Primary Clear Cell Carcinoma of the Endometrium: A Clinicopathologic Study of 20 Cases
Primary Clear Cell Carcinoma of the Endometrium: A Clinicopathologic Study of 20 Cases
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原发性子宫内膜透明细胞癌20例临床病理分析
DOI：
10.1097/00004347-199101000-00008
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发表时间：
1991
影响因子：
2.4
通讯作者：
H. Tobón
中科院分区：
文献类型：
--
作者：
A. Kanbour‐Shakir;H. Tobón
摘要：子宫内膜原发性透明细胞腺癌（CCE）是一种罕见的侵袭性肿瘤，占所有原发性子宫内膜癌的1-5.5%。20例CCE进行了研究，涵盖1973年至1987年期间。我们回顾了子宫内膜刮除术和子宫切除术的双侧输卵管卵巢切除术（BSO）标本。所有患者的治疗均为全腹直肠癌切除术/BSO，伴/不伴术前和术后和/或术后化疗。大体上肿瘤形成肉质、柔软的肿块，并累及大部分子宫内膜表面。10例肿瘤部分发生于子宫内膜息肉。肌层穿透12例，穿透率5 ~ 100%。肿瘤表现出以下纯粹形式或混合形式的显微镜下模式：乳头状，管状囊性，腺和实性。所有病例均为低分化腺癌（3级）。所有病例中肿瘤细胞周围的间质均显示淋巴浆细胞浸润。随访时间从5个月到165个月不等，粗生存率为60%; 8名患者死亡;其中6名患者的子宫肌层浸润率为40- 100%。总之，CCE是具有明确组织学参数的特定肿瘤，其中细胞学分级和/或肿瘤形态似乎不影响结局。另一方面，肌层浸润深度和临床分期是可靠的预后因素。
Summary:Primary clear cell adenocarcinoma of the endometrium (CCE) is a rare, aggressive tumor, representing 1–5.5% of all primary endometrial cancers. Twenty cases of CCE were studied, covering the period 1973–1987. Both endometrial curettings and hysterectomy with bilateral salpingo-oophorectomy (BSO) specimens were reviewed. Treatment was total abdominal hysterec-tomy/BSO for all patients with/without pre- and postoperative and/or postoperative chemotherapy. Grossly the tumors formed fleshy, soft masses and involved most of the endometrial surface. The tumor arose in part in an endometrial polyp in 10 cases. Myometrial penetration was found in 12 cases and varied from 5 to 100%. The neoplasm exhibited the following microscopic patterns in pure form or mixed: papillary, tubulocystic, glandular, and solid. All cases were graded as poorly differentiated (grade 3) adenocarcinomas. The stroma surrounding tumor cells showed a lymphoplasmocytic cellular infiltrate in all cases. Follow-up varied from 5 to 165 months, with a crude survival of 60%; eight patients died; six of those had myometrial invasion of 40–100%. In conclusion, CCEs are specific tumors with defined histologic parameters in which the cytologic grade and/or tumor morphology do not appear to influence outcome. On the other hand, the depth of myometrial invasion and clinical staging are reliable prognostic elements.