Primary hepatoid adenocarcinoma of the uterine corpus: A case report with immunohistochemical study for expression of liver-enriched nuclear factors
Primary hepatoid adenocarcinoma of the uterine corpus: A case report with immunohistochemical study for expression of liver-enriched nuclear factors
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DOI：
10.1016/j.prp.2011.02.010
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发表时间：
2011-01-01
影响因子：
2.8
通讯作者：
Nakatani, Yukio
中科院分区：
文献类型：
--
作者：
Ishibashi, Katsuhiko;Kishimoto, Takashi;Nakatani, Yukio
我们报告一例 86 岁女性子宫肝样腺癌病例。入院时血清 AFP 升高（7824 ng/ml）。单纯子宫切除术和双侧输卵管卵巢切除术获得的手术标本显示，子宫体中有一个大小为10.5厘米×6.0厘米×3.7厘米的外生性肿瘤。显微镜下，肿瘤细胞呈小梁状或索状排列增殖，被认为是“肝样外观”。腺癌成分混合在一起。在本例和19例子宫内膜样腺癌（11例2级和8例3级）中研究了富含肝脏的转录因子、肝细胞核因子（HNF）-1β、HNF-3、HNF-4α和CCAAT/增强子结合蛋白（C/EBP）-β的表达，因为这些核因子参与胚胎肝发生。在本病例中 HNF-4 α 呈弥漫性阳性，但在所有子宫内膜样腺癌病例中呈阴性。本病例和对照腺癌病例的 HNF-3 和 C/EBP-β 呈阳性（HNF-3，36.8%，C/EBP-β，84.2%）。本病例和子宫内膜样腺癌的 HNF-1 β 均为阴性。这是第一份证明 HNF-4 α 在这种罕见子宫肿瘤中表达的报告。 (c) 2011 年爱思唯尔有限公司。版权所有。
We report a case of hepatoid adenocarcinoma of the uterus in an 86-year-old woman. Serum AFP was elevated (7824 ng/ml) on admission. The surgical specimen obtained by simple hysterectomy and bilateral salpingo-oophorectomy showed an exophytic tumor, 10.5 cm x 6.0 cm x 3.7 cm in size, in the uterine corpus. Microscopically, tumor cells proliferated in trabecular or cord-like arrangement, which was considered as "hepatoid appearance". An adenocarcinomatous component was intermingled. The expressions of liver-enriched transcription factors, hepatocyte nuclear factor (HNF)-1 beta, HNF-3, HNF-4 alpha, and CCAAT/enhancer binding protein (C/EBP)-beta, were investigated in the present case and in 19 cases of endometrioid adenocarcinoma (11 cases of Grade 2 and 8 cases of Grade 3), because these nuclear factors are involved in embryonal hepatogenesis. HNF-4 alpha was diffusely positive in the present case, but negative in all cases of endometrioid adenocarcinoma. HNF-3 and C/EBP-beta were positive for the present case and control adenocarcinoma cases (HNF-3, 36.8% and C/EBP-beta, 84.2%). HNF-1 beta was negative for both the present case and endometrioid adenocarcinomas. This is the first report to demonstrate HNF-4 alpha expression in this rare uterine tumor. (c) 2011 Elsevier GmbH. All rights reserved.