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目的观察子宫内膜混合性腺-神经内分泌癌的临床病理特点,探讨其诊断和起源。方法对1例子宫内膜发生的子宫内膜样腺癌伴神经内分泌癌行HE及免疫组化染色,并复习相关文献。结果患者女性,47岁。子宫腔内见一菜花样肿物,大小4 cm×3 cm×2 cm,侵达肌壁。镜检:瘤组织由子宫内膜样腺癌及小细胞神经内分泌癌成分混合构成,子宫内膜样腺癌占70%,小细胞神经内分泌癌占30%,两种肿瘤成分相互掺杂。免疫表型:腺癌成分表达CK、CA125、ER、PR,小细胞神经内分泌癌成分表达Syn、CgA,Ki-67增殖指数为60%。术后随访7个月,患者无复发、转移。病理诊断为子宫低分化子宫内膜样腺癌伴神经内分泌癌(小细胞型,Ⅲ级)。结论子宫内膜混合性腺-神经内分泌癌较罕见,其两种成分可能为多潜能细胞向两个方向分化的结果,诊断主要依靠病理形态学和免疫表型,预后差。
Objective To observe the clinicopathological features of endometrial mixed glandular-neuroendocrine carcinoma and to explore its diagnosis and origin. Methods One case of endometrial endometrial adenocarcinoma with neuroendocrine carcinoma underwent HE and immunohistochemical staining, and reviewed the related literatures. Results Patients Female, 47 years old. See a dish within the uterine cavity mass, the size of 4 cm × 3 cm × 2 cm, invasion of muscle wall. Microscopic examination: tumor tissue by endometrioid adenocarcinoma and small cell neuroendocrine cancer components, endometrial adenocarcinoma accounted for 70%, small cell neuroendocrine cancer accounted for 30% of the two tumor components doped with each other. Immunophenotype: The expression of CK, CA125, ER, PR in adenocarcinoma, Syn, CgA, Ki-67 proliferation index of small cell neuroendocrine carcinoma was 60%. All patients were followed up for 7 months without recurrence and metastasis. Pathological diagnosis of poorly differentiated uterine endometrial adenocarcinoma with neuroendocrine cancer (small cell type, grade Ⅲ). Conclusions Endometrial mixed glandular-neuroendocrine carcinoma is rare, and the two components may be the result of differentiation of multipotent cells in two directions. The diagnosis mainly depends on pathomorphology and immunophenotype, and the prognosis is poor.