. Immunohistochemical SP method was used to detect the expression of P53 protein, Ki-67 index, estrogen receptor (ER), and progestrone receptor (PR) in the tissues. And 10 cases of normal postmenopausal endometrium were enrolled as control group. Results The clinical and pathological features of USC and EmGD were distinctive. Compared to normal endometrium tissues, the local expression of P53 protein and the Ki-67 index in USC were the highest, meanwhile the local expression of P53 and Ki-67 index in EmGD were between those in USC and in normal endometrium. Conclusion There is significant correlation between EmGD and USC, the former can be regarded as precancerous lesion of USC. In addition to treat the patients with USC comprehensively, we also should take active and effective measures to deal with patients with EmGD to block the occurrence of USC.

Key words: uterine serous carcinoma, endometrial glandular dysplasia, precancerous lesions, P53 protein, Ki-67 index