Objective To investigate the clinicopathologic features and clinical significance in mismatch repair (MMR) of deficient endometrial carcinoma. Methods A total of 108 endometrial carcinoma cases younger than 50 years of age who were underwent routine laparotomy in our hospital were included in this study. Immunohistochemistry staining was used for 4 MMR proteins (MLH1, MSH2, MSH6 and PMS2). Patients were divided into two groups (MMR deficiency group and MMR normal group) based on the results of immunohistochemistry staining. Results Thirty-three percent of cases (36 patients) showed at least one deletion of MMR protein expression. The clinicopathological features of 36 cases with deletion of MMR protein expression were analyzed. The 31% showed deep myometrium invasion and 25% were with intense lymphocyte infiltration around tumor cells. Thirty-five percent of endometrial carcinomas associated with mucinous, clear cell or other differentiations, and 14% with heterogeneity. Background endometrium of majority of the cases displayed proliferative endometrium. There were 20% cases complicated with ovarian carcinoma. Features included deep myometrium invasion, lymphocyte infiltration around tumor cells, multiple differentiations and complicated with ovarian carcinoma. There were significant differences in background endometrium between endometrial carcinoma combined with ovarian cancer group and control group. Conclusion MMR deficient endometrial carcinoma has characteristic features, which are different from both type I and type II endometrial carcinoma.%目的 探讨碱基错配修复(MMR)缺陷子宫内膜癌的临床病理特征与临床意义.方法 收集天津市中心妇产科医院常规开腹手术者中≤50岁内膜癌患者共108例,进行4种碱基错配修复(MMR)蛋白(MLH1、MSH2、MSH6及PMS2)的免疫组化检测,MMR蛋白表达完全缺失提示MMR基因缺陷,依据免疫组化结果 进行分组.结果108例内膜癌中,33.3%(36例)至少1种MMR表达缺失.重点对36例MMR蛋白表达缺失患者行临床病理特征分析并与对照组比较.31%伴有深肌层侵犯,25%可见肿瘤细胞周围有密集的淋巴细胞浸润.35%的内膜癌患者合并黏液分化及透明细胞分化等多种分化方式,14%伴有异质性分化.20%患者同时合并卵巢癌.背景内膜多为增生期内膜.倾向深肌层侵犯、多样性分化与异质性分化、肿瘤周围淋巴细胞浸润、同时合并卵巢癌及背景内膜的特征与对照组相比差异有统计学意义.结论 MMR缺陷子宫内膜癌具有区别于传统Ⅰ型及Ⅱ型内膜癌的特征.
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