子宫癌肉瘤2例临床病理特征分析并文献复习

Analysis of Clinicopathological Features of Two Cases of Uterine Carcinosarcoma with a Literature Review

摘要: 目的：探讨子宫癌肉瘤的临床病理学特征；方法：回顾性分析2023年华北理工大学附属医院2例子宫癌肉瘤，分析其临床及病理学资料并文献复习。结果：肿瘤显示双向分化，即由恶性上皮成分和肉瘤样成分2种成分构成，两者或分界清楚或穿插移行。上皮成分均为浆液性癌，肉瘤成分为横纹肌肉瘤、软骨肉瘤或平滑肌肉瘤。上皮成分均表达CK，肉瘤成分表达Vimentin，横纹肌肉瘤表达MyoD1、Myoglobin，软骨肉瘤表达S100，平滑肌肉瘤表达SMA、Desmin、Caldesmon；结论：子宫癌肉瘤预后差，确诊需结合组织形态学、免疫表型或分子表型综合分析，预后与癌的组织学类型、肉瘤样成分的比例及肿瘤分期有关。

Abstract: Objective: To investigate the clinicopathological features of uterine carcinosarcoma. Methods: Two cases of uterine carcinosarcoma in the Affiliated Hospital of North China University of Science and Technology in 2023 were retrospectively analyzed, and their clinical and pathological data were analyzed and literature reviewed. Results: The tumor showed bidirectional differentiation, that is, it was composed of two components, the malignant epithelial component and the sarcomatoid component, and the two were either clearly demarcated or interspersed with migration. The epithelial components are all serous carcinomas, and the sarcoma components are rhabdomyosarcoma, chondrosarcoma, or leiomyosarcoma. The epithelial components expressed CK, the sarcoma components expressed Vimentin, the rhabdomyosarcoma expressed MyoD1 and Myoglobin, the chondrosarcoma expressed S100, and the leiomyosarcoma expressed SMA, Desmin and Caldesmon. Conclusion: Uterine carcinosarcoma has a poor prognosis, and diagnosis requires a comprehensive analysis of tissue morphology, immune phenotype, or molecular phenotype. The prognosis is related to the histological type of cancer, the proportion of sarcomatoid components and the tumor stage.