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目的 :探讨复发性细胞性子宫平滑肌瘤的临床和病理特征。方法 :复习 40例细胞性子宫平滑肌瘤的临床病理资料 ,选择复发的 10例进行临床病理特征观察 ,并选用actin、desmin、ER、PR、PCNA、p5 3、c erbB 2和bcl 2 8种抗体采用LSAB法进行免疫组化染色。结果 :复发性细胞性子宫平滑肌瘤随着复发次数的增多 ,瘤组织的异型性显著 ,核分裂象增多 ,出现病理性核分裂象 ,并见黏液变性和肿瘤性凝固性坏死区。复发 3次以上的 4例均为肉瘤变 ,ER和PR检测与肌瘤分化呈正相关 ,PCNA和 p5 3检测则与肌瘤分化呈负相关 ,与复发次数呈正相关。结论 :细胞性子宫平滑肌瘤第 1次复发时应给予重视。出现第 2次复发时 ,治疗必须到位 ,应常规进行ER、PR、PCNA和 p5 3检测 ,以防止肉瘤变的发生
Objective: To investigate the clinical and pathological features of recurrent uterine leiomyoma. Methods: The clinical and pathological data of 40 cases of uterine leiomyoma were retrospectively reviewed. Clinicopathological features of 10 cases of recurrent uterine leiomyoma were retrospectively studied. Eight of them were selected as actin, desmin, ER, PR, PCNA, p5 3, c erbB 2 and bcl 2 Antibody using immunohistochemical staining LSAB method. Results: The recurrence of uterine leiomyoma recurred with the increase of the number of atypical tumor tissue was significant increase in mitosis, pathological mitosis, and see mucus degeneration and tumor coagulation necrosis. All the 4 cases with recurrence more than 3 times were all sarcoma. The detection of ER and PR was positively correlated with the differentiation of fibroids. The expressions of PCNA and p53 were negatively correlated with the differentiation of fibroids and positively correlated with the recurrence times. Conclusion: The first recurrence of cellular uterine leiomyoma should be given attention. The second relapse, the treatment must be in place, should be routine ER, PR, PCNA and p5 3 test to prevent the occurrence of sarcoma