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目的:对子宫内膜间质肿瘤的临床病理进行探讨分析,为临床诊疗子宫内膜间质肿瘤提供依据。方法:选取35例子宫内膜间质肿瘤患者,通过肉眼观察、镜检和免疫组化标记等方法对患者的临床病理特点进行观察分析。结果:肉眼观察发现6例发生于子宫黏膜下,肿瘤直径为2.4～5.0cm,4例位于子宫肌壁间,直径为5.0～8.0cm,25例位于子宫体,直径为3～18cm;镜检结果显示24例表现为低度子宫内膜间质肉瘤,5例为子宫内膜间质结节,此两者由近增生期肿瘤细胞构成,伴较为丰富螺旋小动脉,6例为未分化的子宫内膜瘤,该类缺乏螺旋动脉,具有明显的细胞异型性;免疫组化显示CD10和Vim的阳性率均为100.00%,ER的阳性率为31.43%,PR阳性率为37.14%,inhibin的阳性率为25.71%。结论:子宫内膜间质肿瘤具有多成分化表现,临床上可以通过其病理组织和免疫组化分析来进行确诊,需与其它诸如平滑肌肿瘤、上皮样肿瘤相区别。
Objective: To explore the clinicopathological features of endometrial stromal tumors and provide the basis for clinical diagnosis and treatment of endometrial stromal tumors. Methods: Thirty-five patients with endometrial stromal tumors were selected and their clinical and pathological features were observed and analyzed by macroscopic observation, microscopic examination and immunohistochemical staining. Results: Six cases of uterine mucosa were found by macroscopic observation. The diameter of the tumor was 2.4-5.0 cm. Four cases were located in the muscle wall of the uterus with a diameter of 5.0-8.0 cm. 25 cases were located in the uterus and the diameter was 3-18 cm. The results showed that 24 cases showed low endometrial stromal sarcoma, 5 cases of endometrial stromal nodules, both from the near-proliferation of tumor cells, with more abundant spiral arteries, 6 cases of undifferentiated Endometrioma, the lack of spiral arteries, with obvious cell atypia; Immunohistochemistry showed that the positive rate of CD10 and Vim were 100.00%, the positive rate of ER was 31.43%, PR positive rate was 37.14%, inhibin The positive rate was 25.71%. Conclusion: The endometrial stromal tumors have multi-component manifestations, which can be diagnosed clinically by histopathological and immunohistochemical analysis. They need to be differentiated from other tumors such as smooth muscle tumors and epithelioid tumors.