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目的探讨子宫内膜增生和子宫内膜上皮内瘤变(EIN)临床病理特征、诊断与鉴别诊断。方法对40例子宫内膜增生和子宫内膜上皮内瘤变进行光镜观察(视野直径>1 mm),免疫组化研究及部分病例随访。结果 40例诊刮子宫内膜组织标本,镜下子宫内膜腺体增生拥挤,且有些不规则,增生腺体分布区域大于间质分布区域,腺上皮细胞多具有非典型性,表现为核大、核浆比大,核变圆、有明显的核仁,核染色质粗颗粒状、分布不均。40例均作PTEN、p53检测,65%(26/40)PTEN(-),5%(2/40)p53(+)。结论在子宫内膜癌前病变诊断标准上强调子宫内膜组织结构的异常改变,在诊断中可重复性较好,使组织病理诊断标准更趋向一致。
Objective To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of endometrial hyperplasia and endometrial intraepithelial neoplasia (EIN). Methods 40 cases of endometrial hyperplasia and endometrial intraepithelial neoplasia were observed by light microscopy (diameter of field> 1 mm), immunohistochemistry and some cases were followed up. Results 40 cases of curettage endometrial tissue samples, microscopic endometrial gland hyperplasia crowded, and some irregular, glandular distribution area is greater than the interstitial distribution area, glandular epithelial cells are atypical, the performance of nuclear large , Nuclear ratio of nuclear, nuclear round, with obvious nucleolus, nuclear chromatin coarse particles, uneven distribution. Forty cases were examined for PTEN, p53, 65% (26/40) PTEN (-) and 5% (2/40) p53 (+). Conclusion The diagnostic criteria of endometrial precancerous lesions emphasize the abnormal changes of endometrial tissue structure, which has good repeatability in diagnosis and makes the diagnostic criteria of histopathology more consistent.