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卵巢和子宫的子宫内膜样癌、伴透明细胞改变的子宫内膜样癌和透明细胞癌的免疫组化比较

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楼主 发表于 2015-08-17 19:06|举报|关注(1)
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Immunohistochemical Comparison of Ovarian and Uterine Endometrioid Carcinoma, Endometrioid Carcinoma With Clear Cell Change, and Clear Cell Carcinoma.

Lim D,Ip PP,Cheung AN,Kiyokawa T,Oliva E

Abstract

Accurate distinction of clear cell carcinoma (CCC) from endometrioid carcinoma (EC) has important clinical implications, but, not infrequently, EC demonstrates clear cell change (EC-CC), mimicking CCC. We examined whether a panel of immunomarkers can help distinguish between these tumors. Sixty-four CCCs (40 ovarian and 24 uterine), 34 ECs (21 ovarian and 13 uterine), and 34 EC-CCs (6 ovarian and 28 uterine) were stained for HNF1β, BAF250a, Napsin A, ER, and PR. Intensity and extent of immunoreactivity was assessed. Fifty-seven of 64 (89%) CCCs, 14/34 (41%) EC-CCs, and 16/34 (47%) ECs expressed HNF1β, and 56/64 (88%) CCCs, 4/34 (12%) EC-CCs, and 1/34 (3%) ECs stained for Napsin A. Most CCCs demonstrated at least moderate and diffuse staining for both markers, whereas only focal and weak expression was identified in most EC-CC/EC. Compared to HNF1β, Napsin A showed increased specificity (93.0% vs. 55.9%, P<0.0001) and similar sensitivity (87.5% vs. 89.1%) in distinguishing CCC from EC-CC/EC. Thirteen of 64 (20%) CCCs, 6/34 (18%) EC-CCs, and 2/34 (6%) ECs showed loss of BAF250a. ER was expressed by 10/64 (16%) CCCs, 30/34 (88%) EC-CCs, and 33/34 (97%) ECs, whereas PR positivity was identified in 9/64 (14%) CCCs, 26/34 (77%) EC-CCs, and 33/34 (97%) ECs. The majority of EC and EC-CC demonstrated diffuse staining for ER/PR, whereas most CCCs showed very focal positivity. There is a statistically significant difference in HNF1β, Napsin A, ER, and PR immunoexpression between CCC and EC/EC-CC, with Napsin A being a more specific marker for CCC than HNF1β. Overall, the immunoprofile of EC-CC is more comparable to that of EC than CCC. The use of a panel of immunostains can help distinguish EC-CC from CCC.


 准确的鉴别透明细胞癌(CCC)和子宫内膜样癌(EC)有着非常重要的临床意义,部分EC伴透明细胞改变(EC-CC),可以模拟CCC。作者评估了一组免疫组织化学标记物能否帮助鉴别这几种肿瘤。64CCCs40例来源卵巢和24例来源子宫)、34ECs21例来源卵巢和13例来源子宫)及34EC-CCs6例来源卵巢和28例来源子宫),免疫组织化学标记HNF1βBAF250aNapsin AERPR,并对免疫组化着色强度和范围进行评估。57/64(89%) CCCs14/34 (41%) EC-CCs16/34 (47%) ECs表达HNF1β56/64 (88%) CCCs4/34 (12%) EC-CCs1/34 (3%) ECs表达Napsin A。大多数CCCs对这两种标记物至少中度至弥漫着色,而大多数EC-CC/EC仅局灶和弱阳性表达。和HNF1β相比,Napsin ACCCEC-CC/EC鉴别上,特异性较强(93.0% vs. 55.9%,P<0.0001),而敏感性相似(87.5% vs. 89.1%)。13/64 (20%) CCCs6/34 (18%) EC-CCs2/34 (6%) ECs不表达BAF250a10/64 (16%) CCCs30/34 (88%) EC-CCs33/34 (97%) ECs表达ER,而9/64 (14%) CCCs26/34 (77%) EC-CCs33/34 (97%) ECs表达PR。多数ECEC-CCER/PR弥漫着色,而大多数CCCs仅局灶阳性。CCCEC/EC-CC中,HNF1βNapsin AERPR的表达在统计学上有显著差异,与HNF1β相比,Napsin ACCC一种更特异的标记。总之,免疫标记组合在EC-CCCCC的鉴别上更具有可比性,利用一组免疫标记物,能够帮助从CCC中鉴别出EC-CC

标签:卵巢 子宫 子宫内膜 癌 透明细胞 子宫内膜 癌 透明细胞癌 免疫组化
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1 楼    发表于2015-08-17 19:11:41举报|引用
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2 楼    发表于2017-12-30 21:25:06举报|引用
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 那EC-CC是属于样腺癌还是混合型呢?对预后和治疗方案有何影响?

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