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目的：研究卵巢有梭形细胞成分宫内膜样癌伴肝样癌的临床病理特征以及肝样癌的组织发生。方法：收集和分析病人的临床病理资料。石蜡切片免疫组化ＡＢＣ法染色。结果：①１例６２岁老妇，患有原发性高度恶性卵巢癌，并伴有ＡＦＰ明显升高。ＡＦＰ常随病情变化而变化；②病理特征主要为有梭形细胞成分宫内膜样癌和明显肝样癌成分。免疫组化染色显示肝样癌及其癌细胞内外玻璃小体ＡＦＰ阳性；内膜样癌中腺上皮Ｋｅｒａｔｉｎ、ＥＭＡ、ＥＲ阳性；而梭形细胞则Ｋｅｒａｔｉｎ、ＥＭＡ和Ｖｉｍ阳性。而Ｄｅｓｍｉｎ、Ｍｙｏｇｌｏｂｉｎ、ＧＡＦＰ、ＨＣＧ所有瘤细胞均为阴性；③由于ＡＦＰ具有免疫抑制作用，患者预后不良。结论：以上结果表明，有梭形细胞成分卵巢宫内膜样癌伴肝样癌为卵巢一种特殊临床病理实体，反复复发后已完全向肝样癌转化
Objective: To study the clinicopathological features of ovarian spindle cell-like endometrial carcinoma with hepatocarcinoma and the histopathology of hepatic carcinoma. Methods: Collect and analyze the patient’s clinical and pathological data. Paraffin sections were stained immunohistochemically with ABC method. Results: ① A 62-year-old woman with primary malignant ovarian cancer, accompanied by a significant increase in AFP. AFP often changes with the changes of the disease; ② pathological features of spindle cells mainly composed of endometrial carcinoma and obvious hepatocellular carcinoma components. Immunohistochemical staining showed that both AFP and AFP were positive in the vitreous of hepatic carcinoma and its cancer cells. The endometrial carcinomas were positive for the keratin, EMA and ER, while the spindle cells were positive for Keratin, EMA and Vim. However, all the tumor cells of Desmin, Myoglobin, GAFP and HCG were negative. Third, due to the immunosuppressive effect of AFP, the prognosis of patients was poor. Conclusion: The above results show that the spindle cell component of ovarian endometrial carcinoma with hepatocellular carcinoma is a special ovarian ovarian clinicopathological entity, repeated recurrence has completely transformed to hepatic carcinoma